|Written by Dr.Md.Redwanul Huq (Masum)|
|Monday, 20 June 2011 15:33|
Treatment plan A (For “No dehydration”): Home treatment.
1. More fluid than usual – Plane water, dub-water, salt sugar solution, salt molasses solution, chira water etc.
2. Amount of Oral Rehydration Solution (ORS) to be given:
|Age||Amount of ORS after each stool|
|Less than 2 years||50 -100 ml (10 – 20 tsf)|
|2 – 9 years||100 – 200 ml (20 – 40 tsf)|
|10 years or more||As much as the child wants|
3. More food for 2 weeks (after acute attack), for 4 weeks (after chronic attack)
4. Referral knowledge to the mother: To take the child to the health facility centre if diarrhea does not get better in 3 days or develop any of the following signs/symptoms –
a) Sunken eye
b) Eat or drink poorly
c) Increased frequency or duration
d) Passage of blood through stool
e) Noticeable thirst
f) Recurrent vomiting
Treatment plan – B (For “Some dehydration”):
1. Existing fluid deficit should to be corrected in 4 hours by ORS
2. Treatment should be done in the ORT corner or in an observation room in the hospital & no admission in the hospital is usually required
3. Amount of ORS required is – 75 ml / Kg
4. To continue breast feeding / other normal feeding during the rehydration phase
5. To monitor the patient one hourly and re-assess the child after 4 hours & then select plan A, B or C to continue treatment.
If again plan B – to give the child food, milk, juice also.
Treatment plan – C (For “Severe dehydration”):
1. The child should be admitted in the hospital for treatment of dehydration.
2. The existing fluid deficit (more than 10 % of body wt.) to be corrected by normal saline / cholera saline / Ringer’s lactate solution in 6 hours in infants and in 3 hour in older children. For intravenous treatment:
|Age||At first 30 ml/Kg||Then 70 ml/Kg|
|Infant (below 1 year)||In 1 hour||In 5 hours|
|Older (1 year or more)||In 30 minutes||In 2.5 hour|
3. To re-assess every 1 -2 hours and finally after 6 hrs (in case of infant) or 3 hrs (in case of older children) and then to choice appropriate plan (A/B/C) to continue treatment guidelines. If hydration is not improving, IV fluid should be given more rapidly.