Chart 13. Diarrhoea treatment plan C: Treat severe dehydration !
➞ $ollo% the arro%s. If the ans%er is YES& 'o a"ross. If NO& 'o do%n.
Can yo! 'ive intraveno!s (I() fl!id immediately) YES
*tart I( fl!id immediately. If the "hild "an drin#& 'ive +,* -y mo!th %hile the drip is -ein' set !p. .ive 100 ml/#' ,in'er0s la"tate sol!tion (or& if not avail1 a-le& normal saline)& divided as follo%s:
Age First give 30 Then give 70 ml/ kg in: ml/ kg in:
Infants (< 12 months) Children (12 months to 5 years)
1 ha 30 mina
5h 2.5 h
,epeat on"e if radial p!lse is still %ea# or not dete"ta-le
■ ,eassess the "hild every 15330 min. If hydration stat!s is not improvin'& 'ive the I( drip more rapidly. 2lso %at"h for over1hydration. 2lso 'ive +,* (a-o!t 5 ml/#' per h) as soon as the "hild "an drin#: !s!ally after 33 4 h (infants) and Is I( treatment 132 h ("hildren). YES ■ ,eassess an infant after 5 h and a "hild after 3 h. availa-le near-y %ithin Classify dehydration. Then "hoose the appropriate 30 min) plan (2& 6 or C) to "ontin!e treatment.
NO 2re yo! trained to !se a naso'astri" t!-e for rehydration) NO Can the "hild drin#) NO ,efer !r'ently to hospital for I( or naso'astri" treatment.
,efer urgently to hospital for I( treatment. If the "hild "an drin#& 'ive the mother +,* sol!tion& and sho% her ho% to 'ive fre !ent sips d!rin' the trip.
*tart rehydration -y t!-e (or mo!th) %ith +,* sol!1 tion: 'ive 20 ml/#' per h for 5 h (total& 120 ml/#'). ■ ,eassess the "hild every 132 h: 3 If there is repeated vomitin' or in"reasin' a-domi1 nal distension& 'ive the fl!id more slo%ly. 3 If hydration stat!s is not improvin' after 3 h& send the "hild for I( therapy. ■ 2fter 5 h& reassess the "hild and "lassify dehydra1 tion. Then& "hoose the appropriate plan (2& 6 or C) to "ontin!e treatment.
Note: If possible, observe the child for at least 6 h after rehydration to be sure the mother can maintain hydration by giving the child ORS solution by mouth.