Dehydration – Diagnosis & treatment

Diagnosis

Your doctor can often diagnose dehydration on the basis of physical signs and symptoms. If you’re dehydrated, you’re also likely to have low blood pressure, especially when moving from a lying to a standing position, a faster than normal heart rate and reduced blood flow to your extremities.

To help confirm the diagnosis and pinpoint the degree of dehydration, you may have other tests, such as:

• Blood tests. Blood samples may be used to check for a number of factors, such as the levels of your electrolytes — especially sodium and potassium — and how well your kidneys are working.
• Urinalysis. Tests done on your urine can help show whether you’re dehydrated and to what degree. They also can check for signs of a bladder infection.

More Information

Treatment

The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause.

For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an over-the-counter oral rehydration solution. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes.

Start with about a teaspoon (5 milliliters) every one to five minutes and increase as tolerated. It may be easier to use a syringe for very young children. Older children can be given diluted sports drinks. Use 1 part sports drink to 1 part water.

Most adults with mild to moderate dehydration from diarrhea, vomiting or fever can improve their condition by drinking more water or other liquids. Diarrhea may be worsened by full-strength fruit juice and soft drinks.

If you work or exercise outdoors during hot or humid weather, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful.

Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room. Salts and fluids delivered through a vein (intravenously) are absorbed quickly and speed recovery.

Preparing for your appointment

You’re likely to start by seeing your or your child’s doctor. However, in some cases when you call to set up an appointment, the doctor may recommend urgent medical care. If you, your child or an adult who you care for is showing signs of severe dehydration, such as lethargy or reduced responsiveness, seek immediate care at a hospital.

If you have time to prepare for your appointment, here’s some information to help you get ready, and what to expect from the doctor.

What you can do

• Write down any symptoms you or the person you’re caring for is experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. If you or the person you’re caring for has been vomiting or has had diarrhea, the doctor will want to know when it began and how frequently it’s been occurring.
• Write down key personal information, including any recent trips taken or foods recently eaten that might have caused illness. In addition, your doctor will want to know if you or the person you’re caring for has recently been exposed to anyone with diarrhea.
• Make a list of key medical information, including other conditions you or the person you’re caring for is being treated for and the names of the medications being taken. Include on your list prescription and over-the-counter drugs, as well as any vitamins and supplements.
• Write down questions to ask your doctor.

For dehydration, some basic questions to ask the doctor include:

• What’s causing these symptoms?
• What kinds of tests are needed?
• What treatment do you recommend?
• How soon after treatment will there be improvement?
• Are there any activity or dietary restrictions?
• Is there anything I can do to prevent a recurrence of dehydration?
• I have other health conditions. Do I need to change the treatments I’ve been using for them?
• What steps can I take to prevent dehydration from happening again?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• When did the symptoms begin? What were you doing?
• Are you able to keep down any food or drink?
• How recently have you urinated? Are you experiencing any pain or urgency with urination?
• Do you also have other signs or symptoms, such as abdominal cramping, fever, headache or muscle aches? How severe are these signs and symptoms?
• Has there been blood in your stools?
• Have you recently eaten any food that you suspect was spoiled?
• Has anyone gotten sick after eating the same food that you did?
• Have you recently been exposed to someone who you know was experiencing diarrhea?
• Have you been coughing or had a runny nose?
• What medications are you currently taking?
• Have you recently traveled to another country?
• Do you know what your or your child’s weight was before symptoms started?

Dehydration Treatment – Oral Rehydration Therapy and Fluid Replacement

Written by WebMD Editorial Contributors

• Is Drinking Water Enough?
• What to Do for a Dehydrated Child

You can become dehydrated for many different reasons. It could be from sweating too much. Vomiting or diarrhea can quickly remove fluids from your body, too. So can medicines that make you pee a lot.

All of these things can cause you to lose more water and electrolytes (essential minerals in your blood and body fluids) than are good for you. If you don’t have enough, your body has trouble doing the things it’s supposed to do.

There’s really only one way to treat dehydration — replace the fluids and electrolytes your body has lost.

For a mild case, it should be enough just to drink plenty of fluids. Water is your first choice, but there are lots of special drinks on the market that will help you replace your body’s lost water and electrolytes.

If you can’t get a pre-mixed rehydration solution, don’t try to make one yourself. Instead, replace lost fluids naturally with sips of water, fruit juice, crushed fruit mixed with water, or salty soups or broths.

Fruit juices may upset your stomach, so it’s best to dilute them with water. Avoid coffee, tea, soda, and alcoholic drinks. They’re diuretics, which means they can dehydrate you more because they all pull water from your body.

If your dehydration is serious, you may need to see a doctor to get treated with intravenous (IV) fluids. Severe dehydration may require you to go to the hospital. You should get medical attention immediately if you:

• Haven’t peed in 8 hours
• Have had a seizure
• Are disoriented or confused
• Have a weak or rapid pulse
• Feel very tired
• Feel dizzy when you stand
• Are too sick (nauseated or vomiting) to take in fluids

If your baby or child becomes dehydrated (usually because of a fever, vomiting or diarrhea), treatment with an oral rehydration solution is your best bet. There are several over-the-counter options (Hydralyte and Pedialyte), which will give your child the right balance of electrolytes and salts.

Try giving small sips or by the teaspoon to begin with. You may even need to use a syringe if they’re having trouble drinking. For an older child, sports drinks diluted with water are the best treatment. Again, start with small sips and give them more as they show they can tolerate it.

For an infant, give plenty of breast milk and formula, but don’t give fruit juices if they are vomiting or have diarrhea. They can make it worse.

Dehydration can be serious in a baby or young child. If you notice these signs, see a doctor right away:

• Extreme sleepiness
• Less responsive than usual
• Few wet diapers
• Cold and blotchy hands and feet
• No tears when crying
• Dark yellow pee
• Very dry mouth

Usually, dehydration is easy to treat at home if you get out of the heat and drink plenty of liquids. But once you’re thirsty, you’re probably already dehydrated, so it’s best to drink plenty of fluids regularly.

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Dehydration and its symptoms

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Dehydration percentage:

• 1% – intense thirst, headache, general malaise;
• 5% – dizziness, nausea, fatigue, shortness of breath;
• 10% – convulsions, cell death;
• 20% – death.

1

During illness, especially in case of poisoning and SARS, drink much more than usual, and not only hot tea, popular in such situations, but also just clean water;

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2

When exercising and in hot weather, also increase the intake of water that is lost through sweat;

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3

Don’t tolerate being thirsty – always have a small bottle of water with you. And even better – a stylish and compact AQUAPHOR City filter bottle.

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symptoms, causes, complications, treatments

1. How dehydration occurs
2. Causes of dehydration
3. Additional factors
4. What happens when you get dehydrated
5. Dehydration types
6. Symptoms
7. Diagnostics
8. Treatment for dehydration
9. Prophylaxis
10. Making a rehydrating solution at home

Image by Freepik

Dehydration is a state of increased loss of moisture from the body. Otherwise, this condition is called dehydration or exsicosis. It is characterized by thirst, dry skin, decreased urine output. As the moisture deficit increases, the patient’s blood pressure decreases, the skin becomes pale, there are disturbances in consciousness, pathological changes in the blood composition – an increase in hematocrit. This is the name for an increase in the volume of red blood cells relative to the volume of the liquid part of the blood.

Dehydration is a dangerous condition in which the body needs an urgent restoration of water and electrolyte balance.

How dehydration occurs

Dehydration occurs when the liquid drops to 40–50 ml/kg. In this case, body weight decreases by 4-5% due to the loss of water. In the body, it is found in the blood, cells of organs and tissues, and intercellular space. If water loss as a result of exsicosis reaches 20-25%, tissue ischemia begins – a violation of the blood supply to organs and tissues due to an increase in hematocrit.

Causes of dehydration

Exicosis most often occurs against the background of various diseases and pathological conditions. Among them:

• intestinal infections that cause vomiting and upset stools;

• burns of the second or more degree, in which there is an extensive release of exudate;

• diseases that are accompanied by fever and increased sweating;

• insufficient fluid intake with food;

• diseases accompanied by shortness of breath, in which the body loses moisture due to the release of water vapor.

The most common cause of dehydration is intestinal infections. Up to 48% of all clinical cases of exsicosis are associated with such diseases. They pose the greatest danger to young children. Frequent vomiting and loose stools lead to rapid loss of moisture, which causes dehydration. In countries with a low standard of living and a high incidence of intestinal infections, excoses are one of the main causes of death in young children under the age of 5–6 years.

With extensive burns, a large amount of exudate is released. If the patient does not receive fluid replacement therapy, a fluid deficiency develops.

Increased sweating at elevated body temperature requires control of the drinking regimen. This is especially important if the patient is in a warm room.

Insufficient fluid intake with meals can lead to dehydration if a person voluntarily or deliberately restricts drinking. About one and a half liters of water the body loses per day with sweat, defecation and urination. If the fluid intake is below normal, exsicosis develops.

Dehydration associated with shortness of breath occurs in patients with respiratory and cardiac pathologies. This phenomenon in healthy people is observed when traveling to high mountainous areas due to changes in the composition of the air.

Additional factors

Even healthy people who live in hot regions, do intensive sports or physical labor in hot weather, and stay in the mountains face a moisture deficiency in the body. To avoid dehydration, it is necessary to consume enough water, fresh vegetables and fruits.

Patients taking diuretics and people on mechanical ventilation are also at risk. To prevent exsicosis, patients on mechanical ventilation are injected with saline solutions and moisten the respiratory mixture that enters the body.

What happens when you get dehydrated

When the body loses a lot of moisture, blood viscosity changes first of all. It increases against the background of a decrease in plasma volume. This negatively affects the blood supply to organs and tissues, including the brain. Dehydration leads to an electrolyte imbalance, a decrease in the amount of mineral salts. A decrease in the concentration of potassium, calcium and sodium ions leads to disruption in the work of the heart.

A patient with severe dehydration has acidosis, which is characterized by an acid-base imbalance. The pH formula shifts to the acid side. This leads to repeated vomiting, after which the person develops metabolic alkalosis. It is manifested by various disorders in the work of the respiratory and cardiovascular systems.

Dehydration types

The classification of exicoses includes their division into several groups depending on the severity of the course, the cause of the development of the pathology, the presence or absence of complications.

The severity of dehydration is mild, moderate and severe. It can be caused by external and internal causes, pass with complications and without them.

When choosing therapy, experts pay attention to the ratio of the loss of mineral salts and water. On this basis, three forms of dehydration are distinguished:

• hypoosmolar. It is characterized by a rapid loss of salts with a slow development of water deficiency. This leads to the rapid onset of negative symptoms from the central nervous system. The patient’s blood circulation is disturbed, signs of a neurological disorder appear;

• hyperosmolar. Fluid loss occurs faster than electrolyte loss. Due to this, their concentration increases. With this kind of dehydration, pronounced symptoms appear only with a significant deficit of moisture;

• isosmolar. The loss of water and salts is about the same. The patient has a decrease in the amount of urine excreted, may decrease blood pressure (BP) and central venous pressure.

Symptoms

Each degree of dehydration is characterized by special signs:

• mild degree. The patient is thirsty, the pulse remains normal, may become more frequent. Skin and mucous membranes are unchanged. On the part of the nervous system, there may be signs of anxiety and anxiety;

• average degree. Externally, the pathology is manifested by dry skin and mucous membranes, a decrease in diuresis. The eyes become sunken, the patient’s pulse quickens, the pressure is increased or decreased by about 20% of the usual values. From the side of the central nervous system, both anxiety and lethargy can be observed;

• severe degree. Pronounced fluid deficiency causes neurological disorders. The patient is very lethargic and practically does not react to anything. Breathing becomes difficult, blood pressure is greatly reduced, tachycardia is characteristic. The skin looks pale and has a bluish tint, it is cold to the touch.

Moderate to severe dehydration increases the risk of complications. First of all, they are associated with the formation of blood clots due to the high viscosity of the blood. When a thrombus clogs the vessels of vital organs, the patient may die or receive irreversible negative changes. Some people who survive severe dehydration develop chronic headaches, weakness, and reduced muscle mobility. Children have cognitive impairment.

Diagnostics

At the first signs of dehydration, it is necessary to contact a medical institution to a general practitioner, a general practitioner, a pediatrician. If dehydration is severe, an ambulance must be called to hospitalize the patient in a medical facility.

For the diagnosis of exicosis, the following are used:

• visual examination and questioning of the patient for the presence of vomiting, diarrhea;

• measurement of arterial and central venous pressure;

• blood test for electrolytes and hematocrit.

A decrease in central venous pressure and an increase in hematocrit above the age norm indicate fluid deficiency.

Treatment for dehydration

With mild dehydration, the patient is treated at home. With moderate and severe fluid deficiency, which are accompanied by changes in the central nervous system, circulatory disorders, hospitalization and intensive treatment are necessary.

The main ways to eliminate exsicosis are:

• the use of rehydrating solutions or large amounts of liquid with the addition of salt to restore water and electrolyte balance;

• intravenous infusion of glucose and saline solutions. It is used in conditions that are accompanied by severe vomiting. Fluid therapy will make up for the lack of fluid if the patient cannot drink it by mouth due to frequent vomiting.

Severe dehydration may require intensive care with a ventilator. With signs of tissue ischemia, neuroprotectors, potassium preparations, drugs to maintain the work of the heart are prescribed.

Treatment is continued until normalization of blood circulation and diuresis. To achieve stable results, it is important to identify the exact cause of the pathological condition and eliminate it.

As a rule, with a slight dehydration, it is possible to completely normalize the patient’s condition within 1-2 days. In moderate and severe dehydration, the prognosis depends on the severity. In some cases, the risk of developing serious violations of body functions, up to irreversible processes, increases.

Prophylaxis

To avoid dehydration, you need to know what factors provoke it, and take appropriate safety measures. This is, first of all, adequate intake of water and fluids. Its volume is from 1.5 liters per day and increases with intense physical exertion, in hot weather.

If the patient has diarrhea or vomiting, rehydration solutions should be used to prevent dehydration. You can buy them at a pharmacy or make your own at home. Pharmacy rehydrating solutions contain potassium chloride, sodium chloride and other mineral salts.

The funds are available in the form of a powder that dissolves in water and is taken orally to prevent water and electrolyte disorders. Powders contain flavoring additives, due to which the use of the drug does not cause discomfort in adults and children.

In addition to powders, rehydrating agents are available as infusion solutions.

Making a rehydrating solution at home

If it is not possible to buy a pharmacy product, it can be seen as a home analogue. To prepare the drink, you need a tablespoon of salt, a teaspoon of soda and two tablespoons of sugar.