6 year old drowsy child came in emergency with history of vomiting, loose motion for 3 days. On examination he had sunken eye, hypothermia, skin on pinching taken time to revert diagnosis –
Correct Answer: Severe dehydration
Description: Ans. is 'd' Le., Severe dehydrationo A child with severe dehydration will have at least two of the following four signs : sensorium is abnormally sleepy or lethargicr sunken eyes, drinking poorly or not at all, and a very slow skin pinch, o A child with some signs of dehydration will have two of the following : restlessness or irritability, sunken eyes, drinking eagerly or slow skin pinch.o A child with either one or none of these signs is classified as having no signs of dehydrationTreatment plan to prevent dehydration - Plan Ao The mother should be educated to use increased amount of culturally appropriate home available fluids,o In addition, they should be given ORS packets for use at home,o Breast feeding should not be discontinued.AgeORS to be given after each stoolAmount of ORS to beprovided for home use< 24 months2 mt - 10 yr> 10 yr5-100 ml100-200mlAs much as wanted500 mg.'day1000 ml1 day2000 ml/dayGuidlines for treating patients with some dehydration ( but not severe dehydration ) treatment plan Bo Basic is to give 75 ml/kg of ORS in the first 4 hours.WeightORS solution to give in first 4 hours< 5 kg200-400 ml5-8 kg400-600 ml8-11 kg600-800 ml11-16 kg800- 1200 ml16-30 kg1200-2200 ml> 30 kg> 2200 mlIntravenous fluid therapy for severe dehydration - Treatment plan Co Give 100 ml/kg of the chosen fluid as followsAgeFirst giveThen give<12 months12mt - 5 yrs30 ml/kg in 1 hour30 ml/kg in 30 minutes70 ml/kg in 5 hr70 ml/kg in 2'A hr.
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Pediatrics
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