What is the standard minimum fluid bolus dose for isotonic crystalloid in pediatric hypovolemic shock?

• A. 10 mL/kg isotonic crystalloid
• B. 20 mL/kg isotonic crystalloid
• C. 30 mL/kg isotonic crystalloid
• D. 40 mL/kg isotonic crystalloid

Answer: (B)

In pediatric hypovolemic shock, the priority is to rapidly restore circulating volume with isotonic crystalloids. The standard minimum bolus is 20 mL/kg, given quickly (about 5–10 minutes) to promptly increase preload and improve perfusion. Isotonic solutions like normal saline or lactated Ringer’s are used because they stay in the intravascular space long enough to support circulation without drawing water into cells. After the first bolus, reassess clinical signs of perfusion; if still in shock, repeat boluses up to a total of about 60 mL/kg within the first hour, while monitoring for signs of fluid overload and respiratory status.