Pediatrics

Pediatric Maintenance Fluids (4-2-1 Rule)

Calculates hourly IV fluid requirements for children.

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Parameters

Pediatric Maintenance Fluids (4-2-1 Rule) Result

Formula

4-2-1 Rule:
First 10 kg: 4 mL/kg/hr
Next 10 kg: 2 mL/kg/hr
Every kg above 20 kg: 1 mL/kg/hr

Clinical Pearls

Provides a safe and standardized baseline for IV hydration in children who are NPO (nil per os).

Limitations

Calculates MAINTENANCE fluids only. It does not account for fluid resuscitation needs (boluses for shock/dehydration) or ongoing abnormal losses (e.g., severe diarrhea, surgical drains, fever).