symptoms and signs of clinical dehydration related to childhood gastroenteritis

Last edited 07/2018

symptoms and signs of clinical dehydration related to gastroenteritis

Dehydration caused by acute gastroenteritis is a major concern in the paediatric patients and clinicians must assess the circulatory volume status as part of the initial evaluation in these patients (1).

The following symptoms and signs can be used to detect clinical dehydration and shock. For clinical shock, one or more of the symptoms and/or signs listed would be expected to be present.

Note:

• within the category of 'clinical dehydration' there is a spectrum of severity indicated by increasingly numerous and more pronounced symptoms and signs.

Symptoms indicating category of dehydration of child with gastroenteritis (remote and face-to-face assesssments)

Signs indicating category of dehydration of child with gastroenteritis (face-to-face assessments)

Notes:

• dashes (---------) in the tables above indicate that these clinical features do not specifically indicate shock
• ** red flag symptom - may help to identify children at increased risk of progression to shock. If in doubt, manage as if there are symptoms and/or signs with red flags (2).
  

Suspect hypernatraemic dehydration if there are any of the following:

• jittery movements
• increased muscle tone
• hyperreflexia
• convulsions
• drowsiness or coma.

Reference:

• (1) National Institute for Health and Care Excellence (NICE) 2009. Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management