CHILD WITH ACUTE GASTROENTERITIS 6 months Old male child
Treatment
Doctor, my child is passing watery motions since morning and has vomited 3 times. He is crying almost continuously. Have a look at the baby.Does it look dehydrated with sunken eyeballs?Is it toxic? (My main worry is whether it is dehydrated and needs urgent & rapid fluid replacement) Has the child passed urine? Was it scanty or in sufficient quantity? "No, Doctor, it is passing very small amounts of urine” (That’s Grade II dehydration) Palpate the anterior fontanelle, if it is open. (Depressed fontanelle = dehydration > Grade I) Examine the Eyeballs. Are they sunken? Is the tongue dry?(if eyeballs are sunken, tongue is dry, it is Grade II dehydration) Pinch the skin over the abdomen and release it. (if the fold flattens very slowly, it is >Grade II dehydration) Inspect the perianal area for redness and skin excoriation. Instruct mother to dry the perianal area after each motion and apply siloderm (Zno) paste. Feel the pulse. Feeble pulse = Grade III i.e. severe dehydration. Other signs of severe dehydration = deep sighing respiration, semi-consciousness, anuria. Key points for Gastroenteritis: Degree of dehydration – skin turgor, dry tongue, sunken fontanelle, sunken eyeballs, scanty urine, weak pulse. Action: Orolyte Anti-diarrhoeals, anti-spasmodics, anti-emetics, antibiotics.Clean the nipple before feeding / Boil milk bottle or cup before ruse. I.V. fluids – since the dehydration is grade II. Give first Ringer’s lactate, then Isolyte-P as per formula.
