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Friday, April 10, 2020

Discharge Instructions - Pediatric Dehydration


As discussed in the Emergency Department prior to discharge, your child has been diagnosed with dehydration.  Dehydration is the term doctors use when the body loses too much water.  Losing too much water is a problem, because the body needs a certain amount of water to work normally.  Another word doctors sometimes use is "hypovolemia."

Dehydration can be mild or severe.  Mild dehydration doesn't usually cause problems.  But if mild dehydration isn't treated, it can get worse.  Severe dehydration is a medical emergency and can be life-threatening.

Children are at higher risk for dehydration than adults.  There are a few reasons for this:
-Their bodies are smaller
-They are more likely to get viruses that cause vomiting and diarrhea, which can lead to dehydration.
-Babies and young children depend on adults to give them liquids, and might not be able to tell someone if they are thirsty.

Dehydration happens when your body loses more water than you take in from drinking and eating.
It's normal for people to lose some water from their bodies every day, for example, in their urine and bowel movements.  But some things make people lose a lot of water. In children, this can include: vomiting, diarrhea, a high fever, and problems or medicines that cause a person to urinate more than usual.

Some things keep people from taking in enough water.  For example, children might not drink or eat if they have an upset stomach or sore throat.

As dehydration gets worse, it can cause symptoms such as:
    -Feeling thirsty
    -Urinating less often, or having dark yellow or brown urine
    -A dry mouth or cracked lips
    -No tears when the child cries
    -Feeling tired or confused
    -Feeling dizzy or light-headed
    -Eyes that look sunken in the face
    -A "sunken fontanel" in babies – A fontanel is a gap between the bones in a baby's skull. When babies are dehydrated, the fontanel on the top of their head can look or feel caved in.

Severe dehydration can make people stop breathing normally or go into a coma.

Dehydration is treated with fluids.  Children with severe dehydration usually need to be treated in the hospital.  Treatment might involve getting fluids through an "IV," which is a thin tube that goes into the vein, or getting small sips of a special fluid designed for children with dehydration.

If your child only has mild dehydration, you can also treat it by giving them fluids to drink.  You'll know that the treatment is working when:
    -Your child urinates more often and the urine looks pale yellow or clear.
    -Your baby has more wet diapers.

Some fluids help treat dehydration better than water, because they give the body the right amount of water and salts.  You should use the following fluids to treat your child's dehydration:
  -Oral rehydration solutions – These are special drinks meant to help with dehydration, such as Pedialyte.  You can buy them in a store or pharmacy.  Try to give your child a few teaspoons of fluid every few minutes.  If your baby won't drink it from a bottle or cup, you can feed him or her with a spoon or syringe.
  -Breast milk – Babies who breastfeed should continue to breastfeed.
  -Apple juice mixed with an equal amount of water mixed into it.

The child can return to their normal diet once they are no longer dehydrated.  Keep giving extra fluids if your child's vomiting or diarrhea continues.

Return to the Emergency Department if your child has diarrhea that lasts more than a few days, has vomiting that lasts more than 1 day, can't keep any fluids down, vomits blood or has bloody diarrhea, hasn't had anything to drink in many hours, hasn't needed to urinate in the past 6 to 8 hours (in older children), or hasn't had a wet diaper for 4 to 6 hours (in babies and younger children), or for any new or concerning symptoms.

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