Introduction. Oral rehydration solution. How to prepare ORS. How to administer ORS. How to give ORS. Limitation of ORS. Definition of Dehydration. Degree of dehydration.

1. Haneen Hassan Shaker.
Baghdad university/Alkindy
college of Medicine.

2. Objectives
Introduction.
Oral rehydration solution.
How to prepare ORS.
How to administer ORS.
How to give ORS.
Limitation of ORS.
Definition of Dehydration.
Degree of dehydration.

3. Introduction
Water
ᴔIs A Primary Component Of Body
Fluids , Water Is Essential To
Sustain Life.
ᴔWater Plays A Vital Role In
Several Physiologic
Processes Such As Digestion,
Absorption , Use Of Nutrients,
Distribution, Waste Excretion,
Perfusion And Maintenance Of
Hemodynamics.

4. Total body fluid (TBW)
Total body fluid (TBW), accounts for approximately 60% of
total body weight (this can be 70% or higher in a newborn
down to 50–55% in a mature woman).

5. • Overweight or obese and Women typically have a
lower percentage of total body water than men due to a
higher percentage of body fat.
• Elderly patients tend to have a lower concentration of
water overall, due to an age-related decrease in muscle
mass.
• Children tend to have a higher percentage of water
weight-as much as 70-80% in a full-term neonate.

7. Total body fluid (TBW)
2/3 TBW 1/3 TBW
Intraceluller fluid: Extracellular Fluid:
 Interstitial fluid. ¾
 Intravascular fluid. ¼
 3rd space. (1.5%_2.5%)
Found inside the
plasma membrane of
the body's cells
28 liters

8. Functional compartment of body fluids
Compartment 70 Kg Man % Body weight
Plasma 3500 cc
Total ECF
volume 20%Interstitial fluid
(intercellular fluid)
10,500 cc
Intracellular volume 28,000 cc Total ICF
volume 40%

9. Minimal Obligatory Daily input:
• 500mL: Ingested water
• 800mL: Water content in food
• 300mL : Water from oxidation
TOTAL: 1600mL

10. Minimal Obligatory Daily water output:
• 500mL : Urine
• 500mL: Skin
• 400mL: Respiratory tract
• 200mL: Stool
• TOTAL : 1600mL
•On average, an adult input and output is 30-35mL/kg/day
(about 2.4L/day)

11. •Water requirements increase with:
• Fever
• Sweating
• Burns
• Tachypnea
• Surgical drains
• Polyuria
• Gastrointestinal losses through Vomiting or diarrhea
• Water requirements increase by 100 to 150 mL/day for
each C degree of body temperature elevation.

12. Types of Fluid therapy
1. Oral rehydration solution .
2. Intravenous fluid .

13.  Is a type of fluid replacement.
 Is a solution of glucose and electrolytes in defined amount .
 when given orally enhance the intestinal absorption of salt
and water thus it can correct electrolyte and water deficit.
The NA, K and CL in ORS solution replaces losses of these
electrolyte in Stool.
 Citrate helps correct acidosis.
Oral rehydration solution

14. Oral rehydration solution
((ORS CONTENT))
Nacl 2.6 gm
Na citrate 2.9 gm
Kcl 1.5 gm
Glucose 13.5 gm

15. How to prepare ORS
 Dissolve the entire contents of the packet of
ORS in 1L of clean sterile boiled water .
 It is used for mild and moderate dehydration .

16. Oral Rehydration Therapy ORT includes two phases:
1. Rehydration Phase:
 50 mL/kg of ORS should be given within 4 hr to patients
with mild dehydration.
100 mL/kg over 4 hr to those with moderate dehydration.
An additional 10 mL/kg of ORS is given for each episode
of vomiting and diarrhea .
((How to give ORS))

17. feeding should be allowed after rehydration.
Vomiting may occur during the first 2 hr of
administration of ORS, but it usually does not
prevent successful oral rehydration.
Reassessment of the child.

18. 2. Maintenance Phase:
Patients with mild diarrhea usually can then be treated at home
with 100 mL of ORS/kg/24 hr until the diarrhea stops.
Patients with more severe diarrhea require continued
supervision, an intake of 10–15 mL of ORS/kg/hr is appropriate.
Breast-feeding or supplemental water intake should be
maintained.

19. ((How to administer ORS))
By dropper , teaspoon , cup , NG.
Beginning slowly and increased as the child tolerated.
Should be given in frequent small amount with a teaspoon.
As frequent sips from cup for older children.
Fluid intake should be decrease if the patient appears fully hydrated.
Vomiting is not contraindication for ORS >> should wait 5_10 min and
start to given ORS again but more slowly.

20. Limitations of ORS
1. Severe vomiting
2. Shock
3. Ileus
4. Intussusception
5. Carbohydrate intolerance
6. High stool output 10 ml / kg /hr.

23. Degrees of DEHYDRATION

24. Key signs of severe
DEHYDRATION
 conscious level .
Eager to drink .
Skin turger
mild to moderate
severe

25. Thank you