In pediatric hypovolemia, the recommended initial fluid bolus is:

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In pediatric hypovolemia, the priority is to rapidly restore intravascular volume with an isotonic crystalloid to quickly improve perfusion. The best initial choice is a 20 mL/kg bolus of isotonic fluid, typically normal saline, because this amount provides a meaningful expansion of the circulating volume without causing rapid fluid shifts. A much smaller dose, like 5 mL/kg, would likely be insufficient to treat shock. Dextrose-containing solutions do not address intravascular volume promptly and can complicate glucose management, so they’re not used for initial resuscitation. Lactated Ringer’s is also isotonic and acceptable in many protocols, but the standard teaching here emphasizes normal saline at 20 mL/kg as the starting bolus. If perfusion remains inadequate after the first bolus, additional boluses can be given up to 60 mL/kg total in the first hour, with careful monitoring for signs of fluid overload.