Acute Diarrhoeal Diseases - Clinical Features and Management

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Slide 8 - The importance of the glucose in the solution is shown here.

The importance of the glucose in the solution is shown here. It enhances the absorption of sodium and water in the intestine so that, even though the ingestion, of isotonic saline alone can worsen diarrhoea, when glucose is present electrolytes and water are absorbed and dehydration is corrected.

Signs and symptoms Mild dehydration Moderate dehydration Severe dehydration
General appearance and condition
- infants and young children
Thirsty; alert; restless Thirsty; restless, or lethargic but irritable when touched Drowsy; limp, cold, sweaty, cyanotic extremities; may be comatose
- older children and adults Thirsty; alert; restless Thirsty; alert; giddiness with postural changes Usually conscious; apprehensive; cold, sweaty cyanotic extremities; wrinkled skin of fingers and toes; muscle cramps
Radial pulse Normal rate and volume Rapid and weak Rapid, feeble, sometimes impalpable
Respiration Normal Deep, may be rapid Deep and rapid
Anterior fontanelle Normal Sunken Very sunken
Systolic blood pressure Normal Normal - low Less than 10,7 kPa (80mmHg); may be unrecordable
Skin elasticity Pinch retracts immediately Pinch retracts slowly Pinch retracts very slowly (>2 seconds)
Eyes Normal Sunken Deeply sunken
Tears Present Absent Absent
Mucous membranes Moist Dry Very dry
Urine flow Normal Reduced amount and dark None passed for several hours; empty bladder
% body weight loss 4-5% 6-9% 10%, or more

*Source: A Manual for the Treatment of Acute Diarrhoea, unpublished document WHO/CDD/SER/80.2(1980)

Rehydration Project

Slide set created by WHO

updated: 4 July, 2014