Q: My 7-year-old received 4 bags of IV fluids for tonsillitis and is now lethargic and constantly sleeping. Should we go to the ER?
- Myeongchan Kim
- May 31
- 3 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
Last night, my 7-year-old child (weighing 16kg) had a high fever of 39.6°C. We went to the pediatrician right when they opened this morning. The doctor ruled out the flu and said the fever was caused by severe inflammation and swelling in the tonsils. We were advised to get IV fluids, and my child received about 4 bags. Since coming home, my child's condition seems very poor, possibly from crying so much at the hospital. They are constantly sleeping and seem very lethargic. Is it okay to just keep an eye on them, or should I be worried about having received too much IV fluid and take them to the emergency room?
Answer:
It is completely understandable to be worried when your 7-year-old is sleeping continuously and appears lethargic after a hospital visit and receiving IV fluids.
Things to check right away:
• When you wake your child and call their name, do they open their eyes and respond?
• When awake, can they drink a few sips of water?
• Is their breathing comfortable? (Ensure their lip color is normal and the skin under their ribs isn't pulling in when they breathe).
Go to the Emergency Room immediately if you notice any of the following:
• Your child is very difficult to wake up or remains completely limp when awakened.
• They do not respond properly when their name is called.
• They cannot drink water at all or are vomiting.
• Their lips turn blue or they seem to be struggling to breathe.
• They have not urinated for more than 8 hours.
If none of the emergency signs are present and your child responds when awakened, you can observe them at home:
A high fever from tonsillitis, combined with the stress and crying at the hospital, can leave a child completely exhausted. Their current sleepiness may simply be extreme fatigue from fighting the illness and the hospital visit.
• Wake your child every 2 to 3 hours to give them a few sips of water and check their responsiveness.
• If they can make eye contact and answer you when awakened, they are doing okay.
• Monitor their urine output and color. If the urine is dark yellow, they need more oral fluids.
• If the severe lethargy persists until tomorrow morning or if the high fever returns, follow up with the pediatrician who treated them today.
Regarding the IV fluids:
For a 16kg child, receiving 4 bags of IV fluids (which typically range from 100 to 250 mL each) is an appropriate intervention if the doctor determined that dehydration correction was necessary. The total volume is not excessive. Right now, your child's current responsiveness and clinical condition are much more important than the amount of IV fluid they received. Continue to monitor their breathing, hydration, and responsiveness closely at home, and seek emergency care if their condition worsens.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
