Dehydration: Classification & Treatment Plan

Dehydration: An Introduction

Water is essential for the human body, and its deficiency leads to dehydration, which can be life-threatening. The World Health Organization (WHO) classifies into different levels and provides three treatment plans (Plan A, B, and C) for effective management.

WHO Classification

WHO classifies dehydration into three categories:

No Dehydration

Symptoms:

Normal activity and alertness

Normal eyes

Moist mouth and tongue

Skin returns to normal immediately when pinched.

Normal urine output

Treatment:

Encourage increased fluid intake

Continue breastfeeding and feeding as usual

Prioritize liquid-based foods

Some (Mild to Moderate)

Symptoms

Fatigue or irritability

Sunken eyes

Dry mouth and tongue

Skin takes longer to return to normal when pinched

Reduced urine output

Treatment (Plan B)

Provide Oral Rehydration Solution (ORS)

Give ORS based on body weight (75 ml/kg over 4 hours)

Continue breastfeeding or other fluid intake

Reassess after 4 hours and decide if further treatment is needed

Severe

Symptoms

Lethargy or unconsciousness

Deeply sunken eyes

Extremely dry mouth

Skin takes a very long time to return to normal when pinched

No urine output

Treatment (Plan C)

Immediate hospitalization

IV fluid administration

First hour: 30 ml/kg Ringer’s lactate solution

Over the next five hours: 70 ml/kg IV fluid

Shift to ORS once the condition improves

WHO Treatment Plans (Plan A, B, C)

Plan A:

Home Treatment (No Dehydration)

Encourage increased fluid intake

Provide ORS or liquid foods (lentil soup, rice water, broth, coconut water)

Continue breastfeeding

Give zinc supplements (10 mg/day for children under 6 months, 20 mg/day for older children, for 10 days)

Seek medical help if symptoms worsen

Plan B

Administer ORS (75 ml/kg over 4 hours)

Continue feeding with liquid foods

If vomiting occurs, wait 5–10 minutes before reintroducing ORS

Reassess after 4 hours to decide if Plan C is needed

Plan C

Immediate IV fluid administration

Ringer’s lactate: 30 ml/kg in the first hour, then 70 ml/kg over five hours

If the patient can drink, provide ORS

If unconscious, provide emergency medical care

Conclusion

The WHO classification and treatment plans are simple yet highly effective. Managing through Plan A, B, and C can save lives. Timely intervention with ORS, fluid-based diets, breastfeeding, and emergency IV fluids is crucial in preventing complications and ensuring a quick recovery