A 22-month-old boy presents to the ED with his parents following 4 days of vomiting and diarrhea. The parents report that the child has not been playful and has had decreased wet diapers. The mother reports that the child is drinking small amounts, but is vomiting 4-5 times per day. Physical exam shows dry oral mucosa, sunken eyes, and a crying (no tears) toddler. The child clings to his mother during the exam. What is the FIRST sign of moderate volume depletion in this age group?
The Goods
By Dr Sally Bogoch and Dr Andrew Grock
Tintinalli’s 7th ed
sbogoch
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