I think it is often an issue of practicality--available room and available staff. Clearly the literature supports ORS, but the time involved for the nursing staff seems to be a big factor. Once the IV is in, the whole process of hydrating is a lot easier. A cranky child can sleep through IV hydration and many nurses will tell you that the taste of rehydrating solutions is a deterrent to children. The literature also notes the discrepancy between what is known and what is practiced. Trudi Scott, CPNP