[author image=”http://hunzanews.com/wp-content/uploads/2014/01/Dr-Sadia.jpg” ]Saadia Khan A paediatric resident at the Children’s Hospital and Institute of Child Health, Multan, she has a keen interest in preventative paediatric medicine and community work, and tweets as@drkhanchc (twitter.com/drkhanchc).[/author]
KAMZORI KA ILAJ BOTTLE (drip), TAQAT K LIYE BOTTLE, in pregnancy even without emesis, bottle lagwao, Single loose stool without dehydration bottle lagwaoo.
Why we all are fond up of IV Fluids?
Being a pediatric resident and working at Government hospital we daily met parents arguing to give intravenous fluid in clinically stable child with diarrhea having no signs of dehydration .IV fluid is not only available treatment for diarrhea. It is not for stopping diarrhea rather to stop ongoing loses in a child who is unable to take orally either due to persistent vomiting or altered sensorium.IV fluid has nothing to do with severity, frequency and consistency of diarrhea. There is no need of IV fluid for a child who is able to get orally as oral rehydration therapy is the gold standard treatment for child with diarrhea capable of oral intake.
Quacks often malpractice especially in children by giving excessive fluid in child with no sign of dehydration and child often landed to tertiary hospital with puffiness, heart failure secondary to fluid overload and pneumonia.
Interesting fact is that people not only from rural area argue for IV rehydration but most of the educated people from cities also argue for IV rehydration and consider it as only available treatment for diarrhea people from rural area mostly know about the use of ORS in diarrhea and start giving it prior to coming hospitals , Special thanks to PTV (who on off give messages regarding use ORS in diarrhea) or LHW’s that visited the rural area and counsel the people there regarding diarrheal management, while urban class who has switched to cables where there are no campaigns about early diarrheal management often take IV rehydration only treatment option available for diarrhea.
Professor came for the treatment of diarrhea at our hospital said;
Iam not satisfied with the treatment at the tertiary hospital because her child have diarrhea and kept for Oral rehydration therapy.
Are tertiary care units are just meant for aggressive management, IV rehydration, injectables and this and that.
A child with diarrhea needs more than IV fluid and key role should be played by family itself.
Following are key points for diarrheal management.
1-Breast feeding is treatment as well as prevention of diarrhea. Infants who are breast fed have 14% less risk of diarrhea. Bottle feeding is risk factor associated with diarrhea.
2- Proper homemade complementary feed in form of banana, yogurt and rice should be given.
3 Safe water, adequate sanitation and proper hygiene are important foundation of primary health care system .Hand washing with soap alone is 40% effective for decreasing diarrhea.
4- Get your child Immunized.
5- Give Vitamin A supplementation. It decreases the risk of death in children with diarrhea.
6- Give Zinc supplementation. It decreases the severity and duration of diarrheal episodes.
7-Fluid intake, Oral rehydration therapy is the key and initial step for treatment of diarrhea but only 39% with diarrhea has access to it.
8-Get your child checked by doctor he will prescribe antibiotics only if needed don’t give your child antibiotics cocktails by yourself or by quacks.
More important is that TRUST YOUR DOCTOR, He/she will not let your deserving child for IV rehydration to go home without giving fluid.
Diarrhea is the 2nd most common cause of death under 5year of children worldwide and it kills more than combined burden of Malaria, Measles, and AIDS.
Emphasis should be on proper management of diarrhea to reduce child deaths and prevention to reduce the burden of diarrhea for years to come in child life.