Dehydration

Dehydration

Last week I was camping and the weather had 50 degree variance within 2 days. At first, I was freezing and a day later, it was so hot I couldn’t breathe. I felt so parched and lethargic. Welcome to Spring in New York: the weather is vacillating between cold and hot. Or it goes from hot to very hot. If you don’t have enough fluids you could be at risk of dehydration.

Dehydration is a condition where there is a lack of fluids in the body. Either the total body fluid level is low, or, (more commonly) there is a low level of fluid in the blood vessels. Whichever the cause, dehydration can lead to several devastating effects including shock.

Causes of Dehydration

It is important to determine the cause of the dehydration, in order to properly treat it. Dehydration can be due to not ingesting enough fluids, losing too much fluids, or not replacing lost fluids fast enough. Losing fluids can stem from such causes as vomiting, diarrhea, sweating.

The most common causes of dehydration are gastroenteritis (“stomach bug”) that causes either vomiting and/or diarrhea; infections or swellings in the mouth or throat that make drinking and eating painful; and fevers that raise the body temperature causing loss of fluids.

There are other conditions that can cause dehydration, including heat stroke from playing sports in heat and sweating too much. Certain recreational drugs and medications can lead to an increased metabolic rate and a reduced desire for fluids. Diabetes can also cause a life threatening case of dehydration.

Manifestations

The symptoms of dehydration can be vague, which makes it difficult to asses with great accuracy the degree of dehydration. In general, dehydration is categorized into three broad categories: mild, moderate, and severe. It is based on the constellation of all the physical signs.

In mild dehydration the person is alert and the mucous membranes of their lips, mouth and throat are still normal, their eyes look bright. Their heart rate might be slightly elevated, but their urine output is diminished.

In moderate dehydration, the person is lethargic. Their mouth, lips, throat and are dry. Their eyes have a sunken appearance. They have diminished tears and a fast heart rate.

In severe dehydration, the patient is confused and difficult to arouse. Their mouth lips and throat are parched and cracked and dry. They have a fast heart rate and are breathing fast. Their pulse is faint, and difficult to find. Their eyes are sunken and they do not urinate.

History of Patient

It is important to assess the history of the person who is suspected of being dehydrated. It is crucial to know what type of fluid and the quantity of fluid they ingested; how much are they urinating, including amount and frequency and the color and smell. In a baby, it is necessary to find out how many wet diapers did they have; do they have diarrhea, how frequently and watery are their stools; are they vomiting? How often and how many times have they been in contact with sick people, especially people with gastroenteritis; do they have any underlying medical conditions; do they have fever; how is their appetite; have they lost weight?

Treatment

Oral Rehydration Solutions (ORT) are appropriate for mild to moderate dehydration. Only products such as Pedialyte should be used because they have the correct level and ratio of salts and sugar. Clear fluids such as apple juice, ginger ale (and milk, even though it’s not clear) should not be used for rehydration. They don’t have the appropriate ratio of salt to sugar, and they have too much sugar which causes problems with water absorption and can make diarrhea (if there is) worse.

Intravenous Treatment (IV) is the best treatment for dehydration. However, normally it is reserved for use by emergency departments. Some certified urgent care clinics are able to administer IV therapy to treat dehydration. If an urgent care clinic has IV therapy, they can administer this treatment as an alternative to going to the Emergency Room. Now that we see spikes in temperature, patients come to the clinics more frequently after having been out in the sun too long. They complain of feeling dehydrated and fatigued, especially when they have an over consumption of alcohol. IV supplementation can be a great way to get back on track.

 

Written by: Jacob Gerlitz

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