You and your friend goes for a picnic to a hilly area. He has 5 to 6 episodes of loose stools. There is no fever, tachycardia or no other signs of dehydration. What should you do next?
ANS. BClassification of diarrhea based on severity in children and management.SignsClassify asIdentify treatment(Urgent pre-referral treatment are in bold print)Two of the following signs:* Lethargic or unconscious* Sunken eyes* Not able to drink or drinking poorly* Skin pinch goes back very slowlySevere dehydration* If child has no other severe classificationGive fluid of severe dehydration (Plan C)ORIf child also has another severe classificationRefer urgently to hospital with mother giving frequent sips of ORS on the way. Advise the mother to continue breastfeeding* If child is 2 years or older, and there is cholera in your area, give antibiotic for cholera.Two of the following signs:* Restless, irritable* Sunken eyes* Drinks eagerly, thirsty* Skin pinch goes back slowly.Some dehydration* Give fluid, zinc supplements and food for some dehydration (Plan B)* If child also has a severe classification:Refer urgently to hospital with mother giving frequent sips of ORS on the way. Advise the mother to continue breastfeeding* Advise mother when to return immediately* Follow-up in 5 days if not improving* If confirmed/symptomatic HIV, follow-up in 2 days if not improving* Not enough signs to classify as some or severe dehydrationNo dehydration* Give fluid, zinc supplements and food to treat diarrhea at home (Plan A)* Advise mother when to return immediately* Follow-up in 5 days if not improving* If confirmed/symptomatic HIV, follow-up in 2 days if not improving
Start a course of oral ofloxacin and onidazole
Give ORS solution with water
Take him to a nearby hospital
Start intravenous (IV) fluids
Fluid & Electrolyte