Oral Rehydration Therapy

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Oral Rehydration Therapy

  1. 1. Oral rehydration therapy Jervin mano
  2. 2. What is oral rehydration therapy? <ul><li>Rehydrating a dehydrated person through oral route is called as ORT . </li></ul>
  3. 3. AIM <ul><li>To correct the water &electrolyte deficiet </li></ul><ul><li>To prevent dehydration </li></ul><ul><li>Reduce mortality </li></ul>
  4. 4. PROOF? <ul><li>A study in kolkatta showed 90-95% of all cases of cholera &acute diarrhoea can be treated with ors alone . </li></ul><ul><li>Mortality rate in cholera has been reduced </li></ul><ul><li>to 0.11% from 49.3% </li></ul>
  5. 6. PRINCIPLE <ul><li>Glucose when given orally enhances the intestinal absorption of salt & water. </li></ul><ul><li>Thus it can correct electrolyte & water deficit. </li></ul>
  6. 7. WHOM CAN IT BE GIVEN? IN WHAT CONDITIONS CAN IT BE GIVEN? <ul><li>All age groups </li></ul><ul><li>All aetiologies </li></ul><ul><li>All countries </li></ul>
  7. 8. TYPES OF ORS?? <ul><li>Sodium bicarbonate based </li></ul><ul><li>Trisodium citrate based </li></ul><ul><li>Reduced osmolarity ORS </li></ul><ul><li>Super ORS </li></ul>
  8. 9. Sodium bicarbonate based ORS <ul><li>Composition </li></ul>2.5 Sodium bicarbonate 2.5 KCl 20.0 Glucose 3.5 NaCl (gm) Contents
  9. 10. Disadvantages <ul><li>Less stable </li></ul><ul><li>Stool output not reduced </li></ul>
  10. 11. Trisodium citrate based ORS
  11. 12. Composition 2.0 Trisodium citrate 1.5 KCl 20.0 Glucose 3.5 NaCl (gm) Contents
  12. 13. Osmolarity 310mM TOTAL 10mM Citrate 20mM K + 110mM Glucose 80mM Cl + 90mM Na +
  13. 14. Advantages <ul><li>More stable </li></ul><ul><li>Less stool output in high output diarrhoea </li></ul><ul><li>Tri Na citrate-increases intestinal absorption of Na & water </li></ul>
  14. 15. Possible adverse effects <ul><li>Hyper tonicity in net fluid absorption </li></ul>
  15. 16. To overcome this
  16. 17. We should reduce the osmolarity of the ORS
  17. 18. Reduced osmolarity ORS
  18. 19. Composition Trisodium citrate KCl Glucose NaCl Contents 2.9 1.5 13.5 2.6 (gm)
  19. 20. Osmolarity TOTAL Citrate K + Glucose Cl + Na + 245mM 10mM 20mM 75mM 65mM 75mM
  20. 21. Advantages <ul><li>Increased efficacy of ORS in non cholera diarrhoea </li></ul><ul><li>Need for unscheduled supplement IV therapy in children fell by 33%. </li></ul><ul><li>Stool output decreased by 20%. </li></ul><ul><li>Vomiting decreased by 30%. </li></ul><ul><li>Safe & effective . </li></ul>
  21. 23. DOSAGE & REQUIREMENT? <ul><li>If the child’s weight is known, the amount of ORS soln.for rehydration during the first 4hrs may be calculated as 75ml/kg </li></ul>
  22. 24. DOSAGE & REQUIREMENT? 2200-4000 1200-2200 800-1200 600-800 400-600 200-400 Soln.(ml) 30< 16-29.9 11-15.9 8-10.9 5-7.9 <5 Wt.(kg) 15yrs< 5-14yrs 2-4yrs 1-2yrs 4-11mths <4mths Age
  23. 25. HOW TO ADMINISTER??? <ul><li>Teach the mother </li></ul>ORS
  24. 26. RULES <ul><li><2yrs :- give 1-2 teaspoon every 2-3 minutes </li></ul><ul><li>Older children :- offer frequent sips out of a cup </li></ul><ul><li>Adults:- drink as much as they can </li></ul><ul><li>Give the estimated amount within 4hrs </li></ul>
  25. 27. If the child vomits?? <ul><li>Wait for 10 minutes </li></ul><ul><li>Give a teaspoonful every 2-3 minutes </li></ul>
  26. 28. If the child wants to drink more than the estimated amount ? <ul><li>No harm , give more </li></ul>
  27. 29. If the child refuses to drink ? <ul><li>See whether the signs of dehydration has disappeared </li></ul><ul><li>If yes </li></ul><ul><li>Treat similar to a non dehydrated diarrheal child. </li></ul>
  28. 30. If the child is breast fed ? <ul><li>Nursing + treatment with ORS solution </li></ul>
  29. 31. Non breast fed infants less than 6 months <ul><li>Along with ORS solution give 100-200 ml of clean water for first 4 hours </li></ul>
  30. 32. Where is it available ? <ul><li>PHC </li></ul><ul><li>Sub centers </li></ul><ul><li>Hospitals </li></ul><ul><li>Chemist shops </li></ul>
  31. 33. Cost? <ul><li>Free </li></ul>
  32. 34. How to prepare it ? <ul><li>Dissolve the entire contents of the packet in 1l of drinking water </li></ul><ul><li>It should be used within 24 hours </li></ul>
  33. 35. If ORS packets are not available ? <ul><li>Table salt (5gm) + sugar (20gm) in 1l of drinking water </li></ul>
  34. 36. <ul><li>Administer till the diarrhea stops </li></ul><ul><li>Earlier the treatment is instituted the better is for the patient </li></ul>
  35. 37. ORT programme <ul><li>First started in 1986-1987 </li></ul><ul><li>Implemented through RCH programme </li></ul><ul><li>ORS packets are supplied by the central govt. </li></ul><ul><li>Twice a year 150 packets of ORS are provided as apart of drug kit supplied to all sub centers in the country </li></ul>
  36. 38. Theme <ul><li>Adequate nutritional care of child with diarrhoea </li></ul><ul><li>Proper advice to mother in feeding </li></ul>
  37. 39. Achievements & benefits <ul><li>Low cost treatment </li></ul><ul><li>Treatment of the patient in their own homes </li></ul><ul><li>Ingredients are inexpensive and readily available </li></ul>
  38. 40. Achievements & benefits <ul><li>Drinking water is sufficient (no need for boiling or other means of sterilization) </li></ul><ul><li>Breakthrough in the fight against cholera and other diarrheal diseases </li></ul><ul><li>Mortality rate in cholera has been reduced to 0.11% from 49.3% </li></ul>
  39. 42. THANK YOU

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