Diarrhoea Control and Management (PDF)

ontrol of diarrheal disease ‫قيس إسماعيل‬  ASSESSMENT OF THE CHILD WITH DIARRHEA FOR THE DEGREE OF DEHYDRATION AND MANAGEMENT Degree of dehydration signs Mild Severe a. Look for General condition Restless, i...

ontrol of diarrheal disease ‫قيس إسماعيل‬  ASSESSMENT OF THE CHILD WITH DIARRHEA FOR THE DEGREE OF DEHYDRATION AND MANAGEMENT Degree of dehydration signs Mild Severe a. Look for General condition Restless, irritable Lethargic, floppy, unconscious, Eyes Sunken Deeply sunken and dry Tears on cry Absent Absent Mouth and tongue Dry Very dry Thirst Thirsty (drinks eagerly) Very thirsty but (drinks poorly or unable to drink) b. Feel for Skin pinch Goes back slowly, takes 1 to 2 Goes back very slowly, takes seconds more than 2 seconds c. Decide there is some dehydration. There is severe dehydration. d. Treatment Plan B Plan C With WHO recommended ORS With IV infusion urgently to solution to correct some correct severe dehydration and to dehydration. prevent death Fluid deficit is 5-10% of body weight > 10% of body weight  HOW CAN DIARRHOEA BE PREVENTED? PREVENTIVE STRATEGIES.  Sanitation - Hand washing - Exclusive breast feeding - Clean food  Environmental sanitation  Elimination of Reservoirs  Breaking the channel of transmissions  PREVENTION OF DIARRHOEA? ELIMINATION OF RESERVOIRS  Prevention of dehydration  Correction of dehydration  Maintenance of hydration  Chemotherapy  Restoration of Nutritional Status.  Diarrhoea- Leads to malnutrition  Increase in Breast feeding frequency  Increase in diet. A 3-year-old child, Ali, presents to the emergency department with a 3-day history of watery diarrhea. His mother reports that he has had decreased appetite and appears to be more tired than usual. There is no history of vomiting. Ali has had six to seven episodes of diarrhea per day. His mother has noticed that he has been very thirsty and drinks a lot of fluids when offered. Clinical Assessment: General Condition: Restless and irritable. Eyes: Sunken. Tears: Absent when crying. Mouth and Tongue: Dry. Thirst: Drinks eagerly when offered fluids. Skin Pinch Test: The skin goes back slowly, taking 1 to 2 seconds Diagnosis: Based on the above signs and symptoms, Ali is diagnosed with mild dehydration as a result of acute diarrhea. Management Plan: 1.Assessment of Dehydration: 1. Ali has some dehydration with a fluid deficit estimated to be 5-10% of his body weight. 2.Treatment Plan: 1. Plan B: Start treatment with WHO-recommended Oral Rehydration Solution (ORS) to correct the dehydration. Ali will be given ORS in small amounts frequently, as he is able to drink. 2. Prevention of Further Dehydration: 1. Encourage continued breastfeeding (if applicable) and regular feeding during the recovery period to prevent malnutrition. 1.Education and Prevention Strategies: 1. Educate the mother on the importance of proper hygiene practices, such as hand washing after using the toilet and before preparing food. 2. Recommend exclusive breastfeeding (for children under six months) to reduce the risk of future episodes of diarrhea. 3. Promote proper sanitation in the household to prevent the spread of infections causing diarrhea. Follow-Up: Ali will be reassessed in 24 hours to ensure improvement in hydration status. If his condition worsens or he develops signs of severe dehydration (such as lethargy, inability to drink, or deeply sunken eyes), he will need urgent intravenous (IV) fluids as per Plan C for severe dehydration. References WHO website Taylor CE, Greenough WB 3rd. Control of diarrheal diseases. Annu Rev Public Health. 1989;10:221-44. doi: 10.1146/annurev.pu.10.050189.001253. PMID: 2655632.