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Paediatrics

Dehydration in Paediatrics

Last Updated on August 28, 2022

Severity of Dehydration

No / Mild dehydration
(<5%)

Moderate dehydration
(5 - 10%)

• ≥2 signs below

Severe dehydration
(>10%)

• ≥2 signs below

General appearance / consciousness

• Well
• Alert, responsive

• Unwell / deteriorating
• Restless / irritable

• Unwell / deteriorating
• Restless / irritable

Sunken eyes

• Absent

• Present

• Present (may be prominent)

Skin turgor

• Normal (immediate)

• Reduced (≤2 seconds)

• Reduced (>2 seconds)

Offer fluid

• Drinks normally

• Drinks eagerly

• Not able to drink / Drinks poorly 

Other signs of dehydration

• Sunken fontanelle
• Dry mucous membrane

Severity of Shock

Normal Circulation

Compensated Shock

Decompensated / Hypotensive Shock

Consciousness level

Clear & alert

Clear

(may be missed if you do not touch patient)

Change of mental state - restless / drowsy

Temperature of extremities

Warm & pink

Cold

Cold clammy extremities

Capillary refill time (CRT)

Brisk (<2 seconds)

Prolonged (>2 seconds)

Mottled skin, very prolonged CRT

Peripheral pulse volume

Good volume

Weak & thready pulses

Feeble / Absent

Heart rate

Normal

Tachycardia

Severe tachycardia // bradycardia in late shock

Blood pressure

Normal

- Normal SBP with rising DBP

- Postural hypotension

Hypotension / Unrecordable BP

Pulse pressure

Normal

Narrowing pulse pressure

Narrowed (≤20 mmHg) / Unrecordable

Respiratory rate

Normal

Tachypnoea

Metabolic acidosis / Hypernoea

Urine output

Normal

Reducing trend

Oliguria / Anuria

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