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Rehydration Therapy & IMCI . Dr. Shreedhar Paudel 03/30/ 2009. Oral Rehydration Therapy (ORT). Based on principle that– intestinal absorption of sodium (and thus of other electrolytes and water ) is enhanced by the active absorption of certain food molecules such as glucose.
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Rehydration Therapy & IMCI Dr. ShreedharPaudel 03/30/ 2009
Oral Rehydration Therapy (ORT) • Based on principle that– intestinal absorption of sodium (and thus of other electrolytes and water ) is enhanced by the active absorption of certain food molecules such as glucose.
Oral Rehydration Therapy (ORT)…… • If patients with secretory diarrhoea drink isotonic salt solution that does not contain a source of glucose or amino acids → sodium is not absorbed and the fluid remains in the gut→ adding to the volume of stool passed by the patient • But if isotonic solution of glucose and salt is given—glucose linked sodium absorption occurs accompanied by absorption of water & other electrolytes
New formulation of Oral Rehydration Salts (ORS) with reduced osmolarity
How to make ORS? • mixed in 1 litre of clean water • A family member should be taught to prepare and give ORS solution. • given to infants and young children using a clean spoon or cup • Feeding bottles should not be used
How to make ORS?........ • For babies, a dropper or syringe (without the needle) can be used to put small amounts of solution into the mouth • Children under 2 years of age should be offered a teaspoonful every 1-2 minutes • older children (and adults) may take frequent sips directly from the cup • Remember -- breastfeeding should be continued for infants and young children
Intravenous therapy • Severe dehydration • Preferred solution:- Ringer’s lactate solution • Supplies adequate concentration of sodium, lactate ( provides bicarbonate for correction of base deficit acidosis) • Potassium is low • No glucose to prevent hypoglycemia
Intravenous therapy…… • Acceptable solutions:- --normal saline --half normal saline • Unacceptable solution:- --plain glucose (dextrose) solution
Integrated Management of Childhood Illness • WHO/UNICEF strategy of Integrated Management of Childhood Illness – children below 5 years • IMCI strategy seeks to reduce childhood mortality and morbidity by adopting a broad, three-pronged approach: --Improving case management skills of health-care staff --Improving overall health systems --Improving family and community health practices
Integrated Management of Childhood Illness • Includes guidelines for diseases like:- • diarrhoea • acute respiratory infections (including asthma) • upper respiratory infections (including ear infections) • malnutrition • tuberculosis • HIV/Aids • measles
