The definition of pediatric diarrhea
Acute pediatric diarrhea is generally defined as
- a decrease in the consistency of stools (loose or liquid )
- and/or an increase in the frequency of evacuations (typically ≥ 3 in 24 hours).
However, a change in stool consistency versus previous stool consistency is more indicative of diarrhea than stool number, particularly in the first months of life.
If your child has diarrhea, assessing its severity; there are indications for a medical visit.
- Age <2 months
- Persistent vomiting
- High-output diarrhea with elevated stool volumes (>8 episodes/day)
- signs of severe dehydration
Dehydration is the consequence of diarrhea, vomiting, and fever. Therefore, estimate the degree of dehydration is important to avoid severe dehydration occurred.
The best parameter of dehydration are skin turgor, sunken eyes, mucous membrane and general appearance.
- The dehydration sign including: Drowsy, limp, cool or sweaty general appearance, sunken eyes, tear absence and dry mucous membrane.
Principles and practices of oral rehydration therapy (ORS).
Oral rehydration therapy is the first line therapy for children with diarrhea.
- Infants younger than 6 months should neither interrupt breast-feeding nor introduce diluted or modified formula.
- Patients should continue to eat a normal diet or resume a normal diet once vomiting stops.
- Give small, frequent sips of ORS, measure the amount drunk, and the fluid lost as diarrhea and vomitus.
- Beverages with a high sugar content such as juice,soda, or sports drinks should not be used ,as they are relatively low in sodium and high osmolarity.
Recipe for Making a 1 liter ORS solution using Sugar, Salt and Water
If ORS is not available, you should provide water, broth, and/or other fluids. You can mix an oral rehydration solution by yourself using one of the following recipes.
- Clean Water - 1 liter - 5 cupfuls (each cup about 200 ml.)
- Sugar - Six level teaspoons
- Salt - Half level teaspoon
Stir the mixture till the sugar dissolves.
Assessment
Reassess the patient every 15–30 minutes and continue hydrating. The volumes and time intervals shown are guidelines provided on the basis of usual needs.
Fluid Replacement or Treatment Recommendations
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Dehydration type
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Treatment Recommendations
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Some dehydration
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Administer in first 4 hours:
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All
ages
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Volume of ORS
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No dehydration
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Administer after each loose stool
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Age
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Volume of ORS
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<2 years
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50–100 ml
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2–9years
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100–200 ml
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≥10 years
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As much as patient wants
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