:BY

SANDHYA JEGANATHAN
3 or more loose or watery stools in
a day.

Recent Change in consistency and

character of stool
Passage of frequent formed stools

Passage of pasty stools in breast fed infants

Transitional stools on 3rd to 7th day of life

Two or more signs
Increased thirst unable to drink
Irritability floppy lethargic
Decreased skin turgor(may be masked in hypernatremic
diarrhoea)
Dry mouth and tongue
Sunken eyes, Sunken AF
Tears absent
Decreased urine output
(classified by clinical syndromes):
Acute watery diarrhoea(some dehydration or
severe dehydration
Dysentery
Persistent diarrhoea (acute watery diarrhoea
and dysentery lasting for more than 14 days)
80% ROTAVIRUS,REO VIRUS

20% Bacteria and parasitic cause

Amoebiasis and giardiasis are unlikely in

childhood
Vomiting
Fever , ARI
Abdominal cramps
Rapid weight loss
anorexia
 electrolytes--Na ,K , Cl
Dehydration (loss of water and electrolytes
HCO3--)
HCO3

Malnutrition

Acute renal failure

Renal v thrombosis , HUS

FLUID REPLACEMENT

CONTINUING FEEDING

RATIONAL USE OF DRUGS

CONTD;
ORS
HOME AVAILABLE FLUIDS
rice water,dal water with salt,lassi with salt, coconut
water--preferably given along with food(starch and
water
protein are provided) that promote luminal absorption
of Na.
 A (patients without physical
signs of dehydration)
Use adequate amounts of home available fluids .
Advice mother to continue feeding despite diarrhoea or
vomiting.
Take to health worker if condition does not improve or
develops any of the danger signs
DANGER SIGNS:
Many watery stools
Repeated vomiting/eating or drinking poorly
Fever/blood in the stool
 (patients with physical signs
of dehydration )
Rehydration therapy

Maintenance therapy

Provision of normal daily fluid requirements

 REPLACEMENT FLUID:
In the first 4 hrs 100ml/kg of ORS

MAINTENANCE FLUID
After 4-
4-6 hrs of treatment with ORS solution(10
solution(10--20ml/kgBW)
no improvement reassess improvement
continue the replacement start on maintenance
maintenance
fluid fluids
 !
9START IV FLUIDS IMMEDIATELY

30 ML/KG IN THE 1ST HR

70 ML/KG IN NEXT 5 HRS

If unable to start ivf give feeds through nasogastric tube
15--30mins(:radial pulse)
Reassess every 15
In children aged >1 yr give this in ½ the time duration
High stool purge
Persistent vomiting
Incorrect preparation
Abdominal distension and ileus
Glucose malabsorption

ORS does NOT stop Diarrhoea

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