82 Diarrhoea in Kids
What would make you think a kid looks sick and dehydrated : Head Bobbing (respiratory distress), Sunken Eyes, Sunken Fontanelle, Lethargic, Poor Feed, Abnormal skin turgor
What organisms are common/important to cause sick kids with diarrhoea: Cholera, Typhoid, Salmonella, NTS, (Salmonella and NTS are gen 3rd most common cause) Rotavirus (most common), Norovirus, Adenovirus, Cryptosporiudum (2nd most common < 1 year), Shigella (2nd most common > 1 year)
How do you identigy bugs in diarrhoea in kids in tropics? : Often syndoromic, Tests you’d like are microscopy, culture, antigen testing, pcr
Which signs are most important in predicting which kids are dehydrated in tropics? : CRT, Turgor, Respiratory Pattern
What does the WHO split Dehydration into? (Categories) : Shock, Severe Dehydration, Dehydration
WHO Symptoms needed for Shock in dehydrated kids: Cold, Weak Pulse, prolonged CRT, decreased gcs
WHO Symptoms needed for Severe Dehydration in dehydrated kids: ok pulse, unable to drink, sunken eyes, skin pinch > 2 s
WHO Symptoms needed for Dehydration in dehydrated kids: Able to drunk plus sunken eyes, skin punch, irritability
What drug would you give for diarrhoea in kids in tropics : ZINC! 2 Weeks (less duration, less treatment failure, less death, more ORS uptake)
Should you continue feeding in diarrhoeal disease in kids in tropics? : Keep Feeding!
What should you do with a kid with persistant (2 weeks) diarrhoea? : Immune Status, Repeat Infections (Unsafe water), Special Pathogen Not Cleared
What should you think with bloody diarrhoea (dysentry) in kids? : Infectious: SHIGELLA (>99%), E. coli, Campylobacter Amoebic dysentry (<1%), Non Infectious: Intussusseption (Super Important! Think think think of this!)
Do you give all kids in tropics with bloody diarrhoea antibiotics? : Yes! Syndromically give: Ciprofloxacin
What do you do with kids who have presented with diarrhoea and have also got Acute Severe Malnutrition (when you’re really worried about overload) : You would give shock patients IV fluids, give most others resomel