World Health Organization (WHO) scale for dehydration

Last reviewed 01/2018

World Health Organization (WHO) scale for dehydration

It is important to determine the degree of dehydration in order to select the appropriate plan to treat or prevent dehydration.

Clinical assessment for degree of dehydration associated with diarrhoea is as follows

• if two or more of the signs in column C are present - the patient has "severe dehydration"
• if two or more signs from column B (and C) are present - the patient has "some dehydration".
• patients who fall under column A -  "no signs of dehydration"

Estimation of fluid deficit (and the requirement) in children with some dehydration or severe dehydration should be carried out by weighing them without clothing. (if weighing is not possible, a child's age may be used to estimate the weight) (1).

Note:

• treatment should never be delayed because a scale is not readily available (1)
• the three most useful predictors of 5% or more dehydration are abnormal capillary refill, abnormal skin turgor, and abnormal respiratory pattern (2)

Reference:

• (1) World Health Organization. Cholera. Fact Sheet 107. July 2012
• (2) Colletti JE et al. The management of children gastroenteritis and dehydration in the emergency department. with J Emerg Med. 2010;38(5):686-98