Answer Scheme
Strategy in this counseling
Explain + Re assurance + 3 Rules home treatment (Paed protocols)
Steps
1)Explain regarding patient’s condition
2)Re assures that it is ok to treat the patient at home
3)Extra fluids (as much as the child will take)
-Breast feed frequently, longer for each period.
-If exclusive breast feed; + ORS or cooled boiled water
-If not exclusive breast feed; + ORS, food based fluids and cooled boiled water
-Teach mother how to mix ORS. Give mother 8 packet of ORS
•Mix 1 pack with 250 ml of warm water
•Up to two year (50-100 ml after each loose stools)
•More than two years (100-200 ml after each loose stools)
-How to give ORS
•Frequent
•Small amount
•If vomit, wait ten minutes and re give.
4)Continue feeding
-Breast feed on demands
-Formula milk (continue usual formula)
-Lactose free milk not necessary
-Continue semi/solid food
-Avoid food with high simple sugar content (Osmotic load worsen the diarrhea)
5)When to bring the child to hospital
-When child not able to tolerate orally
-Becomes sicker
-Develops fever
-Blood in stools
-Not confident to manage child at home.
Notes
-Mild or Moderate dehydration only
-Non Complicated case only
-Mix ORS with plain water only. Do not mix with breast milk, carbonated drink.
Common questions by the doctor
- Can you store the mixed ORS in refrigerator?
- How long can you use the mixed ORS?
- Can you mix ORS with breast milk?
- Content of the ORS