Appendix 5. Volumes of RL and ORS for rehydration


These tables are designed to:
– Simplify the prescription of standard rehydration protocols on admission, according to the degree of dehydration and age or weight if weight is known;
– Facilitate implementation and monitoring of the protocol, by describing standard treatment procedures for severe dehydration or hypovolaemic shock (IV route, Plan C) and some dehydration (oral route, Plan B). 

5.1 Severe dehydration in children 5 years and over and adults (RL, Plan C)
5.2 Severe dehydration in children under 5 years (RL, Plan C)
5.3 Severe dehydration in children under 5 years with severe malnutrition (RL, Plan C)
5.4 Some dehydration in children and adults (ORS, Plan B) 

This appendix gives an overview of what the patient should receive, how, and over what length of time it should be delivered for correctly administered, effective rehydration.
These tables should not be seen as an extremely rigid framework, they are to be used as a guide, following as closely as possible the protocol as administered in ideal conditions. 

The quantities of RL and ORS are rounded off (to the nearest lower or higher whole number) to facilitate practical administration, as the quantity of liquids lost is always an estimation (approximately 10% for severe dehydration and 7.5% for some dehydration). 

RL is administered through:
– a standard infusion set (1 ml = 20 drops) in children 5 years and over and adults;
– a “precision” paediatric infusion set (1 ml = 60 drops; 150 ml chamber; dead volume: approximately 15 ml) in children under 5 years. 

The flow rates are given in ml/minute or ml/hour as they are too high to be given in drops/minute.
During rapid fluid replacement time (“bolus”), the infusion set clamp should be opened without trying to count the number of drops. The bolus is administered in the presence of a nurse or doctor that closely monitors the patient and the volume being delivered. The infusion rate is then lowered to administer the rest of the RL, monitoring the volume delivered and to be delivered over 3 hours (4 hours maximum), except for specific cases requiring slower rehydration (such as severe malnutrition).
Once rehydration has been completed, the catheter is not removed. Further treatment depends on the patient’s clinical evolution and capacity to drink ORS. 

5.1 Severe dehydration in children 5 years and over and adults (RL, Plan C)

RL is administered through a standard infusion set (1 ml = 20 drops). 

Age 
Weight 

Total volume
of RL 

30 ml/kg* RL (bolus) 
in ± 30 minutes 

70 ml/kg RL 
in ± 3 hours 

5 to < 6 years 
19-20 kg 

2000 ml 

600 ml in 30 minutes 
(approx. 20 ml/minute) 

1400 ml in 3 hours 
400 ml in 1h + 1000 ml in 2h 

6 to < 7 years 
21-23 kg 

2200 ml 

700 ml in 30 minutes 
(approx. 25 ml/minute) 

1500 ml in 3 hours 
1000 ml in 2h + 500 ml in 1h 

7 to < 8 years 
24-26 kg 

2500 ml 

800 ml in 30 minutes 
(approx. 25 ml/minute) 

1700 ml in 3 hours 
1000 ml in 2h + 700 ml in 1h 

8 to < 9 years 
27-29 kg 

2800 ml 

800 ml in 30 minutes 
(approx. 25 ml/minute) 

2000 ml in 3 hours 
1000 ml in 1h30 x 2 

9 to < 10 years 
30-31 kg 

3000 ml 

1000 ml in 30 minutes 
(approx. 35 ml/minute) 

2000 ml in 3 hours 
1000 ml in 1h30 x 2 

10 to < 11 years 
32-34 kg 

3300 ml 

1000 ml in 30 minutes 
(approx. 35 ml/minute) 

2300 ml in 3 hours 
1000 ml in 1h + 1000 ml in 1h 
+ 300 ml in 1h 

11 to < 12 years 
35-38 kg 

3500 ml 

1000 ml in 30 minutes 
(approx. 35 ml/minute) 

2500 ml in 3 hours 
1000 ml in 1h + 1000 ml in 1h 
+ 500 ml in 1h 

12 to < 13 years 
39-43 kg 

4000 ml 

1200 ml in 30 minutes 
1000 ml in 20 minutes (50 ml/min) 
+ 200 ml in 10 minutes (20 ml/min) 

2800 ml in 3 hours 
800 ml in 1h + 1000 ml in 1h 
+ 1000 ml in 1h 

13 to < 14 years 
44-49 kg 

4500 ml 

1500 ml in 30 minutes 
1000 ml in 20 minutes 
+ 500 ml in 10 minutes 

3000 ml in 3 hours 
1000 ml in 1h x 3 

14 to < 15 years 
50-54 kg 

5000 ml 

1500 ml in 30 minutes 
1000 ml in 20 minutes 
+ 500 ml in 10 minutes 

3500 ml in 3 hours 30 
500 ml in 30 minutes 
+ 1000 ml in 1h x 3 

≥ 15 years 
≥ 55 kg 

6000 ml 

2000 ml in 30 minutes 
1000 ml in 15 minutes x 2 

4000 ml in 4 hours 
1000 ml in 1h x 4 

* Bolus may be repeated once if necessary.

5.2 Severe dehydration in children under 5 years (RL, Plan C)

RL is administered through a “precision” paediatric infusion set (1 ml = 60 drops; 150 ml chamber).

Weight 
Age 

Total volume 
of RL 

20 ml/kg* RL (bolus) 
in ± 15 minutes 

70 ml/kg RL 
in ± 3 hours 

3 to < 4 kg 
0-1 month 

270 ml 

60 ml in 15 minutes 

210 ml in 3 hours 
70 ml in 1h x 3 

4 to < 5 kg 
1-2 months 

350 ml 

80 ml in 15 minutes 

270 ml in 3 hours 
90 ml in 1h x 3 

5 to < 6 kg 
2-3 months 

450 ml 

100 ml in 15 minutes 

350 ml in 3 hours 
120 ml in 1h x 3 

6 to < 7 kg 
3-4 months 

550 ml 

120 ml in 15 minutes 

430 ml in 3 hours 
145 ml in 1h x 3 

7 to < 8 kg 
4-7 months 

650 ml 

150 ml in 15 minutes 

500 ml in 4 hours 
125 ml in 1h x 4 

8 to < 9 kg 
7-10 months 

750 ml 

150 ml in 15 minutes 

600 ml in 4 hours 
150 ml in 1h x 4 

9 to < 10 kg 
10-12 months 

800 ml 

200 ml in 20 minutes 
100 ml in 10 minutes x 2 

600 ml in 4 hours 
150 ml in 1h x 4 

10 to < 13 kg 
1-2 years 

1000 ml 

250 ml in 20 minutes 
125 ml in 10 minutes x 2 

750 ml in 3 hours 
150 ml in 40 minutes x 5 

13 to < 15 kg 
2-3 years 

1200 ml 

300 ml in 20 minutes 
150 ml in 10 minutes x 2 

900 ml in 3 hours 
150 ml in 30 minutes x 6 

15 to < 17 kg 
3-4 years 

1500 ml 

300 ml in 20 minutes 
150 ml in 10 minutes x 2 

1200 ml in 3 hours 
150 ml in 20 minutes x 8 

17 to < 19 kg 
4 to < 5 years 

1700 ml 

400 ml in 15 minutes 
130 ml in 5 minutes x 3 

1300 ml in 3 hours 
150 ml in 20 minutes x 9 

* In total, up to 3 boluses if necessary.

5.3 Severe dehydration in children under 5 years with severe malnutrition (RL, Plan C)

RL is administered through a “precision” paediatric infusion set (1 ml = 60 drops; 150 ml chamber).

Weight 

Total volume 
of RL 

20 ml/kg* RL (bolus) 
in 30 minutes 

70 ml/kg RL 
in 6 hours 

3 to < 4 kg 

270 ml 

60 ml in 30 minutes 

210 ml in 6 hours 
35 ml in 1h x 6 

4 to < 5 kg 

350 ml 

80 ml in 30 minutes 

270 ml in 6 hours 
45 ml in 1h x 6 

5 to < 6 kg 

450 ml 

100 ml in 30 minutes 

350 ml in 6 hours 
60 ml in 1h x 6 

6 to < 7 kg 

550 ml 

120 ml in 30 minutes 

430 ml in 6 hours 
70 ml in 1h x 6 

7 to < 8 kg 

650 ml 

150 ml in 30 minutes 

500 ml in 6 hours 
85 ml in 1h x 6 

8 to < 9 kg 

750 ml 

150 ml in 30 minutes 

600 ml in 6 hours 
100 ml in 1h x 6 

9 to < 10 kg 

800 ml 

200 ml in 30 minutes 
100 ml in 15 minutes x 2 

600 ml in 6 hours 
100 ml in 1h x 6 

10 to < 11 kg 

900 ml 

200 ml in 30 minutes 
100 ml in 15 minutes x 2 

700 ml in 6 hours 
120 ml in 1h x 6 

11 to < 12 kg 

1000 ml 

220 ml in 30 minutes 
110 ml in 15 minutes x 2 

780 ml in 6 hours 
130 ml in 1h x 6 

12 to < 13 kg 

1100 ml 

240 ml in 30 minutes 
120 ml in 15 minutes x 2 

860 ml in 6 hours 
140 ml in 1h x 6 

13 to < 14 kg 

1250 ml 

250 ml in 30 minutes 
125 ml in 15 minutes x 2 

1000 ml in 6 hours 

14 to < 15 kg 

1300 ml 

300 ml in 30 minutes 
150 ml in 15 minutes x 2 

1000 ml in 6 hours 

* In total, up to 3 boluses if necessary.

5.4 Some dehydration in children and adults (ORS, Plan B)

Weight 

Age 

Total volume
of ORS 

Volume of ORS per hour 

3 to < 4 kg 

0 to < 1 month 

230 ml 

60 ml per hour for 4 hours 

4 to < 5 kg 

1 to < 2 months 

300 ml 

75 ml per hour for 4 hours 

5 to < 6 kg 

2 to < 3 months 

400 ml 

100 ml per hour for 4 hours 

6 to < 7 kg 

3 to < 4 months 

480 ml 

120 ml per hour for 4 hours 

7 to < 8 kg 

4 to < 7 months 

550 ml 

140 ml per hour for 4 hours 

8 to < 9 kg 

7 to < 10 months 

600 ml 

150 ml per hour for 4 hours 

9 to < 10 kg 

10 to < 12 months 

700 ml 

180 ml per hour for 4 hours 

10 to < 13 kg 

1 to < 2 years 

800 ml 

200 ml per hour for 4 hours 

13 to < 15 kg 

2 to < 3 years 

1000 ml 

250 ml per hour for 4 hours 

15 to < 17 kg 

3 to < 4 years 

1200 ml 

300 ml per hour for 4 hours 

17 to < 19 kg 

4 to < 5 years 

1400 ml 

350 ml per hour for 4 hours 

19 to < 21 kg 

5 to < 6 years 

1600 ml 

400 ml per hour for 4 hours 

21 to < 24 kg 

6 to < 7 years 

1600 ml 

400 ml per hour for 4 hours 

24 to < 27 kg 

7 to < 8 years 

1800 ml 

450 ml per hour for 4 hours 

27 to < 30 kg 

8 to < 9 years 

2000 ml 

500 ml per hour for 4 hours 

30 to < 32 kg 

9 to < 10 years 

2200 ml 

550 ml per hour for 4 hours 

32 to < 35 kg 

10 to < 11 years 

2400 ml 

600 ml per hour for 4 hours 

35 to < 39 kg 

11 to < 12 years 

2800 ml 

700 ml per hour for 4 hours 

39 to < 44 kg 

12 to < 13 years 

3200 ml 

800 ml per hour for 4 hours 

44 to < 50 kg 

13 to < 14 years 

3600 ml 

900 ml per hour for 4 hours 

≥ 50 kg 

≥ 14 years 

4000 ml 

1000 ml per hour for 4 hours 

≥ 75 kg 
6000 ml 1500 ml per hour for 4 hours

 If the patient wants to drink more than prescribed, give more ORS.