9634082
Description
Mind Map by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
almost 9 years ago
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Vomiting & dehydration
- Vomiting, diarrhoea, febrile. DDx?
- Obstruction
- Intussusception
- Appendicitis
- Hernia
- abdominal pain, distension, bilious vomitus
- abdominal pain, distension, bilious vomitus
- Intussusception
- Infection
- UTI
- Meningitis
- UTI
- Metabolic
- DKA
- polydipsia, polyuria, weight loss
- polydipsia, polyuria, weight loss
- Haemolytic uraemic syndrome
- pallor, related to food intake
- pallor, related to food intake
- DKA
- Injury
- Raised ICP
- Raised ICP
- Obstruction
- Assess dehydration
- Fluids in
- Percentage of
normal intake
- Beware <50%
- Percentage of
normal intake
- Micturition
- # of wet nappies
- Usual or less weight
- Beware >8h between
- # of wet nappies
- Abnormal losses
- Vomiting >5x
- Diarrhoea >5x
- Vomiting >5x
- Examination
- Mucosa
- Skin turgor
- Tachycardia
- Hypotension
- Mucosa
- Fluids in
- Severity of dehydration
- Mild <5%
- Thirsty, reduced UO
- Dry mucosa, mild tachycardia
- Dry mucosa, mild tachycardia
- Thirsty, reduced UO
- Moderate 7-8%
- Lethargy
- Sunken fontanelles/eyes, reduced skin turgor
- Sunken fontanelles/eyes, reduced skin turgor
- Lethargy
- Severe
- Decrease level of consciousness
- Signs of shock - poor perfusion, hypotension
- Signs of shock - poor perfusion, hypotension
- Decrease level of consciousness
- Mild <5%
- Management
- Oral fluids preferred
- Small frequent breast feeds
- Oral rehydration fluid
- Last resort 1/5 strength juice or lemonade
- Small frequent breast feeds
- If oral not tolerated
- NG
- IV
- NG
- Oral fluids preferred
- Complications
- Dystonic reaction
- 2y prochlorperazine, metoclopramide
- Especially <2yo
- Treat with benztropine
- <1yo consider anticholinergic antihistamine or diazepam
- 2y prochlorperazine, metoclopramide
- Dystonic reaction
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