[Medical Q&A] How to determine whether a child has diarrhea and is dehydrated?

Planner: Chinese Medical Association

Reviewer: Huang Lei, deputy chief physician, Fifth Medical Center, PLA General Hospital

Diarrhea is one of the most common diseases in children, and severe diarrhea can easily lead to dehydration. Dehydration refers not only to the loss of water, but also the loss of electrolytes. It is generally judged based on a comprehensive analysis of spirit, consciousness, skin elasticity, circulation, anterior fontanelle, eye sockets, urine volume and weight at the time of consultation. For children, the judgment of dehydration is particularly important because their body's ability to regulate is relatively weak. The following are some ways to judge whether a child is dehydrated due to diarrhea.

(1) Mild dehydration: Water loss accounts for less than 5% of body weight (30-50 ml/kg). The child is in normal or slightly worse mental state; the skin is slightly dry, but elastic; the eye sockets and anterior fontanelles are slightly sunken; there are tears when crying; the oral mucosa is slightly dry; and the urine volume is slightly reduced.

(2) Moderate dehydration: Water loss accounts for 5% to 10% of body weight (50 to 100 ml/kg). The child is listless or irritable, with dry skin and poor elasticity; the eye sockets and anterior fontanelles are obviously sunken; there are few tears when crying; the oral and lip mucosa are dry; the limbs are slightly cool, and the urine volume is significantly reduced.

(3) Severe dehydration: Water loss accounts for more than 10% of body weight (100-120 ml/kg). The child appears seriously ill, extremely depressed, apathetic, lethargic or even comatose; the skin is gray or patterned, dry, and loses elasticity; the eye sockets and anterior fontanelles are deeply sunken, the eyes are closed but not visible; there are no tears when crying; the oral mucosa is extremely dry; symptoms of shock appear, such as a weak and rapid pulse, a drop in blood pressure, cold limbs, and very little or no urine.

If your child has any of the above symptoms of dehydration, you should replenish water in a timely and scientific manner. If moderate or severe dehydration occurs (such as extreme weakness and unresponsiveness), you should seek medical attention immediately!