Seminar 2 (Paeds)
Seminar 2 (Paeds)
Seminar 2 (Paeds)
(Seminar 2)
14/4/2020
MARINAH MOHD OMAR - BMS17091287
NOR JANNATUL IRFANA – BMS17091289
Approach To A Child a With
Gastroenteritis
• inflammation of the gastrointestinal tract most commonly die to
infections with bacterial, viral or parasitic pathogens\
• most common manifestations are diarrhea and vomitting, associated
with abdominal pain or fever
Diarrhoea Dysentery
• frequent small stools
containing visible blood,
accompanied by fever,
abdominal cramps and pains,
usually resulting from disease
of large intestine
• Inflammatory disease of GIT
• Often associated with blood &
pus in faeces
• different from bloody diarrhea
(larger volume bloody stools
with less systemic illness)
Aetiology of AGE
• Family History
• History of contact diarrhea
• chronic illnesses
• Social history
• Clean water supply at home, dengue area
• Drug history
• Allergy to antibiotics?, on any medication?
• PERINATAL HISTORY
-perinatal, natal, postnatal
• VACCINATION HISTORY
• NUTRITIONAL HISTORY
Physical Examination
• search for signs of comorbid conditions
• estimate of the level of dehydration
• Breastfeeding
• It should be done frequently and for longer at each feed.
• If the child is exclusively breastfed, give ORS or cooled boiled water in addition
of breast milk.
• Otherwise, give one or more of the following:
• ORS, food-based fluids(soup or rice water) or cooled boiled water
111 90 20 80 30
• Na+ is absorbed by the healthy intestinal wall is impaired in the
diarrhoeal state, causing water not able to be absorbed.
• In ORS, glucose is added to a saline solution.
• The glucose molecules absorption through the intestinal wall are
unaffected by the diarrhoeal disease state and in conjunction
sodium is carried through by a co-transport coupling
mechanism of sodium and glucose.
• This occurs in a 1:1 ratio, one molecule of glucose co-transporting
one sodium ion (Na+).
• It should be noted that glucose does not co-transport water, rather
it is the now increased relative concentration of Na+ across the
intestinal wall which pulls water through after it.
Dehydrarion Mild Moderate
Total ORS 50ml/kg over 4 hours by syringe, spoon or 100ml/kg over 4 hours
cup Infants:
• Give 1ml/kg of ORS by syringe every 5 • Give 30ml per hour of ORS
minute for 4 hours OR • Give 5-10ml (1-2tsp) every 15 minutes
• Give 3ml/kg of ORS every 15 minutes Toddler:
for 4 hours • Give 60ml per hour of ORS
• Give 15ml (3tsp) every 15 minutes
Reassessment at 4-hour intervals Child:
• Give 90ml per hour of ORS
• Give 20-25ml every 15 minutes
• Give the recommended amount of ORS over 4-hour period:
1. Use the child’s age only when you do not know the weight.
2. The approximate amount of ORS required(in ml) can be calculated by
multiplying the child weight(in kg) x 75.
3. If the patient requires more ORS than shown, give more.
How to prepare ORS solution
• Empty the entire content of one ORS sachet into 250mls of cool boiled
water, and mix thoroughly.