OBJECTIVE: To review the literature about indication of oral rehydration therapy (ORT) for children in the emergency unit, seeking factors related to medical training, caregiver's attitude and units' conditions as determinants for that practice. DATA SOURCES: Non-systematic literature review including original articles and meta-analysis in English, Portuguese and Spanish, identified via Pubmed/Medline, Cochrane Collaboration, Lilacs and SciELO, published between 1990 and 2008, using the terms "oral rehydration therapy", "diarrhea case management", "emergency department" and related words. DATA SYNTHESIS: When carried out in appropriate rooms, ORT treatment is as effective as intravenous therapy in restoring the level of hydration in children with acute diarrhea in the emergency unit. Time of graduation and professional experience, knowledge and training on acute diarrhea case management showed an association with ORT use. However, reports of inconvenience of its administration in the emergency unit include lack of physical space and pressure care, while simultaneously suggesting structural inadequacy and improper use of the service in these cases. Reports of caregivers' suspicion about the effectiveness of this therapy are cited as a barrier for prescription. CONCLUSIONS: Subuse of ORT in the emergency unit is associated with factors beyond medical training and expertise, such as structural problems and caregivers' expectations about the therapy.
emergency medical services; oral rehydration therapy; gastroenteritis; child