Diagnosis
- History- Patient may give a history of vomiting, diarrhea, heat exposure, fever.
- Physical examination- Inelastic skin, sunken fontanella, dry mouth and tongue, and in severe cases- decreased blood pressure and increased heart rate.
- Labs- Electrolyte imbalances which show increased sodium and potassium, with concentrated blood.
- Urine analysis- Dark colored urine can be seen. Ketone bodies also may be present in the urine and specific gravity may be elevated.
Causes of dehydration should be identified.
Treatment
The only treatment is to replace the fluid and electrolytes which is deficient. Treatment depends on the severity of dehydration and the age of the patient.
Mild dehydration can be treated by oral rehydration with electrolyte solution. If children and babies have diarrhea, they should have plenty of electrolyte fluids by mouth. These fluids should also supply glucose for energy. If there is both diarrhea and vomiting in young children, medical attention should be sought without delay. If electrolyte solutions are not available- this can be made at home by dissolving a half a teaspoon of salt, ½ teaspoon of baking soda, and 3 tablespoons of sugar in 1liter of boiled water. This solution can be used for temporary replacement. In babies, breast milk should be continued, and it is better to avoid lactose if bottle-fed. Plain water should also be avoided.
In sick adults, oral hydration with plain water is best. Avoid fruit juices. Dehydration in athletes, cool water and electrolyte solutions are recommended.
Severe dehydration should be treated in a hospital setting with intravenous fluids.
Prevention
Drinking at least 8 glasses of water per day helps keep patients hydrations. Increase intake in certain conditions, such as exercise, hot, humid weather, and fever.
Complications
1) Decreased blood supply to the brain, leading to confusion and coma.
2) Decreased blood supply to the kidney, leading to kidney failure.
3) Decreased blood supply to the vitals organs, leading to shock.
4) Electrolyte imbalance, leading to seizures, and heart abnormalities.
Dehydration does not occur suddenly, but it has to be detected early and treated aggressively to avoid life-threatening complication, especially in the very young and very old. |
