clinical features of dehydration in an child
Last reviewed 01/2018
It may help to think of childhood dehydration in terms of borrowing from various sources. Thus mild dehydration results in thirst, oliguria and restlessness. Moderate dehydration borrows from reserves; severe dehydration results in circulatory collapse.
Symptoms and signs of clinical dehydration and shock include the following:
- symptoms (remote and face-to-face assessments)
no clinically detectable |
clinical dehydration |
shock |
appears well |
red flag - appears to be unwell or deteriorating |
- |
alert and responsive |
red flag - altered responsiveness (for example, irritable, lethargic) |
decreased level of |
normal urine output |
decreased urine output |
- |
skin colour unchanged |
skin colour unchanged |
pale or mottled skin |
warm extremities |
warm extremities |
cold extremities |
- signs (face-to-face assessments)
no clinically detectable |
clinical dehydration |
shock |
alert and responsive |
red flag - altered responsiveness (e.g. - irritable, lethargic) |
decreased level |
skin colour unchanged |
skin colour unchanged |
pale or mottled skin |
warm extremities |
warm extremities |
cold extremities |
eyes not sunken |
red flag - sunken eyes |
- |
moist mucous membranes (except after a drink) |
dry mucous membranes |
- |
normal heart rate |
red flag - tachycardia |
tachycardia |
normal breathing pattern |
red flag - tachypnoea |
tachypnoea |
normal peripheral pulses |
normal peripheral pulses |
weak peripheral pulses |
normal capillary refill time |
normal capillary refill time |
prolonged capillary refill time |
normal skin turgor |
red flag - reduced skin turgor |
|
normal blood pressure |
normal blood pressure |
hypotension (decompensated shock) |
Hypernatraemic dehydration should be suspected if the child has:
- jittery movements
- increased muscle tone
- hyperreflexia
- convulsions
- drowsiness or coma (1)
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