Classification & Management of dehydration in children with diarrhea

1. Signs of Severe dehydration
Unconsciousness
Sunken eyes
Unable to drink or drinks poorly
Skin pinch goes back in >= 2 sec

How to manage?
Rehydrate with Cholera Saline or Hartman's solution @ 100ml per kg IV stat. DNS but not DS can be used.
If child <1year give total volume i.e 100ml * wt. of child in kg in 6 hours with 30ml/kg in 1hour (repeat if radial pulse absent) and 70ml/kg in next 5 hours.
If child >1year give total volume in 3 hours with 30ml/kg in 30mins and 70ml/kg in 2&half hours. (half of above durations).

After treatment if signs persist repeat ; if signs of some dehydration or no dehydration follow below given protocol.

2. Signs of Some dehydration
Restless
Sunken eyes
Drinks eagerly
Skin pinch goes back < 2 sec

How to manage?
Rehydrate with ORS @ 75ml/kg by 4hours at your clinic/OPD. After 4 hours assess, if still some dehydration present, repeat or follow protocol for no dehydration.

3. Diarrhea but no dehydration
No signs

How to manage?
After ever motion give 50-100ml of ORS for child <2years. For >2years give as per demand.


Also give zinc supplement @10mg/day for 10to14 days for children < 6months. For > 6 months 20mg/day for 10 to 14 days.

Continue breast feeding if child is breastfed and increase number of meals to 6times a day at least up to 2 weeks after diarrhea.