This document provides guidance on assessing and classifying diarrhea based on signs of dehydration. It describes how to determine if a child has no dehydration, some dehydration, or severe dehydration based on symptoms like lethargy, sunken eyes, and skin pinch test. It then provides treatment instructions for each classification, including giving oral rehydration solution or fluids and referring urgently to the hospital if severe dehydration or other severe signs are present.

1. ASSESS AND CLASSIFY DIARRHEA
Assess and Classify DIARRHEA
- How long the child has diarrhea
- Blood in the stool to determine if the child has dysentery
- Signs of dehydration
a. Within 5 day (DEHYDRATION)
GDS + 2 s/sx of DHN – Severe Dehydration
No GDS + s/sx of DHN – Some Dehydration
No GDS/ no s/sx of DHN – No Dehydration
SIGNS CLASSIFY AS
IDENTIFY TREATEMNT
(Urgent pre-referral treatment
are in bold print)
Two of the following signs:
- Lethargic or unconscious
- Sunken eyes Not able to
drink or drinking poorly
- Skin pinch goes back very
slowly
SEVERE DEHYDRATION
- If child has no other severe
classification:
 Give fluid for severe
dehydration (Plan C).
OR
If child also has another
severe classification:
 Refer URGENTLY to
hospital with mother
giving frequent sips of
ORS on the way.
 Advise the mother to
continue breastfeeding
- If child is 2 years or older
and there is cholera in your
area, give antibiotic for
cholera.
Two of the following signs:
- Restless, irritable
- Sunken eyes
- Drinks eagerly, thirsty
- Skin pinch goes back
slowly
SOME DEHYDRATION
- Give fluid and food for
some dehydration (Plan B)
- If child also has a severe
classification:
 Refer URGENTLY to
hospital with mother
giving frequent sips of
ORS on the way.
 Advise the mother to
continue breastfeeding
- Advice mother when to
return immediately.
- Follow up in 5 days if not
improving.
Not enough signs to classify as
some of severe dehydration NO DEHYDRATION
- Give fluid and food to treat
diarrhea at home (Plan A)
- Advice mother when to
return immediately.

2. - Follow-up in 5 days if not
improving