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Oral Rehydration Salts

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14 views

Oral Rehydration Salts

Uploaded by

kotwanivishesh378
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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ORAL

REHYDRATION
SALTS
WHAT?
• Cheap, simple, and effective way
to prevent or treat dehydration
caused by diarrheoa.
• Contains main elements that are
lost from body during diarrhoea.
• Newer forms of ORS have
additional clinical benefits.
WHY?
• Globally, there are nearly 1.7 billion cases of childhood Diarrheal
disease every year.
• Diarrhea is a leading cause of malnutrition in children under five years
old.
• Diarrheal disease is the Second leading cause of death in children
under five years old. It is both preventable and treatable.
• Each year Diarrhea Kills around 5,25,000 children under five.
• A significant proportion of Diarrheal disease can be prevented
through safe drinkingwater and adequate sanitation and hygiene.
DEHYDRATION
• It is the state of the body in which body looses water more than it
compensates for it.
• Water is lost through sweat, stool, urine and breath and body tries to
compensate with drinking water with an average 2000 ml (8 glasses)
per day and the person is said to be dehydrated if it can’t compensate
for the loss.
CAUSES OF DEHYDRATION
PRINCIPLE OF ORS
• Glucose facilitates the absorption of sodium (and hence water) on a
1:1 molar basis in the small intestine.
• Sodium and potassium are needed to replace the losses of these
essential ions during diarrhea (and vomiting).
• Citrate corrects the acidosis that occurs as a result of diarrhea and
dehydration.
• ORS may contain suitable pharmaceutical aids (e.g., suitable flow
agent in minimal quantities to improve the flow characteristics)
and/or the flavoring agents.
ADVANTAGES OF ORS
• Diarrhea being the third most cause of mortality below 5 years in
India. ORT may lower mortality as much as 93%.
• Non-invasive, simple & effective way to treat dehydration, home
therapy can be given along with milk feeds and complimentary foods.

Coke, Limca, Frooti, Glucon-D, Roohafza, Tang and such sugary drinks
are not meant for ORT.
COMPOSITION OF LOW OSMOLARITY
ORS
REDUCED OSMOLARITY ORS Grams/litre REDUCED OSMOLARITY ORS Mmol/litre
Sodium chloride 2.6 Sodium 75
Glucose, anhydrous 13.5 Chloride 65
Potassium chloride 1.5 Glucose, anhydrous 75
Trisodium citrate, dihydrate 2.9 Potassium 20
Citrate 10
Total osmolarity 245
LOW OSMOLARITY
ORS
• Use results in decrease stool output by 25%
• Decrease in vomiting by 30%.
• Decrease need for intravenous fluids.
• Effective in all kinds of Diarrhea including Cholera.
• Decrease in sodium and glucose results in decrease
osmolarity.
ADVANTAGES OF
ZINC
• Reduces the duration of Diarrhea episode by 25%
• Reduces the stool volume by 30%
• Reduces the likelihood of subsequent occurrence in next 2-3
months
• Dose for kids above 6 months: 20 mg daily for 14 days
• Dose for kids below 6 months: 10 mg daily for 14 days
ORS ADMINISTRATION

1. Should begin immediately


2. Can be given by spoon, dropper, cup, tumbler, syringe or nasogastric tube.
3. A Child Less than 2 years a Teaspoon every one to two minutes and one fourth to half a cup
(250 ML) of ORS after every loose stool. Give 1- 2 teaspoon every 2-3 minutes.
4. A Child above 2 years or older give half to one cup (250 ml) with each loose stool.
5. Vomiting if occurs wait for 10 minutes. Vomiting usually stops. Give a Tea Spoonful every 2-
3 minutes.
6. Breast feeding to continue
DIARRHOEA

• Diarrhea is defined as passage of liquid or watery stools that occur more than 3 times a day.
In vast majority the episode of acute Diarrhea subsides in 7 days.
• Main Objective of Diarrhea Management by WHO
1. To prevent dehydration if child doesn’t show signs of dehydration.
2. To treat dehydration, if present.
3. To prevent nutritional damage by feeding during & after diarrheal episode.
4. To reduce the duration and severity of diarrhea and future episodes of
diarrhea.
NO DEHYDRATION

•ORS is given to prevent dehydration


along with normal diet, breast feeding to
continue along with complimentary
foods.
•Point to be noted in no Dehydration
category is that ORS is given as
replacement therapy for ongoing stool
losses only.
SOME DEHYDRATION
Rehydration therapy includes ORS 50-100 ml/ Kg over 3-4 hours, continue breast
feeding. If ORS can not be taken orally use nasogastric tube. If after 4 hours while
assessment child has still some dehydration ORT is repeated as above for 4 hours.
• Replacement of losses-
• Infants and Children Less than 10 kg :
50-100 ml ORS for each loose stool or Vomiting episode up to 500 ML per day
• More than 10 kg body weight
100-200 ML ORS for each loose stool or vomiting episode up to 1 litre per day.
SEVERE DEHYDRATION
• Intravenous isotonic saline / plain Ringer solutions the
fluid of choice and never use 5% dextrose alone.
• 100 ML/ kg of fluid is given over 6 hours in children < 12
months and over 3 hours above 12 months as shown in
the table.
• If IV fluids can not be given due to any reason because of
transport, IV access difficulties ORS can be given 20 ML/
kg / hours for 6 hours( Total 120 ML/ kg) by nasogastric
tube but child requires frequent assessment every 1-2
hours and if no improvement in hydration after 3 hours
or abdominal distension or vomiting occurs switch to IV
fluids.
• The child should be reassess every 15-30 minutes for
pulses , oral mucosa , respiratory rate, urine output, stool
water loss after the first bolus of 100 ML/ kg of
intravenous fluid.
THANK
YOU

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