Acute Diarrhea - Fluid Therapy in Diarrohea

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Gastrointestinal Disorders in Children

Acute Diarrhea in Children

Gastrointestinal Disorders in Children

Zinc and ORS

Acute Diarrhea in Children

Inflammatory Bowel Disease/IBD

Acute Childhood Diarrhea: Review of Recent Advances in Standard Management

Zinc For The Prevention Of Diarrhea

Oral Rehydration Therapy

Approach To Acute Abdominal Pain In Children

Trachea oesophageal fistula

Vomiting and Diarrhea in Children

Upper Gastrointestinal bleed

ORS - Which one to use?

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Prevention of Diarrhea

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ACUTE DIARRHEA

Related topics

What is diarrhoea

Diarrhea Causes

Diarrhea Investigations and ORT And ORS

Indication and Choice of Antibiotics

Treatment and Dietary Management Of Acute Diarrhoea

Dr.Sanjay Prabhu
Consultant Pediatrician

Bhaktivedanta Hospital

Q. How do you give fluid therapy in diarrhoea?

PLAN A - TO PREVENT DEHYDRATION

Provide normal daily fluid requirements.

Breast milk or full strength animal or formula milk.

Semisolid food if eaten by child.

Replace ongoing losses.

Home available fluids- plain water,lemon water,curd water,coconut water,rice kanji, dal without salt .These fluids along with food provide ORT.

Avoid aerated drinks, tea or plain glucose water without salt as it may cause osmotic diarrhoea.

Salt Sugar Solution

A finger pinch of salt plus 1 teaspoon of sugar in a glass of water.

WHO ORS

How much to give?

Less than 24 mths of age:- 50-100 ml per loose stool
2-10 years of age:- 100-200 ml per loose stool
More than 10 years of age:- as much as required

How to give
One teaspoon every 1-2 mins for child less than 2 years and frequent sips from cup for older children. If the child vomits, wait for 10 mins and give slowly.

What are the DANGER SIGNS?

Many water stools
Repeated vomiting
Marked thirst
Eating or drinking poorly
Fever- high grade
Blood in the stool
Drowsy child
Marked oliguria

PLAN B- REHYDRATION THERAPY IN A CHILD WITH SOME DEHYDRATION

75 ml per kg body weight ORS in 1^st 4 hrs and then reassess.

In children less than 6 months, give 100-200 ml water if not breast-fed.

ORS is effective in 95% cases.

When is it not effective?

High rate of purging > 15 ml /kg /hr
Persistent vomiting>3/hr
Incorrect administration or preparation of ORS
Abdominal distension and ileus
Altered sensorium

PLAN C- SEVERELY DEHYDRATED CHILDREN
Ringer lactate or Normal saline given Intravenously 100 ml /kg

1^st 30 ml /kg	over 1 hr in child <12 months
	over 30 mins in child > 12 months
2^nd 70 ml/ kg	over 5 hrs in child <12mths
	over 2 ½ hrs in child>12mths

Next : Indication and Choice of Antibiotics

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