Patients should be seen by physician if:
| |
$
|
$
| | |
$
| |
$
|
n = 4
#
|
They have risk factors for dehydration:
| | | | | | | | | |
Young age
| |
+
|
+
| | | | |
+
|
Y•
|
Low birth weight/premature birth
| |
+
| | | | | |
+
|
N
|
Fever
| |
+
| | | |
+
| | |
N
|
Stopped breastfeeding
| | | | | | | |
+
|
N
|
High output*
| |
+
|
+
| | |
+
| |
+
|
Y•
|
Persistent vomiting/>2 vomits per 24 h
| |
+
|
+
| | | | |
+
|
Y•
|
Signs of malnutrition
| | | | | | | |
+
|
N
|
Reported signs of severe dehydration
| |
+
| | | |
+
| |
+
|
Y•
|
Fluid losses exceed intake
| | | | | |
+
| | |
N
|
Not offered/able to tolerate supplemented fluids/suboptimal response
| |
+
| | | | | |
+
|
N
|
Signs of severe cause for diarrhea/underlying disease
| |
+
|
+
| | |
+
| |
+
|
Y•
|
Family circumstances
| |
+
| | | | | |
+
|
N
|
Blood tests and stool cultures
|
$
|
$
|
$
| |
$
|
$
|
$
|
$
|
n = 7
#
|
Should not be routinely performed
|
+
|
+
|
+
| |
+
|
+
|
+
|
+
|
Y•
|
Perform stool culture if:
|
$
|
$
|
$
| |
$
|
$
| |
$
|
n = 6
#
|
Dehydrated or febrile patients
| | | | |
+
| | | |
N
|
Sick patients with dysentery ¥
|
+
|
+
|
+
| | |
+
| |
+
|
Y•
|
Blood/pus in stool
|
+
| | | |
+
| | | |
N
|
Immuno-compromised patients
| | |
+
| | |
+
| |
+
|
Y•
|
Patients with high infectivity for others
| | | | | |
+
| | |
N
|
In case of outbreak
| | |
+
| | | | | |
N
|
Recently traveled abroad
|
+
| | | | |
+
| |
+
|
Y•
|
To verify another etiology/uncertain diagnosis/if no improvement after 7 days
| | |
+
| | | | |
+
|
N
|
MANAGEMENT
|
Refer/admit to hospital if
|
$
|
$
|
$
| |
$
|
$
| |
$
|
n = 6
#
|
Social/logistic concerns
|
+
|
+
|
+
| |
+
|
+
| |
+
|
Y•
|
Failure of initial rehydration
|
+
|
+
|
+
| |
+
|
+
| |
+
|
Y•
|
Suspected alternative serious diagnosis
|
+
|
+
|
+
| |
+
|
+
| |
+
|
Y•
|
Shock/severe dehydration
| |
+
|
+
| |
+
|
+
| | |
Y•
|
High risk of dehydration
| |
+
|
+
| | |
+
| | |
N
|
Intractable/persistent vomiting
| |
+
| | | | | | |
N
|
Vomiting
| |
$
| |
$
| |
$
| | |
n = 3
#
|
is not a contraindication for ORS
| |
+
| |
+
| |
+
| | |
Y•
|
Do not give ORS if protracted vomiting despite small frequent feeding
| | | |
+
| | | | |
N
|