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 Post subject: Diarrhea, Dehydration and Re-hydrating
PostPosted: Wed Dec 13, 2006 1:46 am 
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Where There Is No Doctor
Chapter 13:

Go here to see entire PDF version: http://www.healthwrights.org/books/WTIND/Chapter_13.pdf


Dehydration results when the body loses more liquid than it takes in. This can happen with severe diarrhea, especially when there is vomiting too. It can also happen in very serious illness, when a person is too sick to take much food or liquid.

People of any age can become dehydrated, but dehydration develops more quickly and is most dangerous in small children.

It is important that everyone-especially mothers-know the signs of dehydration and how to prevent and treat it. Signs of dehydration:


    --thirst is often a first, early sign of dehydration
    --little or no urine; the urine is dark yellow
    --sudden weight loss
    --dry mouth
    --sunken, tearless eves
    --loss of elasticity or stretchiness of the skin

When a person has watery diarrhea, or diarrhea and vomiting, do not wait for signs of dehydration.

To prevent or treat dehydration: When a person has watery diarrhea, act quickly: Give lots of liquids to drink: Rehydration Drink is best. Or give a thin cereal porridge or gruel, teas, soups, or even plain water. Keep giving food. As soon as the sick child (or adult) will accept food, give frequent feedings of foods he likes and accepts. To babies, keep giving breast milk often-and before other drinks.

Give the dehydrated person sips of this drink every 5 minutes, day and night, until he begins to urinate normally. A large person needs 3 or more liters a day. A small child usually needs at least 1 liter a day, or 1 glass for each watery stool. Keep giving the Drink often in small sips, even if the person vomits. Not all of the drink will be vomited.

When the person is vomiting or feels too sick to eat, he should drink: watery mush or broth of rice, maize powder, or potato, rice water (with some mashed rice), chicken, meat, egg, or bean broth, Kool-Aid or similar sweetened drinks, REHYDRATION DRINK, Breast milk.

As soon as the person is able to eat, in addition to giving the drinks listed at the left, he should eat a balanced selection of the following foods or similar ones: ripe or cooked bananas, crackers, rice, oatmeal, or other well-cooked grain, fresh maize (well cooked and mashed), potatoes, applesauce (cooked), Papaya.

For most cases of diarrhea no medicines are needed. But in certain cases, using the right medicine can be important. However, many of the medicines commonly used for diarrhea do little or no good.


Last edited by Readymom on Sun Dec 31, 2006 10:05 pm, edited 1 time in total.

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 Post subject: 10 Things you should know about Rehydrating a child.
PostPosted: Wed Dec 13, 2006 1:55 am 
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From: Rehydration Project
http://rehydrate.org/solutions/homemade.htm

    1- Wash your hands with soap and water before preparing solution.
    2- Prepare a solution, in a clean pot, by mixing - one teaspoon salt and 8 teaspoons sugar or - 1 packet of Oral Rehydration Salts (ORS) - with one litre of clean drinking or boiled water (after cooled) Stir the mixture till all the contents dissolve.
    3- Wash your hands and the baby’s hands with soap and water before feeding solution.
    4- Give the sick child as much of the solution as it needs, in small amounts frequently.
    5- Give child alternately other fluids - such as breast milk and juices.
    6- Continue to give solids if child is four months or older.
    7- If the child still needs ORS after 24 hours, make a fresh solution.
    8- ORS does not stop diarrhoea. It prevents the body from drying up. The diarrhoea will stop by itself.
    9- If child vomits, wait ten minutes and give it ORS again. Usually vomiting will stop.
    10- If diarrhoea increases and /or vomiting persists, take child over to a health clinic.

Footnote: People often refer to home-prepared oral dehydration solutions as “home-brew.” This should be discouraged because the word brew implies: either fermenting which in fact is an obstacle to some home-prepared solutions especially those made with rice-powder or it implies boiling (as in tea) which, especially with sugar and salt or using packets of ORS, should not be done because it decomposes the sugar, or caramelises.

Measure carefully, too much sugar or salt can make diarrhea worse, that can be life threatening Global manufacturers of pre-packaged Oral Rehydration Salts are listed here http://rehydrate.org/resources/suppliers.htm and http://www.supply.unicef.dk/Catalogue/bulletin9.htm


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 Post subject: ORS: Frequently Asked Technical Questions
PostPosted: Wed Dec 13, 2006 2:00 am 
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New formulation of Oral Rehydration Salts (ORS) with reduced osmolarity February 2004 Frequently Asked Technical Questions Here is the list of questions it addresses.

For complete publication go here:
http://www.supply.unicef.dk/Catalogue/N ... ch_Q&A.pdf

What should we advise mothers to give at home to a child with diarrhoea, but who has no signs of dehydration?
Should I continue to breastfeed my child with diarrhoea?
Should we advise mothers to continue to feed a child who has diarrhoea?
What foods to give, how much and how often?

When should I take my child with diarrhoea to a health centre?
What should I do in case of vomiting?
What should I do in case of electrolyte disturbances in a child with diarrhoea?
What should I do if intravenous therapy is not available for a severely dehydrated child?
When should I suspect cholera in a child with diarrhoea?
How can I assess for dehydration in a severely malnourished child?
What should I do in case of fever in a child with diarrhoea?
What should I do in case of convulsions in a child with diarrhoea?
Should we give vitamin A to a child with diarrhoea?
Should we give zinc supplementation to a child with diarrhoea?
Can I give anti-diarrhoeal drugs to a child with diarrhoea?

EXCERPT from PDF Publication:

These agents, though commonly used, have no practical benefit and are never indicated for the treatment of acute diarrhoea in children. Some of them are dangerous.

What antimicrobials can be used with ORS in the clinical management of diarrhoea ?
How can we protect our water?
How important is handwashing?

What should we advise mothers to give at home to a child with diarrhoea, but who has no signs of dehydration? Give the child more fluids, or increased frequency of breastfeeding, than usual, to prevent dehydration What fluids to give Many countries have designated recommended home fluids. Wherever possible, these should include at least one fluid that normally contains salt (see below). Plain clean water should also be given. Other fluids should be recommended that are frequently given to children in the area, that mothers consider acceptable for children with diarrhea, and that mothers would be likely to give in increased amounts when advised to do so. Suitable fluids Most fluids that a child normally takes can be used. It is helpful to divide suitable fluids into two groups: Fluids that normally contain salt, such as:

    ORS solution
    Salted drinks (e.g. salted rice water or a salted yoghurt drink)
    Vegetable or chicken soup with salt
    Breastmilk


Teaching mothers to add salt (about 3g/l) to an unsalted drink or soup during diarrhoea is also possible, but requires a sustained educational effort. Fluids that do not contain salt, such as:

    plain water
    water in which a cereal has been cooked (e.g. unsalted rice water)
    unsalted soup
    yoghurt drinks without salt
    green coconut water
    weak tea (unsweetened)
    unsweetened fresh fruit juice.

Unsuitable fluids
A few fluids are potentially dangerous and should be avoided during diarrhoea. Especially risky are those drinks sweetened with sugar, which can cause osmotic diarrhoea and hypernatraemia. Some examples are:

[list]soft drinks
sweetened fruit drinks
sweetened tea.
Other fluids to avoid are those with stimulant, diuretic or purgative effects, for example:
coffee
some medicinal teas or infusions. /list]

How much fluid to give

The general rule is: give as much fluid as the child wants until diarrhoea stops. As a guide, after each loose stool, give:

children under 2 years of age: 50–100 ml (a quarter to half a large cup) of fluid; or one to two extra breastfeedings

children aged 2 up to 10 years: 100–200 ml (a half to one large cup);
older children and adults: as much fluid as they want.


Last edited by Readymom on Sun Dec 31, 2006 10:50 pm, edited 1 time in total.

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 Post subject:
PostPosted: Sun Dec 31, 2006 11:03 pm 
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From: Preparing for the Coming Influenza Pandemic
by Dr. Grattan Woodson, MD, Decatur GA, edited by David Jodrey, PhD.
(free pdf, 24 pp, 530 KB. Dec 20, 2005 )

http://www.fluwikie.com/annex/WoodsonMo ... c116746509

The ORS Solution, Page 18

Fluids: What will be much appreciated by a sick patient, especially if they are dehydrated, is a simple Oral Rehydration Solution (ORS) made from water, sugar and salt.

The ORS Formula
ORS is simply homemade IV fluids for oral use.

The formula is:

4 cups of clean water

3 tablespoons of sugar or honey

¼ tsp table salt[16],[17]

Identifying Dehydration: Preventing dehydration in flu victims will save more lives than all the other treatments combined. When patients have a fever or diarrhea, they lose much more water from the body than is commonly appreciated. Symptoms of dehydration include weakness, headache, and fainting. Signs of dehydration include dryness of the mouth, decreased saliva, lack or very decreased urine that is dark and highly concentrated, sunken eyes, loss of skin turgor (the elasticity of the skin), low blood pressure especially upon sitting up or rising from the sitting to the standing position and tachycardia (fast pulse) when laying or sitting up.

Fever is an especially easy way to become dehydrated with no one even noticing. That is because the loss of body fluid occurs through the skin and quickly evaporates. This is called insensible loss, and great quantities of fluid can escape a patient this way quickly. The smaller the body size and the higher the temperature, the faster this can happen. Water in the form of vapor is also lost through the breath. So when the patient is short of breath leading and breathing rapidly, this is another source of hidden fluid loss.

If you detect or suspect that dehydration is developing, administer fluids by mouth. If the patient is too ill to drink, someone should sit with the patient giving him or her fluids drop by drop if needed. Work up to using a teaspoon if possible. Don’t stop until the patient has been able to keep down at least quart of fluids. This could take several hours so be patient. It will have a dramatic effect on sick patient’s well being and will be very rewarding to those of you who persist because you just saved a life. After the first quart, the patient should begin to urinate again. This is a good prognostic sign and when this happens you can assume you have restored their fluid level back to a safer level. “Safer” should not be confused with safe. Don’t stop there. With sick patients like these, you really need to “push the fluids” so don’t let your guard down.

This will be very refreshing for the patient and will quickly revive them. Fluids can be served cool or hot depending on the climate, patient symptoms, and fever status. A patient with a high fever should probably not be given hot fluids because it will raise the temperature further. A patient with a sore throat will get relief from a hot beverage. A patient hot with fever might prefer cool or even cold beverage. If it is cold outside especially if the patient is cold, use hot fluids. You can drink the ORS plain or flavor it with just about anything like citrus, mint, or herbs.

If juice is available, you can substitute 1 cup of it for 1 cup of the water and cut the sweetener in half. Boil the solution to purify it if needed or you can use purify water for drinking by adding 1/8 tsp of household bleach to 1 gallon of water. Administering fluids to the sick in your charge will be one of the main activities day in and day out until the crisis passes. Try and get 2 to 3 quarts of fluids down the patient every day at a minimum. Don’t give up or slack off. Make this your most important task.

Preventing the virus and bacteria from spreading within the household
It is unlikely that we will be able to limit exposure to the virus if there are a lot of sick people around us. The flu is so easily passed from one person to the next that it is difficult to control even in the hospital setting. The WHO has issued guidelines for reducing exposure among healthcare workers taking care of rare cases of H5N1 flu under “non-pandemic” conditions in the hospital setting. It is not likely that these techniques will be able to be followed for very long after the pandemic gets going, especially in the case of a major pandemic. The WHO recommendations were published in the September 28, 2005 issue of the New England Journal of Medicine.[18] Under these pre-pandemic conditions the WHO recommends such things as negative pressure rooms, long-sleeved full-length gowns, gloves, and NIOSH N-95 masks, face shields or eye goggles.

Obviously these recommendations are not appropriate for home care. In truth, pandemic influenza is so infectious that those of taking care of sick folks in our homes are simply not going to be able to prevent being exposed to the virus. As we provide needed care to our family, friends and even sick strangers we will be constantly exposed to infectious viral particles. This will happen when we change soiled patient clothes and bedclothes and clean up spilled body fluids, blood, and excrement. Even simply breathing the air in the vicinity of the sick will result in significant exposure. So you see, we simply can’t avoid exposure. It is a fact we will have to accept. Use of a cloth facemask is not effective in preventing the mask wearer from becoming exposed. It is useful for preventing you from spreading disease to someone else. Masks were thought to be an effective means of preventing spread of bacterial pneumonia as secondary infections in patients with lungs already weakened by flu during the 1918 pandemic but this opinion was never proven scientifically.

It will be very important to keep the sick and their bed and bed clothing clean and dry. Likewise the sick rooms and bathrooms need to be maintained in good condition. The soiled garments and bedclothes will need to be washed and dried, a task likely to be made quite challenging by the lack of electrical and water service. It will be important to wash these soiled items in hot water using soap and chlorine bleach if possible. Hard surfaces should be wiped clean using soap and water and then sprayed with 1:10 bleach to water solution and wiped down a second time. This will effectively remove all trace of body fluids, vomitus, and excrement and neutralize all infectious viral particles.

So, care givers and anyone in the vicinity of the sick, which will be virtually everyone, will be exposed repeatedly to the pandemic virus loads sufficient to cause infection. Despite this fact, if this pandemic behaves as expected, roughly half of us will not develop symptoms of flu or if we do will have mild cases. Those of us who do develop infection and recover, will be immune from the pandemic strain in the future.


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 Post subject: The Oral Rehydration Solution
PostPosted: Wed Jan 10, 2007 1:14 am 
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From: Avian Flu Diary, Fla_Med-Wednesday, December 27, 2006, #264
http://afludiary.blogspot.com/2006/12/o ... ution.html

Dehydration, and severe diarrheal disease, particularly among children in the third world, is a massive killer. Recognizing this threat, more than 25 years ago the WHO (World Health Organization) came up with what is now called ORS, or an Oral Rehydration Solution.

Hundreds of millions of sachets, or packets of this powder, are shipped each year to various third world countries, and there is no doubt that their use has greatly decreased the loss of life due to cholera, dysentery, and other diseases.

In a Flu Pandemic, the need for ORS will be great throughout the world. In western societies, where modern medical care is common, IV’s are generally used instead of ORS. There are economic and psychological reasons for this, although many doctors argue that ORS would be just as effective for the majority of patients.


Dehydration, from a prolonged bout of flu; with it’s fever, vomiting, and diarrhea, can easily kill patients that might have otherwise survived the virus. As IV’s may well be in short supply, or simply unavailable during a pandemic, the use of ORS may well be the most beneficial treatment that most patients can receive. Certainly, with home care being the most likely venue for most patients, ORS will play a large role in the tratement of pandemic flu.


There are, however, conflicting opinions as to what constitutes the proper formula for making your own ORS. All formulas use a base of sugar and salt, in an appropriate ratio. Some formulas, however, add potassium and Sodium Bicarbonate.


A little Biochemistry


When the human body becomes dehydrated, it loses both water and essential electrolytes, particularly sodium. This condition can quickly become life threatening.


In the human body, fluids tend to move from a less salty environment to the saltier one. As an example, if someone drowns in fresh water, the water in the lungs is less salty than the blood, and so this water is quickly absorbed from the lungs into the surrounding tissues. If a person drowns in salt water, the water in the lungs is saltier than the blood, and so additional fluid is pulled into the lungs to `dilute’ the salt water. In other words, the body tries to balance both sides of the equation.


This is an important concept when dealing with rehydration therapy.
Ingesting plain water does not help restore the salt content of the body. But ingesting water with too much salt will draw fluids from the body, and make the dehydration worse.


While many believe the exact ratios of sugar and salt to be writ in stone, the truth is, if you have to err, err on the side of less salt.


Sugar is added to the ORS solution for two reasons. First, it was discovered in the early 1960’s that sugar helped with the transport of fluids across the cellular membranes in the bowel. In 1977, the British Medical Journal Lancet called this `possibly the most important medical discovery of the 20th century’.


Sugar also provides needed calories, and as a carbohydrate, can help prevent ketoacidosis from occurring.


But, as with salt, too much sugar can be detrimental, it can promote diarrhea, and make the loss of fluids worse.


This is one concern regarding the use of sports drinks, such as gatoraid, for rehydration therapy. Many of these commercially available mixtures simply have too much sugar.


Making your own ORS


The bottom line, of course, is how to make a cheap, safe, and effective ORS powder yourself.


The simplest formula is 3 Tablespoons of sugar, and 1 teaspoon of salt, dissolved in 1 quart of potable water.


An alternative simple formula is 8 teaspoons of sugar, and 1 teaspoon of salt, dissolved in 1 quart of potable water.

Image

This basic formula has been used effectively for more than 30 years by WHO, UNICEF, and other relief agencies and has saved millions of lives.


Over the past year, there has been some debate over the amount of salt and sugar in this formula. The old formula certainly works, and is safe. But some doctors have argued that a lower salt and sugar level might reduce fluid loss by curbing diarrhea.

I’ve elected to create single-serve packets of ORS powder, with each packet designed to be added to 1 liter of water. Two packets would be used for a 2-liter bottle.

I’ve located small, reclosable baggies, called bagettes sold at Michaels Art Supplies. You will find them in the bead section. Snack sized baggies, though lighter gauge plastic, would work as well. The small 2”x3” bagettes are just a little too small for the amount of powder required. You will need to go to the next size up, which are 3”x5”.


Along with these baggies, you will need table salt and sugar. I am electing to use non-iodized salt, although I am not aware of any reason why iodized salt would present a problem. The only other things you will need are measuring spoons and a felt tipped marker.


Into each baggie I am placing 3 TABLESPOONS of Sugar, and 1 TEASPOON of salt. These do not need to be mixed. I am writing on each Baggie “ORS POWDER- ADD TO 1 LITER OF WATER”.

This is the basic formula recommended by Dr. Grattan Woodson in his GOOD HOME TREATMENT OF INFLUENZA guide: http://www.birdflumanual.com/resources/ ... efault.asp

In his home medical guide, Dr. Woodson writes:



"Preventing or treating dehydration in people with flu will save more lives than any other intervention during the influenza pandemic."

Identification of dehydration

    When patients have a fever, vomiting, and/or diarrhea, they lose much more water from the body than is commonly appreciated. Symptoms of dehydration include weakness, dizziness, headache, confusion, and fainting. Signs of dehydration include dryness of the mouth, decreased saliva, lack of or very small urine volume that is dark and highly concentrated, sunken eyes, loss of skin elasticity, low blood pressure, especially upon sitting up or rising from the sitting to the standing position, and fast pulse rate, especially when moving from the lying to sitting or standing positions
[/list]

You may elect to add a flavoring to this mixture. Unsweetened Koolaid would add flavor and color, and make the drink more palatable to some. It might, however, prove to be an intestinal irritant to some people. I intend to leave mine unflavored, and will add koolaid to individual liters of solution if desired.


For roughly $15 here in the United States, you can buy 400 bagettes, 15 pounds of sugar, and a couple of pounds of salt, and have enough supplies on hand to make 100 gallons of ORS. Personally, I intend to make up at least 600 packets, so I will have plenty to hand out to neighbors who might need them.


I am figuring that a patient, over a week or two, might require as much as 10 gallons of ORS solution. For most adults, ingesting 3 to 4 liters a day would not be excessive. Patients that are very ill, may only be able to take a teaspoon at a time, but every attempt should be made to force fluids.


At 15 cents a gallon, the price is right. And for someone who is dehydrated, having this solution on hand can be lifesaving.

CAVEATS


You should never attempt to force fluids by mouth on anyone who is unconscious. An eye dropper may be used to slowly infuse liquids in semi conscious pateints but there is a risk of choking.


Better to dilute this powder too much, than too little. DO NOT SKIMP ON THE WATER.


For more complete information on oral rehydration fluids visit the Healthlink Worldwide webpage at

http://rehydrate.org/dd/su19.htm


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 Post subject:
PostPosted: Sun May 31, 2009 2:29 pm 
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Original post @ FluTrackers
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http://www.flutrackers.com/forum/showthread.php?t=16760

-snip- . . . . preventing dehydration will be the most important way to avoid a preventable death of a loved one or friend.

As Sally stated, the basic formula is 1 quart of water, 1 tsp of salt and 3 tbsp of sugar. What this amounts to is a physiologic solution that is very rapidly absorbed by the gut.

However, when I took my own medicine (the above recipe) it tasted too salty and was sweeter than I liked. If sick and given this to drink, well being stubborn I just might refuse. If you doubt me, mix this up and try it for yourself. If you do, it would be interesting to hear what you think.

Given my real world experience with ORS as prescribed by the WHO and others including me, I have modified my opinion.

First, the recommended ORS basically is an attempt to provide a physiologic salt and sugar solution orally in a proportion somewhat similar that that provided to patients with dehydration intravenously. It is certain that when sugar is given in addition to water and salt orally that there is improved absorption of all three and this is the essence of the prescriptions components.

What is important to understand about medicine is there are often many ways to successfully treat a serious condition like dehydration. For instance, it is perfectly OK the lower the salt and sugar content of the solution and still obtain excellent results. In fact if the ORS is more palatable to the patient then they are much more likely to take it.

When a patient is really sick with flu there are many ways you can enhance the ORS to make it more palatable to them. First is the temperature of the fluid. If they have a very sore throat, a heated fluid will help relieve the pain. If they have a high fever a cold fluid may prove to be more comforting. In some cases drinking room temperature fluid is preferred. The point is to kowtow to the patient's preferences to the extent possible since their life may depend on them drinking down as much fluid as possible.

Second, don't get hung up on the formula. It is too strong IMO. Way too salty and sweet. It is fine to reduce the salt and sugar content. It will still work great. What is important is they drink the stuff because if they don't they could die.

Caffeinated tea, coffee, or soda helps increase the fluid transfer through the lung, increases the function of the heart, kidneys, and colon and increases awareness. It is a time honored treatment for flu and other infectious diseases. So, simply add a pinch of salt to these beverages, sweeten then with sugar (no diet coke!) and enjoy.

A very good ORS recipe is using juice as the flavor and sugar source added to water and a bit of salt. For instance, 2 cups water, 2 cups juice, and 1/4 tsp salt. This ORS provides plenty of water and sugar but also potassium and sodium. The potassium can substitute for sodium with regards to enhancing water absorption in the presence of sugar. This is my preferred ORS because it tastes so much better to me.

In essence, what is important is not the quantity of salt and sugar but the amount of water given. Yes, to improve the absorption of water from the gut both salt and sugar need to be present but in fact there is a large range of acceptable concentrations of these two that still result in a good clinical recovery. So, don't get locked into a single mantra. There are many variations that also work quite well.

I wish to elaborate a bit on one point Sally made regarding the use of sodium bicarbonate. If the patient is dehydrated from fever then it is fine to use this source of sodium instead of table salt (sodium chloride) if this is all you have available. When doing so, use the flexible guidelines above because like salt, sodium bicarbonate is very salty. The caveat relates to the cause of the dehydration. If it is due to vomiting, sodium bicarbonate administrate will harm the patient because this cause of dehydration results in an excess of bicarbonate in the blood due to loss of chloride in the vomitus. So if your patient is vomiting, the best ORS has plain table salt as the sodium source since it provides both sodium and chloride.

OTOH, if the patient has diarrhea as the cause of dehydration they loose more bicarbonate than chloride. So when diarrhea is playing an important role, using sodium bicarbonate is preferred.

As you can see, it is a little complicated but not all that difficult to manage. I have spelled all this out in a pamphlet entitled Good Home Influenza Care which is widely available.

What is important is not to wait until your child, spouse, or friend comes down with severe flu and the medical establishment is unable to respond due to its being overwhelmed. You need to get the information for how to do this on your own within your own home now. What's more you need to stock up on the simple things like salt, sugar, sodium bicarb, aspirin, acetaminophen, Benadryl etc that you will need to care for people at home.

Recently I had the privilege of advising a mother of a 14 y/o with A (novel H1N1) on how to care for her at home. While sick, she was not ill enough to require hospitalization thank goodness and she recovered quite rapidly (Tamiflu worked wonders). The point in sharing this vignette with you is how totally distraught and disorganized her mother was when she called me for help. Why was this a surprise? Because her mother is someone who works in the medical field and has significantly more knowledge about pandemic influenza than 99% of the population. What she did not have was a plan. She was not prepared to deal with pandemic influenza occurring within her own household and affecting her only child.

The lesson here is the need for everyone, irrespective of how much you "know" about influenza, pandemics, etc to be ready, really ready to handle it if it shows up in your own home. When this happens, it will not be of any value to understand how just-in-time inventory management by industry has broken down or that there is no true surge capacity within the advanced nation's health care system. What will matter most is the lethargic febrile being lying totally defenseless in the bed in front of you. Their life may well depend on what steps you take right now. So, what are you going to do?

Don't wait until then to answer that question. That is all that I am saying.

Grattan Woodson, MD


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 Post subject: Re: Diarrhea & Dehydration
PostPosted: Tue Mar 09, 2010 7:00 pm 
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Dehydration

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UNITED STATES MARINE CORPS
Field Medical Training Battalion
Camp Lejeune

Manage Dehydration Casualties
http://www.operationalmedicine.org/Text ... T_1411.htm

TERMINAL LEARNING OBJECTIVE

1. Given a dehydration casualty in a combat environment and standard field medical equipment and supplies, manage dehydration casualties, to prevent further injury or death per the references. (FMST-HSS-1411)

ENABLING LEARNING OBJECTIVE

1. Without the aid of references, given a description or list, identify levels of dehydration, per the student handout. (FMST-HSS-1411a)

2. Without the aid of references, given a description or list, identify signs and symptoms of dehydration, per the student handout. (FMST-HSS-1411b)

3. Without the aid of references, given a description or list, identify predisposing factors for dehydration, per the student handout. (FMST-HSS-1411e)

4. Without the aid of references, given a description or list, identify treatments for various types of dehydration casualties, per the student handout. (FMST-HSS-1411c)

5. Without the aid of references, given a description or list, identify preventive measures for dehydration, per the student handout. (FMST-HSS-1411d)

6. Without the aid of references, given a description or list, identify the signs and symptoms of hyponatremia, per the student handout. (FMST-HSS-1411f)

7. Without the aid of references, given a description or list, identify the proper treatment of hyponatremia, per the student handout. (FMST-HSS-1411g) ---continued at link, above ----


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 Post subject: Re: Diarrhea, Dehydration and Re-hydrating
PostPosted: Fri Nov 26, 2010 12:53 pm 

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For Home Remedies For Diarrhoea are..A cheaper and equally as effective alternative to these rehydration preparations is to boil some rice in plenty of water, and then drink the water containing the juices of the rice. In addition, rice water contains maltodextrins and L-histidine, which act on the inside lining of the bowel and reduce the inflammatory processes that cause diarrhoea.


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 Post subject: Re: Diarrhea, Dehydration and Re-hydrating
PostPosted: Sun Jan 09, 2011 10:35 pm 
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Treatment

The Treatment of Diarrhoea:
A manual for physicians and other senior health workers. World Health Organization (WHO). 50 pages pdf

http://whqlibdoc.who.int/publications/2 ... 593180.pdf

Excerpt:
2. ESSENTIAL CONCEPTS CONCERNING DIARRHOEA

2.1 Definition of Diarrhoea

Diarrhoea is the passage of unusually loose or watery stools, usually at least three times in a 24 hour period. However, it is the consistency of the stools rather than the number that is most important. Frequent passing of formed stools is not diarrhoea. Babies fed only breastmilk often pass loose, "pasty" stools; this also is not diarrhoea. Mothers usually know when their children have diarrhoea and may provide useful working definitions in local situations.

2.2 Clinical types of diarrhoeal diseases

It is most practical to base treatment of diarrhoea on the clinical type of the illness, which can eaasily be determined when a child is first examined. Laboratory studies are not needed. Four clinical types of diarrhoea can be recognized, each reflecting the basic underlying pathology and altered physiology:

* acute water diarrhoea (including cholera), which lasts several hours or days: the main danger is dehydration; weight loss also occurs if feeding is not continued;

* acute bloody diarrhoea, which is also called dysentery: the main dangers are damage of the intestinal mucosa, sepsis and malnutrition; other complications, inclulding dehydration, may also occur.

* persistent diarrhoea, which lasts 14 days or longer: the main danger is malnutrition and serious non-intestinal infection; dehydration may also occur;

* diarrhoea with severe malnutrition (marasmus or kwashi orkor): the main dangers are severe systemic infection, dehydration, heart failure and vitamin and mineral deficiency.

The management of each type of diarrhoea should prevent or treat the main danger(s) that each presents.

2.3 Dehydration

During diarrhoea there is an increased loss of water and electrolytes (sodium, chloride, potassium and bicarbonate) in the liquid stool. Water and electroyltes are also lost through vomit, sweat, urine and breathing. Dehydration occurs when these losses ar not rplaced adequately and a deficit of water and electroyltes developes.

{snip}

In the early stages of dehydration, there are no signs or symptoms.

As dehydration increases, signs and symptoms develop. Initially these include: thirst, restless or irritable behaviour, decreased skin turgor, sunken eyes and sunken fontanelle (in infants)

In severe dehydration, these effects become more pronounced and the patient may develop evidence of hypovolaemic shock, including: diminished consciousness, lasct of urine output, cool moist extremities, a rapid and feeble pulse (the radial pulse may be undetectable), low or undetectable blood pressure, and peripheral cyanosis. Death follows soon if rehydration is not started quickly.

See above linked artcle for continued information ....


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 Post subject: Re: Diarrhea, Dehydration and Re-hydrating
PostPosted: Mon Jul 25, 2011 2:55 pm 
Site Admin

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From the Mayo CLinic:

Image


Dehydration-Treatments and drugs
By Mayo Clinic staff

http://www.mayoclinic.com/health/dehydr ... -and-drugs

The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause.

(Snip)

In an emergency situation where a pre-formulated solution is unavailable, you can make your own oral rehydration solution by mixing 1/2 teaspoon salt, 6 level teaspoons of sugar and 1 liter (about 1 quart) of safe drinking water. Be sure to measure accurately because incorrect amounts can make the solution less effective or even harmful. If possible, have someone else check your measurements for accuracy.

Whatever alternative you chose, be sure to give enough solution. Your doctor may suggest specific amounts, depending on your child's age and degree of dehydration, but a general rule of thumb is to keep giving liquids slowly until your child's urine becomes clear in color. When your child is vomiting, try giving small amounts of solution at frequent intervals — try a spoonful or so every few minutes, for instance. If your child can't keep this down, wait 30 to 60 minutes and try again. Room temperature fluids are best.


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