Oral Rehydration Solution

1. Preparations: WHO-ORS
   1. Instructions
      1. Dissolve WHO packet in 1 Liter Water
   2. Ingredients of WHO packet
      1. Sodium Chloride 3.5 grams (90 meq/L Sodium)
      2. Potassium Chloride 1.5 grams (20 meq/L Potassium)
      3. Glucose 20 grams (2% Carbohydrate)
      4. Sodium Bicarbonate 2.5 grams (30 meq/L bicarbonate)
         1. Alternative: Trisodium Citrate 2.9 grams
2. Preparations: Commercial ORS
   1. Similar to WHO-ORS contents except sodium is 50 meq/L to match sodium lost in RotavirusDiarrhea
   2. Commercial products include Pedialyte, Rehydrate, Infalyte
3. Preparations: Homemade Cereal Based ORS
   1. Precautions
      1. Commercial products and WHO-ORS are preferred due to potential for errors in home preparation
         1. Meyers (1997) Pediatrics 100(5): E3
   2. Advantages
      1. Better nutrient absorption
      2. Easy and safe to prepare
   3. Preparation
      1. Solution should be thick, but pourable and drinkable
   4. Ingredients
      1. 1/2 cup of dry, precooked baby rice cereal
      2. 2 cups water
      3. 1/4 teaspoon salt
4. Advantages (over rehydration with intravenous fluid)
   1. Faster initiation of fluid replacement without the pain of Intravenous Access initiation
   2. Administered at home by parents with the same solution used for rehydration, maintenance and replacement of losses (e.g. Diarrhea)
   3. Fewer emergent follow-up visits and a higher parent satisfaction with Oral Rehydration Therapy
      1. Duggan (1999) Pediatrics 104(3): e29
5. Efficacy
   1. ORS is as effective as intravenous fluids for mild to moderate Pediatric Dehydration
      1. Atherly-John (2002) Arch Pediatr Adolesc Med 156(12):1240-3
6. References
   1. Canavan (2009) Am Fam Physician 80(7): 692-6