Mx of dehydration

Question 1

Ix of dehydration

Answer 1

• • Usually no investigations ae indicated**
• Stool culture ( - septicaemia /travel)
• U+E, creatinine, glucose
• Blood culture if Abx started

Question 2

How should hypernatremic dehydration be managed?

Answer 2

1. Oral rehydration can be used to rehydrate
2. CI of IV fluids - rapid reduction in extracellular plasma sodium concentration will cause a shift of water to enter cerebral cells
   - the fluid deficit should be replaced over atleast 48 hours
   - Seizures / cerebral oedema

Question 3

Which drugs are not advised in children?

Answer 3

Never give loperamide and anti emetics as they are

• ineffective
• prolong the excretion of bacteria in stool
• may be assoc with side effects

Question 4

Should antibiotics be routinely given?

Answer 4

Not routinely required to treat gastroenteritis even if it a bacterial cause
- only for suspected confirmed cases of sepsis or salmonella < 6 months of age

Question 5

How should clinical dehydration be managed

Answer 5

1. Oral rehydration therapy ( 50 ml per kg) over 4 hours as well as maintenance fluids
   - continue to breast feed
   - continue to supplement with normal fluids

Question 6

How should further deterioration from clinical dehydration be managed?

Answer 6

1. Start Intravenous therapy for rehydration
   - fluids of 100ml/kg - 10%of body weight if shocked
   - continue maintainance fluids
   - monitor U + Es

Question 7

How should shock be managed?

Answer 7

1. Intravenous therapy
   - rapid infusion of sodium chloride therapy to alleviate symptoms of shock
2. Intravenous therapy for rehydration
   - replace fluid deficits via 100ml /kg