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Vomiting and diarrhoea in children under 5 NICE GUIDELINES

Vomiting and diarrhoea in children under 5 NICE GUIDELINES. Maria Cardona GP VTS Oct 2009. Diagnosis. Ask about Recent contact with someone with similar symptoms Exposure to known source of enteric infection Recent travel abroad. Look for:. Temperature >38 in under 3 months old

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Vomiting and diarrhoea in children under 5 NICE GUIDELINES

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  1. Vomiting and diarrhoea in children under 5NICE GUIDELINES Maria Cardona GP VTS Oct 2009

  2. Diagnosis • Ask about • Recent contact with someone with similar symptoms • Exposure to known source of enteric infection • Recent travel abroad

  3. Look for: • Temperature • >38 in under 3 months old • >39 in over 3 months old • SOB/tachipnoea • Altered conscious state • Neck stiffness • Bulging fontanele • Rash • Blood/mucous in the stool • Bilious vomiting • Severe / localised abdominal pain

  4. Stool sample • Indicated if • Septicaemia is suspected • Blood and/or mucous in the stool • Inmunocompromised • And maybe if • Recent travel abroad • Diarrhoea has not improved by day 7 • Uncertainty about diagnosis of gastroenteritis

  5. Stool sample If taken: Collect, store and transport as advised by lab Provide lab with relevant information If giving antibiotics:blood culture

  6. Assess dehydration • Beware increased risk of dehydration: • < 1 year • Low birth weight • >six diarrhoeal stools 24h • >3 episodes of vomiting • Infants who have stopped breastfeeding during illness • Signs of malnutrition • Children who have not been offered or have not tolerated fluids supplementation

  7. Management of non-dehydrated child • Continue breastfeeding or other milk feeds • Encourage fluid intake • Discourage juices/carbonated drinks • Offer oral rehydration salt

  8. Nutrition after rehydration • Give full-strength milk straight away • Reintroduce usual solid food • Avoid fruit juices/carbonated drinks until diarrhoea has stopped

  9. General advise • Most children can be safely managed at home • Information on recognising red flag symptoms, what to do if they are present • Diarrhoea usually last for 5-7 days and stops within 2 weeks • Vomiting usually lasts 1-2 days and stops within 3 days

  10. General advise • Encourage Hand washing • Do Not share towels • Do not attend school during illness and until 48 hours after the last episode of diarrhoea • Children should not swim in swimming pools for 2 weeks after last episode of diarrhoea

  11. Thank you

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