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Dehydration In children
This document provides information on assessing and treating dehydration in children. It defines dehydration as an excess loss of water and body fluids, and lists various causes including gastroenteritis, fever, burns and more. It describes methods for assessing dehydration severity based on weight loss, clinical signs/symptoms, and skin pinch test. Mild dehydration shows thirst and sunken eyes; moderate shows lethargy and poor drinking; severe shows collapse and sunken fontanel. Oral rehydration solution is given as treatment, with recipes provided for making solutions with salt, sugar and water.
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Introduction to dehydration, its definition and significance in children.
Various causes including gastroenteritis, DKA, fever, burns, and genetic conditions affecting hydration.
Methods to assess dehydration including the pinch test, weight loss criteria, and clinical features.
Detailed clinical assessment parameters for mild, moderate, and severe dehydration including weight loss and signs.
Preparation of effective ORS recipes to combat dehydration, emphasizing key ingredient proportions.
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Dehydration In children
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- 4. Dehydration is acondition that can occur with excess loss of water and other body fluids. Dehydration results from decreased intake, increased output (renal, gastrointestinal or insensible losses), a shift of fluid (e.g. ascites, effusions), or capillary leak of fluid (e.g. burns and sepsis).
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- 7. Mouth ulcers, stomatitis,pharyngitis, tonsillitis: pain may severely limit oral intake
- 8. Diabetic ketoacidosis (DKA) Febrileillness: fever causes increased insensible fluid losses.
- 9. Burns: fluid lossesmay be extreme and require aggressive fluid management
- 10. Congenital adrenal hyperplasia:may have associated hypoglycaemia, hypotension, hyperkalaemia, and hyponatraemia. Gastrointestinal obstruction, e.g. pyloric stenosis: often associated with poor intake, vomiting. Bowel ischaemia may cause extensive capillary leak and shock.
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- 13. Cystic fibrosis: excessivesodium and chloride losses in sweat. Diabetes insipidus: excessive output of very dilute urine. Thyrotoxicosis: increased insensible losses and diarrhoea.
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- 16. Of the clinicalindicators used, the pinch test (skin turgor) has been shown to be the most reliable in several studies but is still not a reliable test when used without other clinical indicators.
- 17. Loss of bodyweight: oNormal: no loss of body weight. oMild dehydration: 5-6% loss of body weight. oModerate: 7-10% loss of body weight. oSevere: over 10% loss of body weight.
- 18. Clinical features ofmild-to-moderate dehydration; 2 or more of: Restlessness or irritability. Sunken eyes (also ask the parent). Thirsty and drinks eagerly
- 20. Clinical features ofsevere dehydration; 2 or more of: Abnormally sleepy or lethargic. Sunken eyes. Drinking poorly or not at all
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- 22. Skin turgor isassessed by pinching the skin of the abdomen or thigh longitudinally between the thumb and the bent forefinger. The sign is unreliable in obese or severely malnourished children. Normal: skin fold retracts immediately. Mild or moderate dehydration: slow; skin fold visible for less than 2 seconds.
- 24. Mild or moderatedehydration: slow; skin fold visible for less than 2 seconds. Severe dehydration: very slow; skin fold visible for longer than 2 seconds. Other features of dehydration include dry mucous membranes, reduced tears and decreased urine output. Additional signs of severe dehydration include circulatory collapse (e.g. weak rapid pulse, cool or blue extremities, hypotension), rapid breathing, sunken anterior fontanels
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- 27. Mild Moderate Severe Weightloss Up to 5% 6-10% More than 10% Appearance Active, alert Irritable, alert, thirsty Lethargic, looks sick Capillary filling (compared to your own) Normal Slightly delayed Delayed Pulse Normal Fast, low volume Very fast, thready Respiration Normal Fast Fast and deep Blood pressure Normal Normal or low Orthostatic hypotension Very low Mucous memb. Moist Dry Parched Tears Present Less than expected Absent Eyes Normal Normal Sunken Pinched skin Springs back Tents briefly Prolonged tenting Fontanel (infant sitting) Normal Sunken slightly Sunken significantly Urine flow Normal Reduced Severely reduced
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- 30. Recipe 1 Making a1 (one) litre solution using Salt, Sugar and Water Ingredients: • One level teaspoon of salt • Eight level teaspoons of sugar • One litre of clean drinking or boiled water and then cooled 5 cupfulls (each cup about 200 ml.) Preparation Method: Stir the mixture till the salt and sugar dissolve
- 32. Recipe 2 Making a1/2 (half) liter solution using Salt, Sugar and Water Ingredients: A 3 finger pinch of salt ( approx. 1.75 gms.) A scoop of sugar ( approx. 20 gms.) 1/2 (half) liter of clean drinking or boiled water 2.5 cupfuls (each cup about 200 ml.)
- 33. PREPARATION METHOD: Pour 1/2(half) liter of clean drinking or boiled water, after it has cooled, into a large vessel. Add a 3-finger pinch of salt (approx. 1.75gms). Taste the solution. It shouldn't be more salty than your tears. Add a scoop of sugar ( approx. 20 gms.) Stir the mixture till the salt and sugar dissolve.