Types, Symptoms and Management of Dehydration in Children

Definition of Dehydration in Children:

Dehydration is defined as excessive loss of body water. In physiology, dehydration is a deficit of total body water with an accompanying disruption of metabolic processes.

Classification or Types of Dehydration in Children:

It includes-

1. No signs of dehydration,
2. Some dehydration,
3. Severe dehydration.

Assessment Strategy or Sign and Symptoms of Severe Dehydration in Children:

Points	No signs of dehydration	Some dehydration	Severe dehydration
Look at condition	Well, alert	Restless, irritable	Lethargic or unconscious, floppy
Eyes	Normal	Sunken	Very sunken and dry
Tears	Present	Absent	Absent
Mouth and tongue	Moist	Dry	Very dry
Thirst	Drinks normally, not thirsty	Thirsty, drinks eagerly	Drinks poorly or unable to drink
Feel: Skin pinch	Goes back quickly	Goes back slowly	Goes back very slowly
Decide	The patient has no Some dehydration.	If the patient has two or more signs including at least one sign, there is some dehydration.	If the patient has two or more signs including at least one sign, there is severe dehydration.

Management of Severe Dehydration in Children:

Measures Should Be Taken In Various Degree Of Dehydration:

1. Measure should be taken for no sign of dehydration: Patient first seen with no signs of dehydration can be treated at home:

a. ORS packets should be given at home for 2 days,

b. Demonstration how to prepare and give solution,

c. After each loose stool the mother should give the following amount of ORS to her child.

Age	Amount of ORS
Less than 2 years	50-100ml
2-9   years	100-200ml
> 10 years	As much as wanted

2. Home Management:

a. Give more fluid than usual,

b. Give more food than usual.

c. Minimum one extra meal for two weeks.

d. Referral knowledge.

• If not improved within 3 days,
• More loose motion,
• Increased vomiting,
• Depressed anterior fontanels,
• Thirsty,
• Unable to drink or food,
• Visible blood in stool,
• Fever.

Instruction to the mother of patient to return if any sign (above) develop.

3. Measure should be taken for some sign of dehydration: Rehydration therapy:

ORS 75 ml/kg within 4 hours irrespective of age. Reassess after 4 hours. If improved then treated as no sign of dehydration if not, referred to the hospital.

4. Measure should be taken for severe dehydration:

In severe dehydration, patient should be rehydrated by intravenous (TV) fluid such as cholera saline as follows:

Age	1st give 30 ml/kg	Then give 70 ml/kg
Infants (<12 months)	1 hour	5 hours
Older (> 12 months)	30 minutes	2-14 hours

More questions related to this article:

1. What do you mean by dehydration?
2. What are the types of dehydration?
3. What is the classification of dehydration?
4. How will you assess dehydration status of a child?
5. How will you assess dehydration status of a patient with diarrhea?
6. Mention the assessment strategy of severe dehydration.
7. What are the sign and symptoms of dehydration?
8. Discuss the management of severe dehydration.
9. How will you manage a child with some dehydration?
10. How will you manage a child having diarrhea with severe dehydration?
11. A two years boy presented with acute watery diarrhea for 2 days. How will you assess his dehydration status and how can you manage a child with some dehydration?