Management of a child with severe PEM having loose stools includes ________
Management of a child with severe protein-energy malnutrition (PEM) having stools includes Use of low sodium ORS for Rehydration 5ml/Kg every 30 min for first 2 hours. Donot give IV fluids unless the child is in shock Give ReSoMal (low sodium rehydration solution for malnutrition) 5ml/Kg every 30 min for first 2 hr orally or NasoGastric tube Then give 5-10 ml/Kg in alternate hours for upto 10 hr. The amount depends on stool loss and eagerness to drink. Feed in the other alternate hour. Give ReSoMal after each watery stool as preventive strategy. Treatment of hypoglycemia in malnutrition: If conscious: 10% glucose (50mL) or a feed or 1 teaspoon sugar under the tongue, whichever is the quickest. If unconsious : Immediately give sterile 10% glucose (5ml/Kg) by IV. Composition Low-osmolar ORS (mmol/L) ReSoMal(mmol/L) Glucose 75 125 Sodium 75 45 Potassium 20 40 Chloride 65 70 Citrate 10 7 Magnesium -- 3 Zinc -- 0.3 Copper -- 0.045 Osmolarity (mOsmol/L) 245 300 Ref: Nelson textbook of pediatrics 21st edition Pgno: 340,341
Initiation of IV fluids immediately
Administration of 50ml of 10% glucose orally, if unconsious
Continuation of aggressive hydration, even after dehydration resolves
Use of low-sodium oral rehydration solution (ORS) for rehydration 5 ml/Kg every 30 min for the first 2 hours
Nutrition