Pediatric Dehydration: Clinical Classification & Management
Assessment of dehydration severity is primarily clinical. Prompt classification is essential to determine the appropriate rehydration plan.
1. Clinical Classification (WHO)
| Sign | Some Dehydration | Severe Dehydration |
|---|---|---|
| Mental Status | Restless, irritable | Lethargic, unconscious |
| Eyes | Sunken | Very sunken/dry |
| Skin Pinch | Goes back slowly | Goes back very slowly (>2s) |
| Drink | Thirsty/drinks eagerly | Unable to drink |
2. Management Plans
- Plan A (No signs): Home management; increase fluids, continue breastfeeding, educate on danger signs.
- Plan B (Some signs): Oral rehydration therapy (ORT) using Low Osmolarity ORS over 4 hours (75 mL/kg).
- Plan C (Severe): Emergency rehydration; IV fluids (Ringer’s Lactate or Normal Saline).
NEET PG Hint: Remember that for Severe Dehydration, the priority is **Rapid IV rehydration**: 30 mL/kg of IV fluids in 1 hour (for infants < 1 year) or 30 mins (for children > 1 year), followed by 70 mL/kg over the next 5 hours (infants) or 2.5 hours (children). Always check for free medical courses and questions at mymedschool.org to reinforce these concepts.