Assess the child with diarrhoea for signs of dehydration
There are three possible classifications of dehydration:
Classify the child's dehydration:
Counsel the mother on the 4 rules of home treatment.
Give recommended amounts of ORS over a 4 hour period
FOLLOW THE ARROW, IF ANSWER IS “YES”, GO ACROSS, If “NO”, GO DOWN Diarrhoea could be:
Classify the child with PERSISTENT DIARRHOEA if the child has had diarrhoea for 14 days or more. Classify the child with SEVERE PERSISTENT DIARRHOEA if the child had diarrhoea for 14 days or more and the child has some or severe dehydration. Classify the child as having DYSENTERY the child has diarrhoea and blood in the stool. Classify the child as having CHOLERA if it is known that there is an on-going cholera epidemic in the area and the child has watery diarrhoea. Cholera should be suspected when a child older than 5 years or an adult develops severe dehydration from acute watery diarrhoea, or when any patient older than 2 years has acute watery diarrhoea when cholera is known to be occurring in the area. Younger children also can develop cholera but the illness may be difficult to distinguish from other causes of acute watery diarrhoea. A child with PERSISTENT or SEVERE PERSISTENT DIARRHOEA needs both fluid and nutrition.
A child with DYSENTERY1 needs antibiotics and fluid.
A child with CHOLERA needs fluid. Fluid replacement is the mainstay of cholera management. Antibiotics can be administered in addition to fluids if the cholera is severe.
1 In some countries, the major cause of dysentery might be amoebic dysentery. In this case, you need to use metronidazole. |