Oral Rehydration Therapy

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Oral rehydration therapy Jervin mano

What is oral rehydration therapy? <ul><li>Rehydrating a dehydrated person through oral route is called as ORT . </li></ul>

AIM <ul><li>To correct the water &electrolyte deficiet </li></ul><ul><li>To prevent dehydration </li></ul><ul><li>Reduce m...

PROOF? <ul><li>A study in kolkatta showed 90-95% of all cases of cholera &acute diarrhoea can be treated with ors alone ....

PRINCIPLE <ul><li>Glucose when given orally enhances the intestinal absorption of salt & water. </li></ul><ul><li>Thus it ...

WHOM CAN IT BE GIVEN? IN WHAT CONDITIONS CAN IT BE GIVEN? <ul><li>All age groups </li></ul><ul><li>All aetiologies </li></...

TYPES OF ORS?? <ul><li>Sodium bicarbonate based </li></ul><ul><li>Trisodium citrate based </li></ul><ul><li>Reduced osmola...

Sodium bicarbonate based ORS <ul><li>Composition </li></ul>2.5 Sodium bicarbonate 2.5 KCl 20.0 Glucose 3.5 NaCl (gm) Cont...

Disadvantages <ul><li>Less stable </li></ul><ul><li>Stool output not reduced </li></ul>

Trisodium citrate based ORS

Composition 2.0 Trisodium citrate 1.5 KCl 20.0 Glucose 3.5 NaCl (gm) Contents

Osmolarity 310mM TOTAL 10mM Citrate 20mM K + 110mM Glucose 80mM Cl + 90mM Na +

Advantages <ul><li>More stable </li></ul><ul><li>Less stool output in high output diarrhoea </li></ul><ul><li>Tri Na citra...

Possible adverse effects <ul><li>Hyper tonicity in net fluid absorption </li></ul>

To overcome this

We should reduce the osmolarity of the ORS

Reduced osmolarity ORS

Composition Trisodium citrate KCl Glucose NaCl Contents 2.9 1.5 13.5 2.6 (gm)

Osmolarity TOTAL Citrate K + Glucose Cl + Na + 245mM 10mM 20mM 75mM 65mM 75mM

Advantages <ul><li>Increased efficacy of ORS in non cholera diarrhoea </li></ul><ul><li>Need for unscheduled supplement IV...

DOSAGE & REQUIREMENT? <ul><li>If the child’s weight is known, the amount of ORS soln.for rehydration during the first 4hrs...

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 W...

HOW TO ADMINISTER??? <ul><li>Teach the mother </li></ul>ORS

RULES <ul><li><2yrs :- give 1-2 teaspoon every 2-3 minutes </li></ul><ul><li>Older children :- offer frequent sips out of ...

If the child vomits?? <ul><li>Wait for 10 minutes </li></ul><ul><li>Give a teaspoonful every 2-3 minutes </li></ul>

If the child wants to drink more than the estimated amount ? <ul><li>No harm , give more </li></ul>

If the child refuses to drink ? <ul><li>See whether the signs of dehydration has disappeared </li></ul><ul><li>If yes </li...

If the child is breast fed ? <ul><li>Nursing + treatment with ORS solution </li></ul>

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...

Where is it available ? <ul><li>PHC </li></ul><ul><li>Sub centers </li></ul><ul><li>Hospitals </li></ul><ul><li>Chemist sh...

Cost? <ul><li>Free </li></ul>

How to prepare it ? <ul><li>Dissolve the entire contents of the packet in 1l of drinking water </li></ul><ul><li>It should...

If ORS packets are not available ? <ul><li>Table salt (5gm) + sugar (20gm) in 1l of drinking water </li></ul>

<ul><li>Administer till the diarrhea stops </li></ul><ul><li>Earlier the treatment is instituted the better is for the pat...

ORT programme <ul><li>First started in 1986-1987 </li></ul><ul><li>Implemented through RCH programme </li></ul><ul><li>ORS...

Theme <ul><li>Adequate nutritional care of child with diarrhoea </li></ul><ul><li>Proper advice to mother in feeding </li...

Achievements & benefits <ul><li>Low cost treatment </li></ul><ul><li>Treatment of the patient in their own homes </li></ul...

Achievements & benefits <ul><li>Drinking water is sufficient (no need for boiling or other means of sterilization) </li></...

THANK YOU

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