Slide 5
Recognising dehydration and why it is important
(See also Figure 2)
Here we show the most important signs of
dehydration in children. Notice that on the left we list the early signs, and on
the right the late signs.
Now look at the percentage numbers- 5% for 'mild', 10% for 'moderate' and 15%
for 'severe' (anything over 10% is considered to be 'severe').
Q. What do you think the numbers show?
A. The numbers show the percentage of a child's total body weight or his body
total body water, that he has lost when he shows those clinical signs.
Look first at the late signs - that is, the signs of moderate and severe
dehydration. These are:- sunken fontanelle, sunken
eyes, acidotic breathing, loss of skin elasticity, rapid
pulse, cyanosis,
cold limbs and coma. If you ask a health worker to tell you the signs of
dehydration, these are probably the ones that he or she will find it easiest to
remember. Notice that the signs are all easy to find. Some you can see, some you
can feel. But none are very difficult. Remember that a sunken fontanelle is only
a useful sign in a baby less than a year old. After that age the fontanelle is
closed.
Now look at the list of early signs, that is, the signs of mild dehydration.
They are:- thirst, dry mouth, less urine, and loss of weight.
Q. Which of the early signs do you see and which do you feel?
A. You can see a dry mouth. But you cannot see or feel the other signs so
easily. You have to weigh the child-and he may not have been weighed before, so
it is difficult to say if he has lost weight. You have to offer him a drink; you
have to look for wet clothes and to ask when he passed urine and how much. If a
child has watery diarrhoea, you may not know if it is urine or stool or both.
His mother may not see the urine coming out.
So the signs of early dehydration are more difficult to find than the signs of
late dehydration. But it is very important to try to diagnose dehydration early,
so that you can treat it early. Do not wait for the late signs.
Now, turn off the projector, and try to write out the signs listed on Slide 5
for yourself.
Teacher's Note
Slide 5 is complicated and it contains a lot of important information. Even
students who already know the signs of dehydration may not have seen the information organised in this way
before. They may find it difficult to remember
if they only see it once.
We suggest that you turn the slide off, and ask each student to write out the
slide from memory. They should do this tidily enough to keep for later revision.
Then, ask them to reconstruct Slide 5 on a blackboard as a class exercise. |
