Diarrhea, Dehydration and Re-hydrating

From: Where There Is No Doctor
Chapter 13:

Go here to see entire PDF version: http://www.healthwrights.org/books/WTIND/Chapter_13.pdf

Dehydration results when the body loses more liquid than it takes in. This can happen with severe diarrhea, especially when there is vomiting too. It can also happen in very serious illness, when a person is too sick to take much food or liquid.

People of any age can become dehydrated, but dehydration develops more quickly and is most dangerous in small children.

It is important that everyone-especially mothers-know the signs of dehydration and how to prevent and treat it. Signs of dehydration:

--thirst is often a first, early sign of dehydration    --little or no urine; the urine is dark yellow    --sudden weight loss    --dry mouth    --sunken, tearless eves    --loss of elasticity or stretchiness of the skin

When a person has watery diarrhea, or diarrhea and vomiting, do not wait for signs of dehydration.

To prevent or treat dehydration: When a person has watery diarrhea, act quickly: Give lots of liquids to drink: Rehydration Drink is best. Or give a thin cereal porridge or gruel, teas, soups, or even plain water. Keep giving food. As soon as the sick child (or adult) will accept food, give frequent feedings of foods he likes and accepts. To babies, keep giving breast milk often-and before other drinks.

Give the dehydrated person sips of this drink every 5 minutes, day and night, until he begins to urinate normally. A large person needs 3 or more liters a day. A small child usually needs at least 1 liter a day, or 1 glass for each watery stool. Keep giving the Drink often in small sips, even if the person vomits. Not all of the drink will be vomited.

When the person is vomiting or feels too sick to eat, he should drink: watery mush or broth of rice, maize powder, or potato, rice water (with some mashed rice), chicken, meat, egg, or bean broth, Kool-Aid or similar sweetened drinks, REHYDRATION DRINK, Breast milk.

As soon as the person is able to eat, in addition to giving the drinks listed at the left, he should eat a balanced selection of the following foods or similar ones: ripe or cooked bananas, crackers, rice, oatmeal, or other well-cooked grain, fresh maize (well cooked and mashed), potatoes, applesauce (cooked), Papaya.

For most cases of diarrhea no medicines are needed. But in certain cases, using the right medicine can be important. However, many of the medicines commonly used for diarrhea do little or no good.

New formulation of Oral Rehydration Salts (ORS) with reduced osmolarity
https://www.unicef.org/supply/files/Oral_Rehydration_Salts(ORS)_.pdf

EXCERPT from PDF Publication:

These agents, though commonly used, have no practical benefit and are never indicated for the treatment of acute diarrhoea in children. Some of them are dangerous.

What antimicrobials can be used with ORS in the clinical management of diarrhoea ?
How can we protect our water?
How important is handwashing?

What should we advise mothers to give at home to a child with diarrhoea, but who has no signs of dehydration? Give the child more fluids, or increased frequency of breastfeeding, than usual, to prevent dehydration What fluids to give Many countries have designated recommended home fluids. Wherever possible, these should include at least one fluid that normally contains salt (see below). Plain clean water should also be given. Other fluids should be recommended that are frequently given to children in the area, that mothers consider acceptable for children with diarrhea, and that mothers would be likely to give in increased amounts when advised to do so. Suitable fluids Most fluids that a child normally takes can be used. It is helpful to divide suitable fluids into two groups: Fluids that normally contain salt, such as:

ORS solution
Salted drinks (e.g. salted rice water or a salted yoghurt drink)
Vegetable or chicken soup with salt
Breastmilk

Teaching mothers to add salt (about 3g/l) to an unsalted drink or soup during diarrhoea is also possible, but requires a sustained educational effort. Fluids that do not contain salt, such as:

plain water
water in which a cereal has been cooked (e.g. unsalted rice water)
unsalted soup
yoghurt drinks without salt
green coconut water
weak tea (unsweetened)
unsweetened fresh fruit juice.

Unsuitable fluids
A few fluids are potentially dangerous and should be avoided during diarrhoea. Especially risky are those drinks sweetened with sugar, which can cause osmotic diarrhoea and hypernatraemia. Some examples are:
[list]soft drinks
sweetened fruit drinks
sweetened tea.
Other fluids to avoid are those with stimulant, diuretic or purgative effects, for example:
coffee
some medicinal teas or infusions. /list]
How much fluid to give

The general rule is: give as much fluid as the child wants until diarrhoea stops. As a guide, after each loose stool, give:

--children under 2 years of age: 50–100 ml (a quarter to half a large cup) of fluid; or one to two extra breastfeedings

--children aged 2 up to 10 years: 100–200 ml (a half to one large cup);
older children and adults: as much fluid as they want.

50 Page PDF: From the World Health Organization:

The Treatment of Diarrhoea:
A manual for physicians and other senior health workers. World Health Organization (WHO).
http://whqlibdoc.who.int/publications/2005/9241593180.pdf

(SNIP)   ...Many  diarrhoeal  deaths  are  caused  by dehydration.  An  important  development  has  been  the discovery  that  dehydration  from  acute  diarrhoea  of  any  aetiology  and  at  any  age,  except  when  it  is  severe,  can  be  safely  and  effectively treated in over 90% of cases by the simple method of oral rehydration using a single fluid.   ---CONTINUED---

From the Mayo CLinic:



Dehydration-Treatments and drugs
http://www.mayoclinic.com/health/dehydr ... -and-drugs

By Mayo Clinic staff

The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause.

(Snip)

In an emergency situation where a pre-formulated solution is unavailable, you can make your own oral rehydration solution by mixing 1/2 teaspoon salt, 6 level teaspoons of sugar and 1 liter (about 1 quart) of safe drinking water. Be sure to measure accurately because incorrect amounts can make the solution less effective or even harmful. If possible, have someone else check your measurements for accuracy.

Whatever alternative you chose, be sure to give enough solution. Your doctor may suggest specific amounts, depending on your child's age and degree of dehydration, but a general rule of thumb is to keep giving liquids slowly until your child's urine becomes clear in color. When your child is vomiting, try giving small amounts of solution at frequent intervals — try a spoonful or so every few minutes, for instance. If your child can't keep this down, wait 30 to 60 minutes and try again. Room temperature fluids are best.

UNITED STATES MARINE CORPS
Field Medical Training Battalion
Camp Lejeune

Manage Dehydration Casualties
http://www.operationalmedicine.org/TextbookFiles/FMST_20008/FMST_1411.htm

TERMINAL LEARNING OBJECTIVE

1. Given a dehydration casualty in a combat environment and standard field medical equipment and supplies, manage dehydration casualties, to prevent further injury or death per the references. (FMST-HSS-1411) ---CONTINUED---

Stockpiling Electrolytes-A review of the best electrolyte powders and tablets
http://www.happypreppers.com/electrolytes.html

 Best electrolyte powders and tablets:
As a prepper you'll want to stockpile electrolytes in your prepper's pantry, and put some electrolylte powders or tablets in your bugout bag, because electrolytes balance the amount of lifesaving water in your body! Excessive sweating from a strenuous activity or illness are just two reasons why you'll want to stockpile electrolytes as part of your overall prepping plan. Electrolyte powders and tablets are easy to stockpile and they'll last just about forever.

Below is everything a prepper needs to know about stockpiling electrolytes, including a review of the top electrolytes and how to make your own electrolyte drink...   ---CONTINUED---

Treating the Runs in a Survival Situation
https://www.backdoorsurvival.com/treating-the-runs-in-a-survival-situation/

  One of the most dangerous outcomes is dehydration.  Dehydration can cause headache, fatigue, sallow and dry skin, constipation and other woes.  It can compromise your immune system and make you weak or even faint.  In the most dire cases, diarrhea can cause vomiting, fever, and bloody stools.  All of this is in addition to cramps and bloating.

In a worst-case scenario, diarrhea and the resulting symptoms can cause death, especially in children.   ---CONTINUED---

Emergency Re-Hydration Procedure via Enema
http://www.curemanual.com/2010/05/emergency-re-hydration-procedure-via-enema/

ehydration can kill anyone at any age. Special note during loose bowel movement / diarrhea episodes, sometimes the intake of plain water may not be enough as the body gets an imbalance in electrolyte levels and cannot make use of the plain water. First aid I usually choose is water melon, then follow up with coconut juice with coconut meat for raw fats. But what if the dehydrated person is far beyond that stage? What if he cannot take anything orally? ---CONTINUED---

Electrolyte Options For The Prepared
https://www.backdoorsurvival.com/electrolyte-options-for-the-prepared/

  (SNIP) ... There are many ways to supplement electrolytes. This is not an expensive prep but it can make a big difference during a survival situation. Here are some options to consider.

Many electrolytes are fairly acidic so if you get heartburn easily you may want to try a few different ones and see which one agrees with you the most or try not to drink too many right before bed. You can also add more water than recommended if that helps. ---CONTINUED---

How to Make Gatorade
https://www.heavenlyhomemakers.com/how-to-make-gatorade

The thing about me experimenting with an idea to try to come up with a healthy alternative is that I can get super excited about the result – but then immediately question, “Will this taste as good to other people as I think it tastes? Will others who are used to the ‘real version’ think this only tastes like a so-so ‘healthy version?'” These questions were especially tricky when making a Gatorade alternative because 1) I haven’t actually sipped on any Gatorade for several years so I couldn’t even remember what it was supposed to taste like and 2) the homemade version looked so cute in my recycled juice bottles that I was going to be super disappointed if my kids didn’t like it. ---CONTINUED---