Last Updated on August 28, 2022
Severity of Dehydration
No / Mild
dehydration
Dehydration | Moderate
dehydration
Dehydration • ≥2 signs below | Severe
dehydration
Dehydration • ≥2 signs below | |
General appearance / consciousness | • Well | • Unwell / deteriorating | • Unwell / deteriorating |
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
Anterior fontanelle • Anterior fontanelle usually closes sometime between 9 months and 18 months • AFNT = anterior fontanelle normotensive ===== Anterior fontanelle is important in assessing neonates & infants: (i) Hydration • Anterior fontanelle sunken in moderate to severe dehydration (ii) Intracranial pressure • Anterior fontanelle tense / bulging in meningitis due to hydrocephalus / brain swelling ===== Notes: Anterior fontanelle is tense when a child is crying
• 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
Abbreviation: SBP • Systolic blood pressure • Spontaneous bacterial peritonitis Abbreviation: DBP • Diastolic blood pressure -
Postural hypotension
Postural hypotension: https://www.myhouseman.my/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 |