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If severe dehydration then excessively rapid rehydration may result in cerebral oedema.
World Health Organization (WHO) scale for dehydration
It is important to determine the degree of dehydration in order to select the appropriate plan to treat or prevent dehydration.
Clinical assessment for degree of dehydration associated with diarrhoea is as follows
| A | B | C |
general appearance | well, alert | restless, irritable | lethargic or unconscious |
eyes | normal | sunken | sunken |
thirst | drinks normally, not thirsty | thirsty, drinks eagerly | drinks poorly, or not able to drink |
skin turgor | goes back quickly | goes back slowly | goes back very slowly |
Estimation of fluid deficit (and the requirement) in children with some dehydration or severe dehydration should be carried out by weighing them without clothing. (if weighing is not possible, a child's age may be used to estimate the weight) (1).
| fluid deficit as % of body weight | fluid deficit in ml/kg body weight | treatment |
no signs of dehydration | <5% | <50 ml/kg | use treatment plan A |
some dehydration | 5-10% | 50-100 ml/kg | use treatment plan B |
severe dehydration | >10% | >100 ml/kg | use treatment plan C |
Note:
fluid management following rehydration
Following rehydration, some children may be at risk of recurrence of dehydration.
Recomendations on fluid management following rehydration:
Restart oral rehydration therapy if dehydration recurs after rehydration (3)
Reference:
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