For pediatric cramps/exhaustion, what IV fluid dose is recommended?

• A. Normal Saline 5 ml/kg
• B. Normal Saline 20 ml/kg
• C. Normal Saline 50 ml/kg
• D. No IV fluids

Answer: (B)

The essence is to rapidly restore circulating volume with an isotonic fluid when a child is dehydrated and showing signs of reduced perfusion. A single IV bolus of normal saline at 20 mL per kilogram is the standard starting dose because it quickly expands intravascular volume and improves perfusion without overly stressing the body. A smaller amount like 5 mL/kg wouldn’t reliably reverse hypoperfusion, while a much larger amount such as 50 mL/kg could risk fluid overload and electrolyte imbalance. Skipping IV fluids leaves the child in a hypovolemic state. If signs of shock persist after the initial bolus, additional boluses can be given up to a total around 60 mL/kg, with ongoing reassessment; oral rehydration can be used later as appropriate.