1. Dehydration By Heather Kräpp

2. Why Dehydration? Dehydration is a real problem, especially here in the heat of Florida. Infants and children have a higher risk of dehydration because of their smaller bodies and higher turnover of water and electrolytes.

3. What is Dehydration? Dehydration is when the body lacks enough fluid (this includes water and salts). Total fluids lost is greater than amount being taken in. Thirst

4. Causes Dehydration can result from not drinking, vomiting, diarrhea, or any combination of those. Often, dehydration is caused by a viral infection that causes a fever, diarrhea, vomiting, and a decreased ability to eat or drink. (rotavirus, Norwalk virus, and adenovirus) A sore in a child’s mouth may also prevent them from eating or drinking. May be caused by a more serious bacterial infection the would make a child less likely to eat and may cause vomiting and diarrhea. (Salmonella, Escherichia coli, Campylobacter, and Clostridium difficile) Increased sweating from a very hot environment. Excessive urination caused by unrecognized or poorly treated diabetes. Conditions such as cystic fibrosis or celiac sprue do not allow food to be absorbed and can cause dehydration

5. How is Dehydration Discovered Dehydration may occur when your child has a fever, diarrhea, vomiting, is sweating a lot on a hot day or during intense physical activity. Symptoms: –Dry or sticky mouth. –Few or no tears when crying. –Eyes that look sunken into the head. –Soft Spot that looks sunken. –Lack of urine or wet diapers for 6 to 8 hours in an infant ( or only a very small amount of dark yellow urine). –Lack of urine for 12 hours in an older child ( or a very small amount of dark yellow urine). –Dry, cool skin. –Lethargy or irritability. –Fatigue or dizziness in an older child.

6. Frequency of Occurrence Dehydration more frequently occurs in infants and children and may occur more frequently in children who are often sick with symptoms previously stated.

7. Treatments Home Care –Fluid Replacement If dehydration is due to diarrhea or vomiting it is important to replace the fluids while the child is sick. Under 2- Pedialyte, Rehydralyte, Pedialyte freezer pop, etc. (Product to replace fluids, sugar, and Electrolytes), ORS Over 2- ORS or Gatorade, Give a few sips every minute. Medical Treatment –Mild Oral Rehydration (above) –Moderate (5-10% total body weight loss) IV to replace fluids & oral rehydration –Severe (more than 10-15% total body weight loss) Admitted to hospital for continued IV fluid replacement Observation & other tests to determine cause

8. Dehydration due to overexertion –In an older child with mild dehydration Will be thirsty and should be allowed to drink as much as he/ she wants Plain water for first 1-2 hours After they should have drinks with electrolytes or regular food (to replace salts).

9. Duration & Life Span Expectancy Factors influencing duration: –Age, condition, and general health of patient –Underlying cause of dehydration * –Complications Life Span Expectancy –Common condition –Depends on underlying condition and severity of dehydration

10. Developmental Impact Physical- –Can cause: Kidney Failure, Coma, Shock, Heat Related Illnesses (heat stroke, heat cramps, heat exhaustion), Electrolyte abnormalities –May also impact ability to participate in physical activities. If a child is dehydrated they will need to take a break while they re-hydrate and regain their electrolytes. Cognitive –Depending on the severity, depends on how cognitive development will be impacted. If the dehydration leads to a coma, there may be significant cognitive damage. If it is mild, however, cognitive development may not be impacted at all. Social –Depending on what happens as a result of the dehydration will determine how social development is impacted. If a child gets dehydrated while playing a team sport (and the experience impacts them significantly emotionally), they may be less willing to participate and cooperate in team sports. Emotional –Depending on the severity, this may be a very scary situation. (Especially if a visit to the hospital is required.)

11. Infection Control and/or Isolation Implications If dehydration is due to illness that cause diarrhea or vomiting, it is important to take precautionary steps to prevent others from catching illness. –Avoid close contact if possible –Frequent hand washing

12. Potential Impact on Parents and Siblings Spread of illness Depending on severity, this may be a very emotional and scary experience for parents and siblings. Ethical Considerations Be culturally sensitive and aware of the families needs.

13. Teaching Modifications A very important teaching modification to consider is providing water for your students at all times. The students should know where the nearest water fountain is and should be allowed to use it whenever they would like. Dehydration can be very serious. Teachers should be aware of the signs and symptoms and should know how to rehydrate their students.

14. Addressing Dehydration in the Classroom If your have a student who is mildly dehydrated due to heat or overexertion, it is important to get them hydrated and allow them to rest. If it is a more severe case, you may need to send them to the nurse, send them home, or even call an ambulance if it is very serious. The good news is that this is preventable. Provide students with opportunities for water breaks. If a student says they are thirsty, dehydration is already underway. Allow students to hydrate themselves whenever necessary. (Bring water for your students when they are playing out in the heat.) If dehydration is due to illness, make sure proper infection control techniques are used. FREQUENT HANDWASHING IS CRUCIAL!!!

15. Summary There are so many different factors that contribute to the cause of dehydration and to the treatment. There is also a huge range of severity in dehydration. As teachers, it is our responsibility to know the signs of dehydration and to get the necessary help for children if they need it. Dehydration is a very common condition. Teachers should educate their students of dehydration and teach proper hydration techniques, knowledge of how to detect dehydration, and good health habits like hand washing.

16. Bibliography Ferry, R., MD. (2007). Dehydration in children. Retrieved from http://www.emedicinehealth.com/dehydration_ in_children/article_em.htm Google Health. (2010). Dehydration. Retrieved from https://health.google.com/health/ref/Dehydration MedicineNet, Inc. (2011). Dehydration. Retrieved from http://www.medicinenet.com/dehydration/ article.htm Nemours. (2010). Dehydration. Retrieved from http://kidshealth.org/parent/firstaid_safe/ emergencies/dehydration.html#