29th February 2024

An 8-year-old girl is referred to the paediatric surgical assessment with suspected appendicitis.

An 8-year-old girl is referred to the paediatric surgical assessment with suspected appendicitis.

On examination

On inspection the patient is subdued, with visibly dry mucous membranes and a mottled appearance. Voluntary guarding with maximal tenderness in the right iliac fossa. Rovsing’s sign is positive.

Temperature 38.4 oC, BP 60 / 40 mm Hg, HR 155, RR 27, pO2 98% on air

Weight 27 kg

Investigations

Some of the blood results have been reported and can be viewed below:

WCC 16.8 (4.0 – 11.0 x 109/L)

Neutrophils 12.2 (2.0 – 7.5 x 109/L)

Lymphocytes 8.2 (1.5 – 7.0 x 109/L)

CRP 134 (< 3 mg/dL)

Please select the most appropriate fluid to prescribe for this patient