Acute Watery Diarrhoea: Severe Dehydration Management
Severe dehydration in acute watery diarrhoea is a medical emergency characterized by rapid fluid loss, leading to hypovolemic shock. Immediate fluid resuscitation is the priority.
1. Recognizing Severe Dehydration (WHO Criteria)
Presence of at least two of the following signs:
- Lethargy or Unconsciousness
- Sunken Eyes
- Inability to Drink or Drink Poorly
- Skin Pinch Goes Back Very Slowly (>2 seconds)
2. Management: Plan C (Rapid IV Rehydration)
Administer Ringer’s Lactate (preferred) or Normal Saline as follows:
| Age | 1st Phase (30 mL/kg) | 2nd Phase (70 mL/kg) |
|---|---|---|
| Infants (<12 months) | 1 hour | 5 hours |
| Children (≥1 year) | 30 minutes | 2.5 hours |
3. High-Yield Clinical Pearls
- Reassess: Check every 15–30 minutes until a radial pulse is present. If the patient is still not improving, increase the IV drip rate.
- Oral Rehydration: As soon as the patient can drink (usually within 2–3 hours), start oral rehydration therapy (ORS) in addition to the IV fluids.
- Zinc Supplementation: Always provide zinc (10–20 mg/day) for 10–14 days to reduce the duration and severity of the episode.
NEET PG Hint: Remember: Never use Dextrose-containing fluids for initial resuscitation of severe dehydration, as it may lead to hyponatremia and cerebral edema. For more high-yield protocols and free medical questions, visit mymedschool.org.