The protocols below are focused on treatment of dehydration caused by diarrhoea and vomiting. Rehydration mild diarrhea is a discomfort, but not dangerous if the child can continue to drink. Dehydration is defined as the condition that results from excessive loss of body water 1. Fluid therapy maintains the normal volume and composition of body fluids and, if needed, corrects any existing abnormalities.
Tell the mother which signs require immediate medical attention. Dehydration treatment plans, using ort to prevent and treat dehydration, what to do if dehydration occurs, preventing dehydration, mothers must learn. Oral rehydration therapy and iv fluids should be administered depending on the severity of a condition. To treat or prevent dehydration, give your child liquids that contain electrolytes. In the 1960s, efforts by young scientists and researchers led to the development of ort for the treatment of dehydration that often accompanies acute attacks. In children, the most common abnormality requiring fluid therapy is hypovolemia or dehydration, often related to vomiting and diarrhea from gastroenteritis. There are several causes of dehydration, which are described below. Initial management includes placement of an intravenous or intraosseous line and rapid administration of 20 mlkg of an isotonic crystalloid eg, lactated ringer solution, 0. Evaluation and management of dehydration in children. Paediatric emergency triage, assessment and treatment. Dehydration is one of the leading causes of pediatric morbidity and mortality throughout the world.
Clinical pathway for treatment of diabetic ketoacidosis determine the extent of dehydration. Dehydration remains a major cause of morbidity and mortality in infants and young children worldwide. Suitable fluid replacement for children younger than two years includes. Although oral rehydration is underutilized in the united states, most children with dehydration can be successfully rehydrated via the oral route. If your dehydration is serious, you may need to see a doctor to get treated with intravenous iv fluids. Young children and pregnant women may be more susceptible to. Aug 16, 2017 most people who have healthy immune systems will recover without treatment. Sep 19, 2019 dehydration also can occur in any age group if you dont drink enough water during hot weather especially if you are exercising vigorously. Most people who have healthy immune systems will recover without treatment. Our study purpose was to evaluate the usefulness of routinely ordering a sep in the treatment of dehydrated pediatric patients receiving intravenous fluids ivfs. In severe acute malnutrition, dehydration is caused by untreated diarrhoeal disease which leads to the loss of water and electrolytes 2. A regular usage of this ort prevents the death that is caused due to a 93% diarrhea and dehydration. Common viral infections that cause vomiting or diarrhea include rotavirus, norwalk virus, and adenovirus. Managing acute gastroenteritis among children oral rehydration, maintenance, and nutritional therapy prepared by caleb k.
As a rule, treatment of dehydration should be initiated first, unless there is another severe classification. For an infant, give plenty of breast milk and formula, but dont give fruit juices if he is vomiting or has diarrhea. Dehydration can be treated with oral, nasogastric, subcutaneous, or intravenous fluids. You can also give your child an oral rehydration solution, such as pedialyte, naturalyte, infalyte, or ceralyte, as directed. Severe dehydration caused by cholera should be treated with intravenous fluids 3. In children with dehydration, feeding should be resumed as soon as normal hydration is achieved through any rehy dration therapy appropriate for the severity of the dehydration.
The resuscitation phase should reduce moderate or severe dehydration to a deficit of about 8% body weight. In either treatment, the preferred method of rehydration for adults and children is by mouth, however if a child is drinking poorly, a nasogastric tube may be used. Diagnosis and management of dehydration in children american. You can make oral rehydration solutions at home pdf, 90kb. Nov 22, 2014 to minimize the risk of cerebral edema during the correction of hypernatremic dehydration, the serum sodium concentration should not decrease by 12 meql every 24 hr. Objectives to compare oral with intravenous therapy for treating dehydration due to acute. People who are in poor health or who have weakened immune systems are at higher risk for more severe and prolonged illness. Dehydration is caused by not drinking enough fluid or by losing more fluid than you take in. Dehydration treatment oral rehydration therapy and fluid. Treatment is with oral or iv replacement of fluid and electrolytes. This causes an imbalance of electrolytes, which are nutrients the body needs to properly function. The american academy of pediatrics and the who both recommend oral replacement therapy for mild and moderate dehydration. It was developed through a comprehensive search and analysis of the medical literature.
Mar 19, 2020 dehydration is most often caused by fever, diarrhea, vomiting, and a decreased ability to drink or eat associated with a viral infection. Severe acute malnutrition and diarrhoeal disease run in a vicious cycle, each making the other more severe and more likely to occur. Fluid resuscitationtreatment of dehydration for dehydration,shock,blood lossisotonic normal saline or lactated ringers give 20mlkg as bolus. Pediatric oral rehydration therapy pathway in the emergency. Management strategies in the treatment of neonatal and. What are critical treatments for children with diarrhoea and dehydration. See oral rehydration therapy protocol in pediatric dehydration mild to moderate dehydration. The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. Pdf on mar 1, 2018, sohair khider and others published management of dehydration in children. Severe dehydration may require you to go to the hospital. Jan 26, 2017 it is a dehydration treatment which involves the fluid replacement. It becomes a medical concern when there is an extreme loss of water known as dehydration. Pediatric oral rehydration therapy pathway in the emergency department the following information is intended as a guildeline for the acute management of pediatric patients 3 months old with signs and symptoms of mild to moderate dehydration in the setting of diarrhea with or without vomiting. Pdf understanding clinical dehydration and its treatment.
Children with severe dehydration eg, evidence of circulatory compromise should receive fluids iv. Some people lose their sense of thirst as they age, so they dont drink enough fluids. Give extra fluids in frequent, small sips, especially if the child is vomiting. Water routinely leaves the human body through sweat, breath and urine. Compared to earlier versions, it includes revised guidelines on the management of children with acute diarrhoea using the new reduced low osmolarity ors formulation and using zinc supplements, which have been shown to reduce duration and severity of diarrhoeal. The provisional committee on quality improvement of. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause. Obtain intravenous access, and give a 20 mlkg isotonic fluid bolus ringer lactate or normal saline to children with severe volume depletion. C 17, 18, 19 a single dose of ondansetron zofran may facilitate ort in children with dehydration. The severity of dehydration can depend on a number of factors, such as climate, level of physical activity and diet. Usefulness of the serum electrolyte panel in the management of pediatric dehydration treated with intravenously administered fluids. Dec 07, 2018 severe dehydration is characterized by a state of hypovolemic shock requiring rapid treatment. Also give ors about 5 mlkg per h as soon as the child can drink.
Effect of nursing protocol find, read and cite all the. Signs of chronic dehydration that a doctor will look for include a concentrated blood volume, abnormal electrolyte levels, and reduced kidney function over time. Pediatric vascular access and blood sampling techniques. This practice parameter formulates recommendations for health care providers about the management of acute diarrhea in children ages 1 month to 5 years. Fluid therapy for pediatric patients with diabetic. Diarrheal disease and dehydration account for 14% to 30% of worldwide deaths among infants and toddlers. Who initial treatment of dehydration for severe acute. Usefulness of the serum electrolyte panel in the management. Diagnosis and management of dehydration in children. Treatment in the emergency department centers first on restoring blood volume and then body fluids, while determining the cause of the dehydration. If dehydration is moderate, 20 mlkg 2% body weight is given iv over 20 to 30 minutes, reducing a 10% deficit to 8%. Selfcare at home most children become dehydrated because of diarrhea or vomiting caused by a viral infection.
Pediatric dehydration is a common problem in emergency departments and wide practice variation in treatment exists. Oct 29, 20 intravenous rehydration is the treatment of choice in cases of failure of ort, and it has to be reserved for patients with severe dehydration or who eliminate more than 1020 mlkghour. Diarrhea and dehydration american academy of pediatrics. This is a method of drinking water with sugar and salts. C 1417 use of an appropriate ort solution corrects and helps prevent electrolyte disturbances caused by gastroenteritis in children. For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an overthecounter oral rehydration solution. C 37, 11 ort is the preferred treatment for mild to moderate dehydration in children. Start the oral rehydration protocol see above calculate 24 hour maintenance requirements. Expert consensus opinion was used to enhance or formulate recommendations where data were insufficient. Traditionally, children with dka are assumed to be severely dehydrated, with fluid deficits ranging from 10% to 15%, with a conservative estimate assumed at 10%. It is also important that the feeding of infants is not interrupted during rehydration, and that. A manual for physicians and other senior health workers.
Guidelines from the american academy of pediatrics on fruit juice in infants, children and adolescents recommend against the use of fruit juice in the treatment of dehydration or the management of diarrhea. Dehydration in children msd manual professional edition. Treatment of hypovolemia dehydration in children uptodate. See maintenance fluid requirements in children hollidaysegar formula. Pediatric emergency medicine practice clinical pathways. Clinically, it is useful to divide fluid therapy into repletion.
Read more about signs of dehydration, causes, symptoms and treatment including signs and symptoms in young children and toddlers. Intravenous rehydration is the treatment of choice in cases of failure of ort, and it has to be reserved for patients with severe dehydration or who eliminate more than 1020 mlkghour. The goal of dysentery treatment is clinical improvement,as well as shortening the fecal shedding of the causative. The assessment and management of dehydration should take into consideration the degree of dehydration, maintenance fluid requirements, and ongoing fluid. Dehydration is a symptom or sign of another disorder, most commonly diarrhea. Treatment of dehydration in infancy american academy of. For moderate dehydration, 100 ml per kg of ort solu tion should be given over four hours in the physicians office or emergency department. Dehydration treatment guidelines what to drink when dehydrated.
Sep 14, 2018 dehydration means your body does not have enough fluid. The serum electrolyte panel sep is a frequently ordered laboratory test, but it has unproven usefulness in the treatment of dehydrated pediatric patients. Dehydration is condition caused by the loss of too much fluid from the body. If dehydration is severe, 3 boluses of 20 mlkg 6% body weight may be required. Pediatric saskatchewan registered nurses association. Children 2 months to 9 years of age who were receiving. Choose clear soup, clear soda, or pedialyte, if possible. Identify symptoms of dehydration and calculate degree of. It happens when you are losing more fluids than you are taking in, and your body does not have enough fluids to work properly. Advances in the assessment of dehydration allow more accurate clinical evaluation, but do not help predict the treatment outcomes. Fluid is lost through sweat, tears, vomiting, urine or diarrhoea. Oral rehydration is an effective and inexpensive treatment, but some physicians prefer intravenous methods. Jul 01, 2015 dehydration is one of the leading causes of pediatric morbidity and mortality throughout the world. The deficits in severe hypernatremic dehydration may need to be corrected over 24 days.
Remember that malnourished children are at higher risk of diarrhea due to intestinal mucosa alteration. Give popsicles, ice chips, and cereal mixed with milk for added water or fluid. Dehydration treatment plans using oral rehydration therapy. Alternative treatment protocols should be used for children with malnutrition see severe acute malnutrition, chapter 1 or in patients with severe burns see burns, chapter 10. Severe dehydration can cause seizures, coma, organ failure, and, in rare circumstances, death. You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment. Treatment plans taken from the cddwho supervisory skills course, from the module on the treatment of diarrhoea. How can i treat or prevent my childs dehydration caused by diarrhea. The way to help a dehydrated child is to give plenty of fluids while the child is ill. Diarrhea can be managed by drinking plenty of fluids to prevent dehydration.
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