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te diarrhoea
Prevention of dehydration (o utpa tien t)
F o llo w Treatment plan A to treat diarrhoea at home, W H O , pa ge 3 0 6 .
Treatment of dehydration
Moderate dehydration (a t d is pen s a ry level)
F o llo w Treatment plan B to treat dehydration, W H O , pa ge 3 0 8 .
Severe dehydration (a t ho s pita l level)
F o llo w Treatment plan C to treat severe dehydration quickly, W H O , pa ge 3 2 1 .
– I n the even t o f hypovolaemic shock o r if there is n o im pro vem en t a fter o n e ho ur:
in crea s e the in fus io n ra te.
– C heck fo r s ign s o f fluid o verlo a d : pa lpeb ra l o ed em a is the firs t s ign o f
o verhyd ra tio n .
S to p rehyd ra tio n un til o ed em a d is a ppea r.
– I f th ere a re s ign s o f a cute pulm o n a ry o ed em a ( la ryn gea l cra ckles , d ys pn o ea
an d
in crea s ed res pira tio n ra te, co ughin g w ith o r w itho ut fro thy s putum , d is tres s , b ila tera l
lun g crepita tio n s , ta chyca rd ia etc.), a d m in is ter IV furosemide im m ed ia tely a n d
repea t
a fter o n e to 2 ho urs if req uired :
C hild ren : 1 m g/ kg/ in jectio n
A d ults : 4 0 m g/ in jectio n
Special situations
Lactate ( R L ) o n t h e firs t d a y. R L po t a s s ium co n t en t is lo w . T h ere is a ris k o f
– C ho lera
I n the even t o f s evere d ehyd ra tio n , a n a d ult m a y req uire up to 1 0 to 1 5 litres o f
Ringer
s ym pto m a tic h ypo ka la em ia in pa tien ts exclus ively reh yd ra ted b y I V ro ute. T hus ,
s ta rt o ra l rehyd ra tio n s o lutio n (S R O ) a s s o o n a s po s s ib le in pa tien ts un d er
in fus io n .
– O ra l rehyd ra tio n a n d s evere m a ln utritio n
U s e s ta n d a rd rehyd ra tio n s a lts (S R O ) in cho lera pa tien ts o n ly. I n a ll o ther
ca s es , us e
R eS o M a l (s ee Severe acute malnutrition, pa ge 4 0 ).
zZininccsuslfuaptepPleOmentation (in children under 5 years)
Z in c s ulfa te is given in co m b in a tio n w ith o ra l rehyd ra tio n s o lutio n in o rd er to
red uce
the d ura tio n a n d s everity o f d ia rrho ea , a s w ell a s to preven t further o ccurren ces in the
2 to 3 m o n ths a fter trea tm en t:
C hild ren un d er 6 m o n ths : 1 0 m g o n ce d a ily (1 / 2 ta b let o n ce d a ily) fo r 1 0 d a ys
C hild ren fro m 6 m o n ths to 5 yea rs : 2 0 m g o n ce d a ily (1 ta b let o n ce d a ily) fo r 1 0
d a ys
Pla ce the ha lf-ta b let o r full ta b let in a tea s po o n , a d d a b it o f w a ter to d is s o lve it, a n d
give the en tire s po o n ful to the child .
D o n o t a d m in is ter th is trea tm en t if th e ch ild receives rea d y- to -us e thera peutic fo o d
(R U T F ) w hich a lrea d y co n ta in s zin c.
Prevention of malnutrition
Prevention of dehydration (o utpa tien t)
F o llo w Treatment plan A to treat diarrhoea at home, W H O , pa ge 3 0 6 .
Treatment of dehydration
Moderate dehydration (a t d is pen s a ry level)
F o llo w Treatment plan B to treat dehydration, W H O , pa ge 3 0 8 .
Severe dehydration (a t ho s pita l level)
F o llo w Treatment plan C to treat severe dehydration quickly, W H O , pa ge 3 2 1 .
– I n the even t o f hypovolaemic shock o r if there is n o im pro vem en t a fter o n e ho ur:
in crea s e the in fus io n ra te.
– C heck fo r s ign s o f fluid o verlo a d : pa lpeb ra l o ed em a is the firs t s ign o f
o verhyd ra tio n .
S to p rehyd ra tio n un til o ed em a d is a ppea r.
– I f th ere a re s ign s o f a cute pulm o n a ry o ed em a ( la ryn gea l cra ckles , d ys pn o ea
an d
in crea s ed res pira tio n ra te, co ughin g w ith o r w itho ut fro thy s putum , d is tres s , b ila tera l
lun g crepita tio n s , ta chyca rd ia etc.), a d m in is ter IV furosemide im m ed ia tely a n d
repea t
a fter o n e to 2 ho urs if req uired :
C hild ren : 1 m g/ kg/ in jectio n
A d ults : 4 0 m g/ in jectio n
Special situations
Lactate ( R L ) o n t h e firs t d a y. R L po t a s s ium co n t en t is lo w . T h ere is a ris k o f
– C ho lera
I n the even t o f s evere d ehyd ra tio n , a n a d ult m a y req uire up to 1 0 to 1 5 litres o f
Ringer
s ym pto m a tic h ypo ka la em ia in pa tien ts exclus ively reh yd ra ted b y I V ro ute. T hus ,
s ta rt o ra l rehyd ra tio n s o lutio n (S R O ) a s s o o n a s po s s ib le in pa tien ts un d er
in fus io n .
– O ra l rehyd ra tio n a n d s evere m a ln utritio n
U s e s ta n d a rd rehyd ra tio n s a lts (S R O ) in cho lera pa tien ts o n ly. I n a ll o ther
ca s es , us e
R eS o M a l (s ee Severe acute malnutrition, pa ge 4 0 ).
zZininccsuslfuaptepPleOmentation (in children under 5 years)
Z in c s ulfa te is given in co m b in a tio n w ith o ra l rehyd ra tio n s o lutio n in o rd er to
red uce
the d ura tio n a n d s everity o f d ia rrho ea , a s w ell a s to preven t further o ccurren ces in the
2 to 3 m o n ths a fter trea tm en t:
C hild ren un d er 6 m o n ths : 1 0 m g o n ce d a ily (1 / 2 ta b let o n ce d a ily) fo r 1 0 d a ys
C hild ren fro m 6 m o n ths to 5 yea rs : 2 0 m g o n ce d a ily (1 ta b let o n ce d a ily) fo r 1 0
d a ys
Pla ce the ha lf-ta b let o r full ta b let in a tea s po o n , a d d a b it o f w a ter to d is s o lve it, a n d
give the en tire s po o n ful to the child .
D o n o t a d m in is ter th is trea tm en t if th e ch ild receives rea d y- to -us e thera peutic fo o d
(R U T F ) w hich a lrea d y co n ta in s zin c.
Prevention of malnutrition
