Gastroenteritis Flashcards
Most common aetiology of gastroenteritis
Rotavirus
Clinical features of gastroenteritis
Diarrhoea usually lasts for 5-7 days and stops within 2 weeks
Vomiting usually lasts for 1-2 days and stops within 3 days
Which children are at increased risk of dehydration?
Younger than 1 year, especially those younger than 6 months
Low birth weight
Passed six or more diarrhoeal stools in the past 24 hours
Vomited three times or more in the past 24 hours
Not been offered or have not been able to tolerate supplementary fluids before presentation
Infants who have stopped breastfeeding during the illness
Children with signs of malnutrition
Features suggestive of hypernatraemic dehydration
Jittery movements
Increased muscle tone
Hyperreflexia
Convulsions
Drowsiness or coma
Clinical features of dehydration in infants
Sunken eyes
Depressed fontanelle
Dry mucous membranes
Lethargic
When to do a stool culture in gastroenteritis
Carry out stool culture if:
You suspect septicaemia or
Blood and/or mucus in the stool or
Child is immunocompromised
Consider stool culture if:
Child has recently been abroad or
Diarrhoea has not improved by day 7 or
Uncertain about the diagnosis of gastroenteritis
Management of gastroenteritis with evidence of dehydration
If shock suspected admit for IV rehydration
Continue breastfeeding and other milk feeds
Encourage fluid intake
Discourage fruit juices and carbonated drinks
Management of gastroenteritis with no evidence of dehydration
50ml/kg low osmolarity oral rehydration solution (ORS) solution over 4 hours, plus ORS solution for maintenance, often and in small amounts
Continue breastfeeding
Consider supplementing with usual fluids (including milk feeds or water, but not fruit juices or carbonated drinks)
What is the main risk of gastroenteritis?
Severe dehydration
