What is the 4-2-1 rule for pediatric fluids?

It's a shortcut for the Holliday-Segar method: 4 mL/kg for the first 10 kg, 2 mL/kg for the next 10 kg, and 1 mL/kg for every kg over 20 kg.

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Pediatric Maintenance Fluids Calculator

Calculate daily fluid requirements for pediatric patients based on weight, essential for hydration management.

Proper hydration is vital for hospitalized children who cannot take fluids by mouth. Pediatric fluid requirements are not linear; they are based on the Holliday-Segar method, which estimates caloric expenditure and the resulting water needs. This calculator uses the '4-2-1 rule' to provide both the hourly infusion rate and the total 24-hour fluid volume required.

Educational use only. This tool does not replace clinical judgment or local protocols.

Weight (kg)

Reference

Maintenance rate

50 mL/hr

Maintenance fluids: 50 mL/hr (1200 mL/day)

40 mL + 2 mL/kg/hr * (15 - 10) kg

Weight (kg)15 kg

Daily total1200 mL/day

Method4-2-1 rule

Cómo funciona

The tool applies a tiered calculation based on the child's weight, ensuring that smaller infants receive proportionally more fluid per kilogram than older children or teenagers.

Fórmula de cálculo

Tiered: 4ml/kg (1st 10kg) + 2ml/kg (2nd 10kg) + 1ml/kg (rest)

Calculation Examples

1. **5kg Infant**: 5 * 4 = **20 mL/hr**. 2. **25kg Child**: (10*4) + (10*2) + (5*1) = **65 mL/hr**.

Why use this tool in your daily life?

This service ensures hydration safety for the most vulnerable patients. By automating the tiered calculation, it eliminates the risk of dehydration or fluid overload in pediatric care, making it an indispensable tool for pediatric nurses and residents.