Assessment of Hydration Status (WHO)
Accurate clinical assessment is the most important step in managing pediatric dehydration. The classification helps determine the appropriate fluid plan.
Clinical Classification Table
| Sign | Severe Dehydration | Some Dehydration |
|---|---|---|
| Mental Status | Lethargic/Unconscious | Restless/Irritable |
| Eyes | Sunken | Sunken |
| Thirst | Drinks poorly/unable | Thirsty/Drinks eagerly |
| Skin Pinch | Very slow (>2 seconds) | Slow |
Management Guidelines
- Severe Dehydration (Plan C): Requires immediate IV fluid resuscitation (Ringer’s Lactate or Normal Saline).
- Some Dehydration (Plan B): Managed with oral rehydration therapy (ORS) at 75 ml/kg over 4 hours.
- No Dehydration (Plan A): Home management with increased fluids and continued feeding.
NEET PG Hint: Remember the “Sunken Fontanelle” in infants as a key indicator of dehydration. If you have two or more signs from the “Severe” category, the patient qualifies for Plan C treatment. Always assess the child’s weight if possible, as a 10% or greater weight loss is a hallmark of severe dehydration.