maalaaak2000
Forum Junior
Topics: 13
Posts: 26
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Hi there:
I want to know how to calculate dehydration management in children.
Thank u.
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| smitha
Forum Elite
Topics: 53
Posts: 236
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Well maalaaak, the Qregarding this dehydration and mgt is always small but the answer is always big..........  So, lemme see how far i can help u...................
To start with......Any child brought in hypovolemic shock, shud first be given 20ml/kg isotonic fluid STAT and then reassess and give again, if needed!!!!!!!!!!!!!
Now, fluid management/repletion shud always consist of replacing the DEFICIT+MAINTENANCE+ONGOING LOSSES(if any)..........
go step by step now, after attending the immediate shock state described as above.............
1. Assess the amount of dehydration...........
MILD MODERATE SEVERE
INFANT 5% 10% 15%
ADOLESCENT 3% 6% 9%
This is how u designate the percentages for particular amount of dehydration according the s/s(s/s of mild , moderate and severe dehydration, which we know already)!!!!!!!!!
2. Calculate the pre-illness weight (if NOT GIVEN)
SAY for example, if the dehydration is MODERATE, AND THE PRESENT WEIGHT IS 5.5KGS............
so, vol of fluid before illness------100
vol of fluid now-----------------90 (coz, the dehydration is 10%, WHICH IS NOTHING BUT 90/100 when taken off)
weight NOW------5.5kgs
weight before illness----X(don't know)
so, now --------100------>90
X------->5.5
= 90X/ 5.5x100 ; OR X= 550/90 =6kgs.
So, weight before illness is 6 kgs.
3.Now, calculate the total volume to be replaced.......
DEFICIT: 1000ml/KG(of difference in weight) = 1000x0.5kg(difference)
= 500ml.
MAINTENANCE: 0-10kg---->100ml/kg
11-20kg---->1000ml + 50ml/kg for each kg >10kg
>20kg ----->1500ml+20ml/kg for each kg >20kg
so, for example, in the above pt. with that wt. ...........
100mlx 6(preillness wt.)= 600ml.
so, TOTAL VOLUME HERE IS------500+600 = 1100ML (IN THE ABOVE CASE)
---ADD THE ONGOING LOSSES, IF PRESENT IN A PATIENT.
---DEDUCT THE STAT FLUIDS U GAVE AS SOON AS THE PATIENT CAME AND THEN CALCULATE THE DEFICIT AND MAINTENANCE AND THEN GIVE.........
----REPLACE 50% DEFICIT IN FIRST 8HRS AND OTHER 50% IN NEXT 16HRS
----REPLACE MAINTENANCE FLUIDS ALONG WITH DEFICIT OVER 24HRS
-----IF SODIUM LEVEL IS HIGH, THEN REPLACE DEFICIT IN 48HRS AND NOT 24HRS, AS SAID ABOVE
-----SODIUM SHUDN'T BE LOWERED FASTER THAN 10MEQ/L/D.
FLUIDS OF CHOICE USED-------
0.2% NACL 5%D-------HYPERNATREMIC DEHYDRATION
0.33%NACL 5%D------ISONATREMIC DEHYDRATION
0.45%NACL 5%D------HYPONATREMIC DEHYDRATION
----POTASSIUM AND OTHER ELECTROLYTES R REPLACE DACCORDING THEIR VALUES..........(POTASSIUM-----20MEQ/L).
Hope that helps u maalaaak!!!!!!!!!!!!!!
Correct me if iam wrong!!!!!!!!!!!!
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| maalaaak2000
Forum Junior
Topics: 13
Posts: 26
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Thank you Samintha for this explanation. Where can I read about dehydration management and calculation in children.
Yours......
maalaaak
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| smitha
Forum Elite
Topics: 53
Posts: 236
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ur welcome maalaaak............but kindly spell my name correctly..................iam SMITHA not SAMINTHA..........
thanx!!!!!!!
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| maalaaak2000
Forum Junior
Topics: 13
Posts: 26
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SMITHA
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