Diarrhoea + Vomiting - Gastroenteritis, Dehydration management Flashcards
Most common cause
-typical duration
Gastroenteritis - rotavirus
-diarrhoea - 5-7 days, stops within 2 weeks
-vomiting - 1-2 days, stops within 3 days
Signs of clinical dehydration
-management
Looks unwell, deteriorating
Altered responsiveness
-irritable
-lethargic
Sunken eyes
Skin colour unchanged
Dry mucous membranes
Reduced skin turgor
Tachycardia, tachy apnoea
Normal peripheral pulses
Normal CRT
Normal BP
50ml/kg ORS over 4hrs + maintenance ORS often in small amounts
Continue breastfeeding
Supplement with milk or water, NOT FRUIT JUICE
Signs of clinical shock
-management
Decreased consciousness
Cold extremities
Pale, mottled skin
Tachycardia, tachypnoea
Weak peripheral pulses
Prolonged CRT
Hypotensive
ADMIT FOR IV REHYDRATION
Groups at increased risk of dehydration
U1, especially U6months
Low birth weight
6+ diarrheal stools in 24hrs
3+ vomits in 24hrs
If not offered/cannot tolerate supplementary fluids before presenting
If breastfeeding stopped during illness
Signs of malnutrition
Hypernatremic dehydration features
Jittery movements
Increased muscle tone
Hyperreflexia
Convulsions
Drowsy, coma
Gastroenteritis
-presentation of travellers diarrhoea
-presentation of acute food poisoning
-most common cause
Travellers diarrhoea - min3 loose/watery stools in 24hrs with/without
-abdo cramp
-fever
-nausea
-vomiting
-bloody stool
Ecoli
Acute food poisoning - sudden onset
-nausea
-vomiting
-diarrhoea after ingestion of toxin
Staph aureus, Bacillus cereus, clostridium perfringens
Ecoli
-key factors
Common in travellers
Watery stools
Abdo cramps, nausea
Giardiasis
-key factor
Prolonged, non bloody diarrhoea
Cholera
-key factor
Profuse watery diarrhoea
Severe dehydration resulting in weight loss
Not common in travellers
Shigella
-key factors
Bloody diarrhoea
Vomiting, abdo pain
Staph aureus
-key factors
Severe vomiting
Short incubation period
Campylobacter
-key factors
Flu-like prodrome
Followed by crampy adbo pain, fever, diarrhoea
Appedicitis mimic
Complications like GBS
Bacillus cereus
-key factors
2 types of illness seen
-vomiting within 6hrs, stereotypically due to rice
-diarrhoeal illness occurring after 6hrs
Amoebiasis
-key factors
Gradual onset bloody diarrhoea, abdo pain, tenderness
-may last several weeks
