This protocol addresses severe dehydration in patients with a recent history of diarrhoea and/or vomiting, reduced urine output, and multiple clinical signs of significant fluid and circulatory compromise.
The patient has a history of diarrhoea and/or vomiting with reduced urine output, and presents with at least two of the following signs:
Management begins with assessment for shock and proceeds with a structured combination of oral and intravenous rehydration guided by WHO criteria, with close monitoring throughout. The complete protocol defines the sequence, monitoring thresholds, and contingency steps in full detail.
History of diarrhoea and/or vomiting and concomitant reduced urine output.
At least 2 of the following signs: lethargic or unconscious; weak or absent radial pulse; sunken eyes; skin pinch goes back very slowly (> 2 seconds); drinks poorly or not able to drink.
Treat shock if present. If able to drink, administer oral rehydration solution (ORS) PO whilst obtaining IV access. Administer Ringer lactate (RL) according to WHO Treatment Plan C, monitoring infusion rate closely. As soon as the patient is able to drink safely (often within 2 hours), provide ORS as the patient tolerates. If RL not available, 0.9% sodium chloride can be used.