4. Dehydration

OBJECTIVES

  • Describe and identify the different types of dehydration.
  • Assess the degree of dehydration.
  • Describe the physiologic basis of oral rehydration therapy (ORT).
  • Explain the characteristics and routes of administration of ORT solutions.
  • List the advantages of ORT.
  • Define when ORT has failed and when ORT is contraindicated.
  • Describe how to give ORT to children with severe dehydration.
  • Outline a strategy for setting up an ORT unit at the site of a disaster.

Dehydration resulting from acute diarrheal illness is one of the most significant causes of morbidity and mortality in populations displaced by disaster. In some cases, it accounts for more than 50% of the deaths during the initial stages of a humanitarian emergency. The use of oral rehydration therapy (ORT) has markedly reduced the morbidity and mortality associated with dehydration caused by diarrheal illness regardless of the etiology.

CASE (contd):

The child presents again 24 hours later. He has continued to have loose stools that have now turned watery. He has also continued to vomit all fluids he has been offered. The mother says he is drowsy and much weakened. There has been no urine output for more than 8 hours. Physical examination shows marked sunken eyes, reduced skin turgor (>4 seconds), capillary refill >5 seconds, and pale and cold skin.

  1. What is the appropriate course of action at this moment?

Dehydration resulting from acute diarrheal illness is one of the most significant causes of morbidity and mortality in populations displaced by disaster.