MANAGEMENT OF DEHYDRATION in childrens.pptx

Management of dehydration with categories

1. APPLY THE IMNCI GUIDELINES IN RISK STRATIFICATION OF CHILDREN WITH DIARRHEAL DEHYDRATION AND REFER 2 ND YEAR MBBS MADE BY DR.SHRUTI

2. NO DEHYDRATION SOME DEHYDRATION (if >= 2 signs) SEVERE DEHYDRATION (if >= 2 signs) CONDITION Well, alert Restless, irritable Lethargic, unconscious EYES Normal sunken Sunken THIRST Drinks normally Thirsty, drinks eagerly Drinks poorly, not able to drink SKIN PINCH Goes back quickly Goes back slowly Goes back very slowly PLAN A PLAN C PLAN B

3. PLAN A ORAL REHYDRATION THERAPY <2 YEARS- 50/100 ml/ loose stool 2-10 YEARS- 100-200 ml/ loose stool >10 YEARS – As much as he wants

4. PLAN B ORS 75ml/kg over 4 hours + Replacement of ongoing loss + Daily maintainance fluid requirement First 1-10kg weight – 100ml/kg body weight Next 11-20 kg weight – 50ml/kg body weight Next >20 kg weight – 20ml/kg body weight

5. PLAN C Iv Ringer lactate – 100ml/kg 30 ml/kg 70ml/kg >1year 30mins 2.5hrs <1 year 1hr 5hrs

6. Ringer lactate 15ml/kg/hr for the first hour Continue monitoring during the infusion: Record pulse, breathing rate, capillary refill time at the beginning and then every 5-10 min Assess after 1 hr Repeat Ringer lactate 15 mL/kg over 1hr Consider severe dehydration with shock Clinically better/ no evidence of shock Give iv fluids 10 mg/kg/hr for next 8hrs and substitute with ors when the child accepts orally SEVERE DEHYDRATION IN A MALNOURISHED CHILD NO IMPROVEMENT/ WORSENING IMPROVEMENT SEEN