In cases of suspected hypovolemic shock in a 16-month-old with severe vomiting and diarrhea, what is the appropriate initial bolus dose of isotonic crystalloid solution?

In the context of suspected hypovolemic shock in a young child, particularly due to conditions like severe vomiting and diarrhea, rapid assessment and correction of fluid deficits are critical for stabilizing the patient. The appropriate initial bolus dose of isotonic crystalloid solution is 20 ml/kg, administered over a timeframe of 5 to 20 minutes.

This dose is based on pediatric guidelines which recommend a larger volume for initial resuscitation in cases of hypovolemic shock to quickly restore intravascular volume and improve perfusion. The rapid approach of administering this volume within a short period is essential to effectively counteract the potential cardiovascular complications associated with continued fluid loss and dehydration.

Administering 20 ml/kg over 5 to 20 minutes allows for flexibility, accommodating the child's condition and response to treatment while ensuring a prompt intervention. Subsequent reassessments of the clinical status can guide additional fluid management, but initial resuscitation at the recommended level is foundational for the management of hypovolemic shock in pediatric patients.