Question

clinical dehydration scales have been used to assess the degree of dehydration in children with acute gastroenterritis and evaluate the response to therapy. do clinical dehydration scales have value in predicting length of stay and iv fluid needs in children 1-36 months? please discuss the dehydration scale and how it may or may not improve clinical outcomes

Answer 1

The CDS(clinical dehydration scales ) composed of four clinical findings these are--- general apperance ,mucous membrane,eyes,tears

each have a score of minimum 0 to maximum 2

for total score of 8

clinical features	score of 0	score of 1	score of 2
1,general apperance	Normal	thirst,lethargic but irritable when it being touch or sensitized	drowsy,cold,comatose(may or maynot be), sweaty
2, mucous membrane(usually tongue)	moist	sticky like	dry like
3, eyes	normal	slighly or minimal sunken	very or severe sunken
4,tears	normal tears	decreased tears	absent tears

Score of 0 means no dehydration

score of 1to 4 means mild dehydration

score of 5 to8 means moderate or severe dehydration( more the score more the dehydration level)

Prediction of length of stay  

  the length of stay known as a appearing in ED and time of seeing by a physician to the time of discharge .

there as no clear data or formula of length of stay determination but from the median legth of stay in ED we can say as seen that , children with no dehydraton has a length of 1 hour

child with mild dehydration has a length of 130 min

child with severe pr moderate dehydration has a length of 440 minutes

IV fluid requirement

iv fluid implimentation is not done according to legth of stay but according to weight

usually first 10 kg needs 4ml/kg per hour

next 10-20kg needs 2ml/kg per hour

any remaining weight over 20 kg needs 1ml/kg /hour

example--

a 10 kg wt child needs iv of 40 ml per hour

calculation- first 10 kg means 4ml/kg per hour x 10 kg = 40 ml per hour

similarly a 23 kg child needs iv of 63 ml per hour

calculation- first 10 kg means 4ml/kg per hour x 10 kg = 40 then second 10 kg means 2ml/kg per hour x 10= 20 then remaining 3 kg means 1ml/kf per hour x 3= 3

total = 40+20+3= 63 ml per hour