Chapter 71: Acute Gastroenteri tis Introduction The following is based on Integrated Management of Childhood Illness (IMCI) and the College of Paediatrics, Academy of Medicine of Malaysia guidelines on the management of Acute Diarrhoea in Children 2!! and modi"cations ha#e been made to Treatment Plan C in $ee%ing with Ad#anced Paediatric &ife 'u%%ort (AP&') %rinci%les • Ac ut e gastroenter it is i s a l eadi ng c ause o f ch il dh ood morb idity an d mort al it y and an important cause of malnutrition. • Many di ar rh oeal deat hs are caused by dehydr ation and el ectr ol yt es loss. • Mi ld an d moder ate dehydra ti on is safely and eect ivel y t reated ith !"# solution but severe dehydration re$uires intravenous %uid therapy. If you have gone through the PALS or APLS course, First assess the state ofperfusion of the child. Is the child in shock? • #igns of shoc& include tachycardia ' ea& peripheral pulses' delayed capillary re(ll time ) * seconds' cold peripheries' depress ed mental state ith or ithout hypotension. Any child with shock go straight to treatment Plan C. * you can also use the +chart below to assess the degree of dehydra- tion and then choose the treatment %lan A, . or C, as neededAssess: +oo& at child,s general condition -ell' alert "est less or irritabl e +oo& for sun&en eyes o sun&en eyes #un&en eyes !er the child %uid /rin&s normally /rin&s eagerly' thirsty 0inch s&in of abdomen #&in goes bac& immediately #&in goes bac& sloly Classify: Mild Dehydration 23 /ehydrated4 IMCI/ 0o signs of Dehydration 5 * above signs: Moderate Dehydration 2 /ehydrated IMCI/ 'ome sig of Dehydration 8reat: Plan A Plan B
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