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Gorelick Dehydration Scale

Assesses degree of dehydration in children 1 month to 5 years

Indication

  • Assesses degree of dehydration in children 1 month to 5 years

Criteria

  • id: caprefill; label: Capillary refill ≥2 seconds; type: yesno
  • id: skin_turgor; label: Decreased skin turgor (tenting); type: yesno
  • id: breathing; label: Abnormal respirations (deep/tachypneic); type: yesno
  • id: tears; label: Absent tears; type: yesno
  • id: mucous; label: Dry mucous membranes; type: yesno
  • id: ill_appearance; label: Ill general appearance; type: yesno
  • id: eyes; label: Sunken eyes; type: yesno
  • id: pulse; label: Abnormal radial pulse (weak/absent); type: yesno
  • id: hr; label: Tachycardia (>150 infant, >130 child); type: yesno
  • id: urine; label: Decreased urine output; type: yesno

Interpretation

  • function(score) { if (score <= 2) return { risk: score + '/10', tier: 'Mild Dehydration (<5%)', action: 'Oral rehydration therapy (ORT). 50 mL/kg over 4 hours. Discharge with instructions.', color: 'green' }; if (score <= 6) return { risk: score + '/10', tier: 'Moderate Dehydration (5-10%)', action: 'Consider IV fluids: NS 20 mL/kg bolus. Attempt ORT. Observe for improvement.', color: 'yellow' }; return { risk: score + '/10', tier: 'Severe Dehydration (>10%)', action: 'IV NS 20 mL/kg bolus, repeat as needed. Admit. Monitor electrolytes, glucose, and urine output.', color: 'red' }; }

Clinical pearls

  • ≥3 signs = at least 5% dehydration (moderate)
  • ≥7 signs = at least 10% dehydration (severe)
  • Capillary refill and skin turgor are the most specific findings
  • Always check glucose in dehydrated infants and toddlers

Source and review

  • Gorelick et al., Pediatrics 1997. Last reviewed: 2024-11-01