Hydration Status Evaluation on Admittance and During Rehydration of Dehydrated Children at Boston Children's Hospital, With Exploratory Hydration Assessment Devices

This is a prospective cohort study to determine the performance of two prototype devices developed to aid in the diagnosis and monitoring of physiological hydration state of dehydrated children. These children are patients presenting to the emergency department with varying degrees of dehydration.

Overview of study procedure:

1. Initial identification of eligible patients. Patients will be initially identified by their chief complaint after registration and triage. Terms such as "Dehydration", "Gastroenteritis", "Diarrhea", "Vomiting", and or "Intolerance of POs" will be noted and those patients will be approached by study personnel for possible participation in the study.
2. Screening and obtaining of consent After patients have been identified as meeting entry criteria for the study, the parents will be asked two screening questions: 1. How far of a distance do you live from the hospital? 2. Would you be interested in a study that includes a follow-up home visit? These questions will be used to gauge the ability of the family to realistically complete the study, as a research coordinator will be travelling to the home to conduct a follow up visit after symptom resolution.
3. Study enrollment i. Risks and benefits of study participation will be discussed, as well as the consent process. After consent is obtained, a symptom survey will be administered to each patient and family to determine the degree of dehydration based on clinical assessment. Detailed information regarding onset and degree of symptoms including vomiting, diarrhea, urine output and amount of oral fluid intake will be recorded. A similar survey was administered as part of a randomized control trial of Dextrose containing fluids, which was conducted in our Emergency Department, (Levy, Waltzman).

ii. Each patient will have his/her weight obtained using a calibrated digital scale in a dry diaper or underwear with an appropriately sized gown. Then both study devices will be utilized by study personnel to obtain three triplicate measurements. Replicate measurements of capillary refill times will also be obtained in the same locations by visual inspection using a commercial stopwatch. Additional information including ambient room temperature, patient skin temperature and amount of applied pressure during the Capillary Refill Time measurements will be recorded.

iii. After the initial measurements are obtained, the treating provider will be given a questionnaire outlining their assessment of the degree of dehydration of the patient and the study protocol. Patients will be treated per the discretion of the health care provider including admission to the hospital or discharge based on his or her clinical judgment. Device measurements will not be provided to the treating clinician. Measurements obtained from the device will have no bearing on the clinical treatment of the patients. All measurements obtained in relation to the study will be used solely for research purposes. Device measurements of capillary refill time and radio-frequency measurements, and initial weight will not be disclosed to treating staff.