It refers to the loss of body water, with or without salt at a rate greater than the body can replace it. The cause of dehydration is a combination of physiological and disease processes. Persons at greatest risk for dehydration include persons with diarrhoea, vomiting, fever, diabetes or infections, impaired level status.
Table 1.2: Types of Dehydrations
Mild | Moderate | Severe | |
Consciousness | Is normal | May be irritable but is conscious | Unconscious |
Skin pinched up | Becomes normal immediately | Takes two seconds for folds to disappear | Remain in folds for over two seconds |
Eyes | Moist and tears are present | Sunken, tears and absent | Sunken and tearless |
Mouth | Not dry | Is dry | Is dry |
Note: In Severe dehydration there is also oliguria
Investigations
- Blood chemistry (to check electrolytes, especially sodium, potassium, and bicarbonate levels)
- Blood urea nitrogen (BUN)
- Full blood count (FBC)
- Creatinine
- Urine specific gravity
Other tests may be done to determine the cause of the dehydration (for example, blood sugar level to check for diabetes).
Non-Pharmacological Treatment
The treatment for minor dehydration often considered the most effective, is drinking water and stopping fluid loss.
Pharmacological Treatment
In more severe cases, correction of a dehydrated state is accomplished by the replenishment of necessary water and electrolytes.
A: Oral Rehydration salt (ORS)
OR
A: IV 0.9% Sodium Chloride
OR
A: IV Ringers Lactate solution
If there is no electrolyte loss; give
A: IV Dextrose solution 5%
Note: If the underlying disease condition is diagnosed; treat as per specific condition in guidelines.