Presentation on theme: "Diarrhoea and Dehydration Paediatric Palliative Care For Home Based Carers Funded by British High Commission, Pretoria Small Grant Scheme."— Presentation transcript:
Diarrhoea and Dehydration Paediatric Palliative Care For Home Based Carers Funded by British High Commission, Pretoria Small Grant Scheme
What is Diarrhoea? Loose or watery stools Above 12 months of age, more than 3 loose stools per day (Eddleston & Plerini, 1999) Often accompanied by fever, nausea, vomiting, abdominal pain May be explosive or foul smelling May contain blood May be green Different categories of diarrhoea (WHO): Acute, watery diarrhoea for 14 days or less Persistent diarrhoea for longer than 14 days Dysentery: diarrhoea with blood, with/without fever
ALL Children are at risk… Dependent on others for good hygiene Does not know to wash his hands Puts hands/objects in his mouth as part of his development Will play in/with anything! There immune system is still developing
Effects of Diarrhoea Diarrhoea increases the risk of skin breakdown A child with HIV is then more likely to get skin infections which may be painful and difficult to treat Skin breakdown and infections must be prevented
Getting it Right! All around the world, children with diarrhoea are dying from dehydration because carers: Stop fluids and food Do not know what fluids to give Do not know the signs of dehydration Do not know how quickly a child becomes dehydrated Do not act quickly enough Have not been taught how to make and use ORS DO not know what to do when the child vomits or refuses to drink
Plan A: ORS and SSS To make SSS: 1 litre boiled (or clean) water + 8 teaspoons sugar + Half a teaspoon salt ORS Teach the Mother How to mix and Give SSS or ORS Used to prevent dehydrationUsed to correct dehydration and can be life-saving!
Plan A: Giving ORS & SSS Show the mother how much fluid to give in addition to the usual fluid intake: Up to 2 Years: 50 – 100 ml after each loose stool 2 Years or more: 100 – 200 ml after each loose stool Tell the mother to: Give frequent, small sips from a cup If the child vomits, wait 10 minutes. Then continue, but more slowly Continue giving extra fluid until the diarrhoea stops
Plan A: Continue Feeding It is therefore extremely important to continue feeding a child with diarrhoea Even if the diarrhoea continues! DO not be surprised if the child loses weight having been ill with diarrhoea BUT, it is important to help the child regain that weight by encouraging an extra meal a day for two weeks Sometimes, a doctor may advise that the child does not taken certain foods ie milk. If the mother has been told this, encourage her to take that advise
Plan B: Treat for Some Dehydration with ORS If a child with diarrhoea has been assessed and considered to have some dehydration, the child needs rehydration with ORS Refer to clinic immediately
Handling Soiled Linen Wear Gloves Cut small holes in a plastic bag and line a container with it Pour Jik 1:10 in to the plastic bag Put the dirty wound dressing, newspaper etc in to the plastic bag for half an hour Remove the bag, allowing the fluid to run into the container Put the plastic bag into a second plastic bag Dispose of it into a pit toilet or bury it OR Wear gloves Place waste in to double plastic bags Knot bags and bury them or dispose in pit Wash hands
Summary Children with HIV will experience episodes of diarrhoea Diarrhoea may resolve itself without drugs Prevent dehydration using Plan A Treat dehydration using Plan B and C Provide nutritious foods throughout Refer if: a) diarrhoea persists after three days, refer for diagnosis and treatment of underlying cause b) child becomes sicker, develops danger signs You can easily prevent many children from dying!