How can you recognise dehydration?

Dehydration develops when excessive amounts of fluid are lost from the body. Diarrhoea can rapidly lead to dehydration, especially if vomiting is also present. Both the history and the clinical examination are important in assessing whether a child is dehydrated.

In all children with diarrhoea the following signs must be looked for:

  • Offer the child a drink. Is the child able to drink? Is there increased thirst or a refusal to drink? Does the child vomit after drinking?
  • Is the child restless and irritable or lethargic or unconscious?
  • Are the eyes sunken?
  • Is the skin turgor (elasticity) decreased?
  • Is the infant’s fontanelle sunken?
  • Has there been a sudden weight loss?

In an attempt to keep the intravascular volume as normal as possible, interstitial and intracellular fluid is moved into the intravascular compartment (serum). This dehydrates the tissues resulting in loss of skin turgor, sunken eyes and a sunken fontanelle.

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