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Diarrhoea in Paediatrics PowerPoint Presentation

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Description : Download free Diarrhoea in Paediatrics PowerPoint presentation with slides on Diarrhoea in Paediatrics and Dehydration.

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Published on : Aug 17, 2017 | Views : 2790 | Downloads : 7

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Slide 1-

Dehydration As a complication of Diarrhoea in Paediatrics
Slide 2-

What is Dehydration? Dehydration is simply the excessive loss of body water resulting a decrease in total body water Total Fluid Loss > Total Fluid Intake There is a NET FLUID LOSS Fluid lost from both intravascular & extravascular compartments Intravascular loss – Hypovolaemia &  Serum osmolality Extravascular loss – Impairment of cellular function & Loss of tissue laxity Often there is an associated electrolyte loss with diarrhoea Sodium is the most affected electrolyte – Hypernatremia or Hypernatremia
Slide 3-

Types of Dehydration
Slide 4-

Assessment When you get a child with vomiting or diarrhoea always look for dehydration. What is there to look for…?? Is there any dehydration? If so how bad is it? Infants are at a higher risk of developing dehydration. Why? High surface area to weight ratio High basal fluid requirement Immature renal tubular reabsorption process Inability to gain access to fluids when thirsty
Slide 5-

Assessment
Slide 6-

Assessment
Slide 7-

Management Management of acute diarrhoea Prevention of Dehydration Management of Dehydration Maintenance of Nutrition Reducing the Duration of Diarrhoea Drug Treatment When to Discharge Parent Education Notification (if necessary) Post Gastroenteritis Syndrome / Lactose Intolerance
Slide 8-

Prevention of Dehydration Give the child more fluids than usual to prevent dehydration. Home based fluids & ORS should be used. As a guide approximately 50ml should be give after each stool or vomiting. Watch for the signs of dehydration.
Slide 9-

Management of Dehydration There are 3 pillars in management of dehydration. 1.) Correction of existing fluid deficit 2.) Replacement of ongoing losses 3.) Providing the normal daily requirement When you are seeing the child for the 1st time, a dehydrated child has already lost a portion of his total body water. This amount is called the “Existing fluid deficit”. Your 1st concern should be to replace that volume of fluid with in a reasonable time.
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Management of Dehydration (Existing fluid deficit – How do I find it?) Ex: existing loss of a 5kg weighing boy presented to you with “Some dehydration” is 250 to 500 ml. This amount should be given over first 4 hours of presentation. Unless the child is severely dehydrated or vomiting frequently & severely, this deficit should be preferably replaced orally with ORS. Vomiting does not prevent successful use of ORS.
Slide 11-

Management of Dehydration (Existing fluid deficit – if the child is severely dehydrated?) If the child’s level of consciousness is reduced airway, breathing & circulation should be assessed. Need parenteral (IV or IO) rapid fluid replacement. 100ml/Kg IV Hartmann solution (or Normal Saline) should be given as follows. Reassess the child in every hourly & increase the infusion rate if not improving.
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Management of Dehydration (deficit corrected – what now?) Even thought the fluid deficit is corrected the child is still losing fluids with each bout of vomiting & stool. This is called the “Ongoing Loss” Replacement of ongoing losses. Give 10-20ml of ORS or any other oral fluid for each bout of vomiting or stool. Depending on the stool volume or volume of vomitus fluid intake should be increased.
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Management of Dehydration Providing normal daily fluid requirement - Continue breast feeding as usual. - If on formula milk, continue the same volume in the same dilution. - Offer as much fluid as possible to drink in addition to ORS or parenteral fluid.
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Complications Hypovolemic shock Seizures Acute kidney injury Cerebral oedema Coma and death
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Reference ”Definition of dehydration” at medicine net National guidelines on “Management of gastroenteritis in children”, Ministry of Healthcare & Nutrition. Lissauer, Tom.Clayden, Graham. (Eds.) (2007) Illustrated textbook of paediatrics /Edinburgh ; Mosby/Elsevier
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