Dehydration how many bags of fluid

The doctor decides what solution to give based on the dehydrations level of severity, age, and medical condition. Dehydration treatment is available at the hospital, urgent care centers, and drip bars. Receiving IV fluids at the hospital or urgent care comes with the guarantee of trained nurses and doctors overseeing your visit.

Drip bars are becoming more popular for celebrities who can afford to pay cash for the treatment. Many famous people claim the benefits of dehydration treatments for jet lag, hangovers, and improving the look of skin and hair, according to Harvard.

But doctors argue these vanity treatments are not necessary. Dehydration due to exercising or jet lag can be resolved through drinking water or electrolyte products to replace lost fluids although the risk is low for IV fluids treatment for reasons other than vomiting, diarrhea, sweating, or frequent urination. The use of IV fluids for dehydration offers many benefits.

It helps people regain the water in their bodies. If the clinical signs of dehydration do not improve, or become worse, fluids should be given intravenously until the vomiting subsides. Remember that vomiting is often most severe during dehydration and usually disappears as water and electrolytes are replaced. Drugs should never be given to control vomiting because they are not very effective and often cause the child to become sleepy, making ORT more difficult.

Inability to drink: Patients who cannot drink because of stomatitis due, for example, to measles, thrush, or herpes , fatigue, or central nervous system depression induced by drugs such as antiemetics or antimotility drugs should be given IV fluid or ORS solution by NG tube. If the patient is comatose, fluid should be given intravenously, if possible, or by NG tube. Abdominal distension and ileus : If the abdomen starts to become distended, ORS solution should be given more slowly.

If abdominal distension continues to increase or is already well developed, and especially if there is paralytic ileus with absent bowel sounds, ORT or nasogastric therapy should be stopped and fluid given intravenously. Paralytic ileus may be caused by opiate drugs e. Glucose malabsorption : Clinically significant glucose malabsorption is unusual during acute diarrhoea. However, when it does occur, the use of ORS solution may cause a marked increase in watery diarrhoea with large amounts of unabsorbed glucose in the stool and worsening signs of dehydration see Unit 2, Figure 2.

The child may also become hypernatraemic and very thirsty. Special tapes or test sticks can be used to detect glucose in the stool. Tests for reducing substances, such as Benedict's solution or Clinitest R tablets, can also be used see Unit 7. When glucose malabsorption prevents successful ORT, fluids should be given intravenously until diarrhoea subsides. Water may also be given to drink until thirst is satisfied.

Seizures Dehydrated children occasionally develop convulsions either before or during rehydration therapy. Some possible causes of seizures and their appropriate treatment are as follows: Hypoglycaemia : This occurs mostly in undernourished infants and young children. After waking up, the child should be fed, given ORS solution, or both, to prevent a recurrence.

Hyperthermia : Some young children especially infants develop seizures when they have a fever; the risk is greatest when the fever is high, e. Treatment involves giving paracetamol or cooling by sponging with tepid water and fanning. Hypernatraemia or hyponatraemia : See Unit 2 for a discussion of these conditions. The preferred treatment is with ORS solution, unless there is also glucose malabsorption see above. When sufficient amounts are given to correct dehydration and restore normal kidney function, serum sodium levels will become normal.

Central nervous system conditions unrelated to diarrhoea , such as epilepsy or meningitis. Appropriate anticonvulsant and antimicrobial therapy should be given. Ahmed has diarrhoea and some signs of dehydration. He is 8 months old and weighs 6kg. Approximately how much ORS solution should he receive during the first 4 hours?

Use the chart in Figure 5. Maria has been assessed and found to have some signs of dehydration. She weighs 12 kg. While at the facility, her mother has given her ml of ORS solution within 4 hours. After 4 hours, Maria still has some signs of dehydration, but is improving.

Assuming that the mother can stay at the facility, what should be done next? There may be more than one correct answer. Start to feed the child as described in Plan A. John, an month-old baby with diarrhoea, has been brought to the health centre by his grandmother. He weighs 9 kg. He has been assessed and found to have some signs of dehydration. The grandmother must leave soon to catch the last bus; it is too far for her to walk home. What should the health worker do? Give the child an antibiotic to treat his infection.

Give the grandmother ml of ORS solution and show her how to give it to John during the next 4 hours. Explain to the grandmother how John should be fed when they return home. Give the grandmother two 1-litre packets of ORS for use in treating John at home during the next 2 days, after he has been rehydrated.

Balaji is a 9 kg boy with signs of severe dehydration who is very drowsy and cannot drink. He is brought to a small health centre. There is no IV equipment at the health centre, but the health worker knows how to use an NG tube. Omo is a 4 month-old baby weighing 4 kg who was severely dehydrated due to diarrhoea. He has received ml of Ringer's Lactate Solution intravenously over 3 hours and is improving. He can now drink. What treatment should be given next?

He should be treated according to Plan A. He should resume breast-feeding. He should receive ml of Ringer's Lactate Solution intravenously in the next 3 hours. He should begin taking small amounts of ORS solution, about 25 ml each hour. Sanjay, a 3 month-old boy weighing 4 kg, has been treated for severe dehydration for 6 hours, by means of IV Ringer's Lactate Solution given intravenously. The child has just been reassessed.

He is improving, but still has some signs of dehydration. What treatment should he receive now? He should be given ml of ORS solution over the next 4 hours.

He should continue to receive IV treatment, following Plan C, until all signs of dehydration have disappeared.

He should be given an antidiarrhoeal drug or antibiotic to help stop his diarrhoea. He should resume breast-feeding if he has not done so already. You are a doctor working in an urban clinic. Ria, an 8 month-old girl is brought to you. She is comatose, with a very rapid heart rate; the radial pulse cannot be felt; the skin of her arms and legs is cool and moist and her skin pinch goes back very slowly; her abdomen is distended and bowel sounds are infrequent. Ria has been having profuse, watery diarrhoea and severe vomiting for the past 2 days.

The local pharmacist prescribed antiemetic drops and a suspension containing codeine. What type of dehydration does Ria have? How much fluid is needed to replace her deficit? Over what time periods would you divide her rehydration therapy? What is the probable cause of Ria's abdominal distension? Hawa is 3 years old and weighs 12 kg. She lives in an area where cholera has recently been diagnosed. Her diarrhoea started yesterday and she has had 6 large watery stools.

Her alarmed mother suspended all food but started giving her extra liquids. However, Hawa has had severe vomiting all morning. The doctor examining Hawa at the local health facility notices that she is very sleepy, has very dry and sunken eyes, and a very dry tongue; a pinch of her skin goes back very slowly.

The doctor works at a health facility where IV fluid is available. What type of dehydration does Hawa have? What solution would be your next choice? How would the possibility that Hawa has cholera affect your choice of treatment? When should you start to give Hawa ORS solution by mouth? Ali is 5 months old and weighs 4. His mother breast-feeds him.

His diarrhoea started last night, and he has had 8 very watery stools. His mother said there was no blood in the stools. As the doctor examines Ali, she finds that the skin pinch goes back slowly, the eyes are a little sunken, and Ali drinks some ORS solution very eagerly. Ali does not have a fever. What type of dehydration does Ali have?

Which treatment plan should be followed for Ali? Approximately how much ORS solution should Ali receive in the first 4 hours? When should the mother start to breast-feed Ali again? If Ali has no signs of dehydration after 4 hours, what treatment plan should be followed next? B,D 3. B,C,D 4. B,C,D 6. A,D 7. Ria has severe dehydration. The fluid should be given intravenously. Codeine, possibly combined with a potassium deficit. Hawa has severe dehydration, possibly caused by cholera.

Normal saline solution O. Hawa should receive an oral antibiotic for cholera, usually tetracycline or doxycycline, after rehydration is complete and vomiting has stopped. Give Hawa small amounts of ORS solution as soon as she is able to drink; this should be possible after hours of rehydration therapy.

Ali has some dehydration. Treatment Plan B. Ali should receive ml of ORS solution during the first 4 hours. The mother should resume breast-feeding at once and breast-feeding should not be interrupted during ORT. Treatment Plan A should be used. On-line since Note 2: If the child continues to vomit or have significant diarrhea, the volume of ongoing fluid loss should be estimated and added to the deficit every few hours as 0.

Ideally, the diapers should be weighed. If this is not possible, then a volume of ml should be used for each stool in an infant and ml for the older child. Dehydration and hypovolemia result in secretion of anti-diuretic hormone, which causes retention of free water, and provision of hypotonic replacement fluid can lead to potentially life-threatening hyponatremia. Step 3: Suppose the child is well hydrated by the second hospital day, but is still feeling queasy and does not want to drink.

The blood brain barrier prevents rapid movement of solutes out of or into the brain. On the other hand, water can move freely across the blood brain barrier. Rapidly developing hyponatremia causes a shift of water into the brain; conversely, hypernatremia can lead to brain dehydration and shrinkage. Severe, acute hyponatremia may result in brain edema with neurological symptoms such as a change in sensorium, seizures, and respiratory arrest.

This is a life-threatening medical emergency and requires infusion of hypertonic saline. Acute hypernatremia results in a reduction in brain volume. This can lead to subdural bleeding from stretching and rupture of the bridging veins that extend from the dura to the surface of the brain. Given time, the brain can alter intracellular osmotic pressure to better match plasma osmolality. With persistent or slowly developing hyponatremia, brain cells extrude electrolytes and organic osmoles and the increase in brain volume is blunted or avoided.

Neurologic symptoms are absent or subtle. With persistent hypernatremia, brain cells generate organic osmoles also known as idiogenic osmoles to compensate for the increase in plasma osmolality.