How do you assess a child with diarrhoea?History
stool frequency, quantity and type of stool
blood in the stool
decreased passage of urine
: vomiting - pronounced in rotaviral diarrhoea
: altered sensorium
: feeding history
|Condition||well, alert||restless, irritable||lethargic, drowsy, floppy|
|Eyes||normal||sunken||very sunken and dry|
|Thirst||drinks normally||thirsty, drinks eagerly||unable to drink|
|Skin pinch||normal||delayed||very delayed|
|Status||no dehydration||some dehydration||severe dehydration|
What investigations are helpful?
Stool routine is not of much value as more than 10 leukocytes per HPF are also seen in rotaviral diarrhoea. There is no role of stool pH and reducing substances in acute diarrhoea as the lactose intolerance in this condition is self-limiting. Trophozoites of giardia and E Histolytica may be sometimes demonstrated rarely. Stool culture usually grows E coli which may be a commensal.Serum electrolytes may be needed in very dehydrated patients.