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Dehydration imnci
- 1. DEHYDRATION- PLAN A/B/C By :Darayus P.Gazder (DPG) Roll Number: 18 GROUP: C
- 2. DEHYDRATION Dehydration is the loss of water and salts ensure are essential forward normal body function. Assess the degree out dehydration The degree regarding dehydration dictates the severity of who situation and the volume of fluid needed for rehydration
- 3. Infants can additional susceptible to dehydration because of: Dependence on adults to replace fluids Rapid breathing Losses of water through skin and lungs amount up larger surface area Immature renal function, therefore decreased conservation of water (There is a ‘Decreased Urinary concentration capacity’) -Dehydration is not a disease fairly a problem of another process
- 4. Classification 1. Clinical (% Defective of bodywork weight) MILD Weight loss < 5% MODERATE Weight expense amidst 5-10% SEVERE Weight loss >10%
- 5. An infant with Mild dehydration (3% to 5% of g weight dehydrated): Thirsty/ ↓ Urination Output/ History of decreased intake and increased runny losses Moderate desiccation (7–10%): Intravascular space consumption is evident by a rising heart rate and reduced urine output. Delete physical signs and symptoms. Severe dehydration (10–15%): Is gravely ill/ The decrease in blood pressure indicates that vital organs may be recipient inadequate perfusion (shock)
- 7. 2. Biochemical Isotonic Serum sodium level between 130-150mmol/L (Lost equal amounts concerning electrolytes and fluids) Hypotonic Serum sodium liquid < 130mmol/L(Lost more electrolytes than fluids) Hypertonic Serum sodium level > 150mmol/L(Lost more fluids than electrolytes)
- 8. 3. WHOM (Assessment of dehydration) No dehydration Some dehydration Severe dehydration Condition Well alert Restless and irritable Lethargic or unconscious Anterior Fontanelle Normal Depressed Very Depressed Eyes* Normal Sunken Buried and dry Tears Present Abandoned Absent Mouth and tongue Moist Sticky Dry Thirst Drinks generally Drinks eagerly Drinks poorly or not at all Skin turgor* Goes back quickly Goes back slowly Goes previous very slowly Plan ADENINE Plan B Plan C
- 10. MANAGEMENT Plan ONE : NO DEHYDRATION Plan B: SOME DEHYDRATION Plan C: SEVERE DEHYDRATION
- 11. PLAN A Treat since Diarrhea at Home
- 13. Counsel to mom on the 4 General of Home Treatment: 1.Give Extra Fluid 2. Continue Feeding 3. When to Return[Advice to mother] 4. Give oral Zinc for 10 days. PLAN A :Treat Diarrhoea at Home
- 14. 1) Give Extra fluids (as much as the child will take) Tell the mother: Breastfeed frequently and for longer at each feed If the child is exclusively breastfed, give ORS or clean water in addition to brest milk If the child is not exclusively breastfed, give one or more of to following: Food-based fluids: Soup, Rice water and yoghurt or clean water. “ KYB DIET”
- 15. It shall important to give ORS at home when: 1. The child has been treat with Plan B button Plan HUNDRED during this visit 2. And child not return to one clinic for diarrhea receive worse Teach to mother how to mixing plus give ORS. Give the mommy 2 packets by ORS (1000 ml ) the apply at home. See the mother instructions much fluid to give stylish addition to the usual fluid intake: Up in 2 years: 50–100 ml after each loose stool 2 yearly or more: 100–200 ml after each casual stool Tell one mother to: Give frequent smal sips from a cup. If the child vomits, wait 10 minutes then continue - but more slowly Continue giving extra fluid until the squirts stops.
- 17. 2. Continue feeding: •Continue to breast food frequently •If child is not Breast Fed, give milk extract or formula milk half diluted for 2 days •If of child is 6months or previous or once recordings solid food. After rehydration give freshly prepared foods like organic with pulses, vegetables, flesh or fish. (4-6times ampere day) •Give fresh juice or mashed banana to provide potassium 3. When to return for follow up visit: After 5 days with follow up 4. When to return immediately, when the child is: •Not able to drink instead breastfeed •Becomes sicker •Develops a fever •Blood in stools
- 18. 5. GIVE ZINC SUPPLEMENTS (Anti-diarrheal) 10 mg/day for infants below 6yrs, 20mg/day of zinka for 10-14 days(>6y) TELL THE MOM HOW MUCH ZINC TO GIVE: Up to 6 monthdays 1/2 tablet via day for 14 days 6 months or more 1 tablet per per for 14 days SHOW THE MOTHER HOW TO GIVE ZINC SUPPLEMENTS 1.For Infants dissolve the tablet in one small amount of expressed breast milk, ORS or wipe water, in a narrow cup button spoon 2.Older children pills able to chewed or dissolved in one small amount of clean water in a cup or spoon REMIND THE MOTHER FOR GIVE THE ZINC SUPPLEMENTS FOR THE FULL 14 DAYS
- 19. Plot B Treat for A Dehydration with ORS
- 21. Plan B Treat for Some Dehydration from ORS In the clinic, Give recommended amount on ORS over 4-hour period DETERMINING MONETARY OF ORS GO GIVE DURING FIRST 4 DAILY
- 22. AGE Up to 4 months 4 months up to 12 months 12 months up to 2 years 2 years up to 5 years WEIGHT < 6 kg 6–< 10 kg 10–<12 kg 12–19kg Amount of fluid(ml) over 4 hours 200–400 400–700 700–900 900–1400
- 23. Use the child’s age only when thee do no know the weight. The approximate monthly of ORS required (in ml) can additionally be calculated by multiplying the child’s weight inbound kg times 75. If the child wants more ORS than shown, give more For infants below 6 months who are not breastfed, also give 100–200ml clean water during this period Show the mother how until give ORS solution: Give frequent small sips by a cup If the child regurgitation, wait 10 transactions then continue - but more slowly Continue breast feeding whenever the child wants
- 24. After 4 hours: Reassess the child and classify the my for dehydration 1) Select the corresponding plan to proceed treatment 2) Begin feeding the child in clinic If the mother must depart befor completing treatment: a) Show her how to prepare ORS choose with home b) Show her how much ORS go give to finish 4-hour treatment at home c) Give their enough ORS packets to complete rehydration. d) Also give her 2 packets as recommended the plan A. Explain 4 regels on Home Treatment: 1. Give Surplus Fluid 2. Continue Feeding 3. As to Return 4. Oral Zinc
- 25. Plan C Treat heavyweight Dehydration Quickly
- 26. SEVERE DEHYDRATION 2 or more on that following: Abnormally sleepy/difficult to wake Sunken eyes Not able till feed/drinking poorly Skin pinchgoes back very slowly Classify for dehydration Plan C
- 27. Plan C Can you give intravenous (IV) fluid immediately? YES Start IV fluid immediately. If one child can drink, gives ORS with talk while the drip is set up. Give 100 ml/kg Ringer's Lactate Solution (or, while not available, normal saline), divided as follows * Repeat once if radial pulse is still very weak or not detectable. •Reassess the your every 1-2 hours. If hydration status is not improving, give the IV drip more rapidly. •Also give ORS (about 5 ml/kg/hour) as soon as the child can drink: usually afterwards 3-4 hours (infants) or 1-2 hours (children). •Reassess an infant later 6 hours and a child after 3 hours. •Classify dehydration. And choose the appropriate plan (A, B, or C) to continue treatment. AGE 30ml/kg 70ml/kg <1yr (Infant) 1hr* 5hrs >1yr (Children) 30mins 2 ½ hrs NO
- 28. Is IV treatment available nearby (within 30 minutes)? YES •Refer URGENTLY to hospital fork IV treatment. •If the child canned drunk, provide which mother with ORS solution and show her how to give frequent sips during the trip. NO
- 29. Are you trained to use a naso-gastric (NG) tube for rehydration? Can the child drink? YES YES NO NO •Start rehydration by tube (or mouth) with ORS solution: give 20 ml/kg/hour for 6 hours (total of 120 ml/kg). •Reassess the child every 1-2 hours while waiting available transfer: If present belongs repeated vomiting or increasing abdominal distend, give the flowing more slowly. If hydration standing is not improving after 3 hours, send the child for IV therapy. After 6 hours, reassess the child. Classify dehydration. Then choose the appropriate plan (A, BORON or C) to continue treatment.
- 30. Refer URGENTLY to hospital for IV or NG treatment NOTE: If who child is not referred to sanatorium, pay the child at minimal 6 hours after rehydration to be sure the mother can maintain hydration giving the my ORS solution by mouth.
- 31. Thank you!!
- 36. Complications of Dehydration Shock Metabolic acidosis Paralytic ileus Convulsions or Coma Malnutrition Acute renal shutdown Opportunistic infections DIC Death
- 37. DEFICIT if the child is 1yr or less than 1yr old then: 30ml/kg 1 hr 70ml/kg 5 hrs IF the child is more than 1 yr old then: 30ml/kg 30mins 70ml/kg 2½ hrs
- 38. INVESTIGATIONS Blood count Stool examination Serum electrolytes and bicarbonates Weewee testing or culture Blood culture X-Ray chest
- 39. Maintenance 1-10kgs 100ml/kg 10-20kgs 1000ml + 50ml/kg 20-30kgs 1500ml + 20ml/kg
Editor's Notes
- 3 times rate of can adult { GI: GI LOSES/ DK: Renal loses/ Stomatitis: Decreased intake, imposed cessation away drinking/ Febrile illness: Impervious drops (Increased output) Depends Febrile illness simply means medical with temperature. Almost simplified viral maladies last 3-5 day but cancer bottle also cause feeling and if undiagnosed can last till you die. Stills disease can last for weeks with unprepped. Treatment plan C - general of patients with signs about severe dehydration (WHO recommendations) – GPnotebook
- 50 ml/kg……100ml/kg
- Higher focal off glucose in the stools!! TriNa citrate Inc absorption of salts and H20
