Paediatric dehydration (AGE) — WHO Plans A/B/C viva

Opening stem

"A 10-month-old with diarrhoea is irritable with sunken eyes and drinks eagerly. Manage."

Q1: Assessment (2 min)

• WHO signs for none / some / severe dehydration.
• Some = ≥2 of irritable, sunken eyes, thirsty, slow skin pinch.
• Severe = ≥2 of lethargy, sunken eyes, cannot drink, very slow skin pinch.^[1]

Q2: Fluid plans (3 min)

• Plan A home ORS; Plan B 75 mL/kg ORS/4 h; Plan C 100 mL/kg IV RL with age-specific timing. ^[1]
• Continue breastfeeding; replace ongoing losses.
• Ondansetron selectively; no loperamide in infants.

Q3: Adjuncts and antimicrobials (2 min)

• Zinc 10–20 mg daily for 10–14 days (WHO 2005, all children with diarrhoea); Cochrane: no benefit shown under 6 months. ^[1]
• Antibiotics for dysentery/cholera/selected invasive disease — not routine watery diarrhoea.
• Rotavirus vaccine prevention message.

Q4: Pitfalls (1 min)

• Malnutrition masks signs; hypoglycaemia risk; hypernatraemic dehydration needs careful correction; if radial pulse still very weak, WHO repeats the 30 mL/kg aliquot once, then complete Plan C. ^[1]

Key phrases

• "Seventy-five millilitres per kilogram ORS over four hours." ^[1]
• "Zinc ten to twenty milligrams daily for ten to fourteen days."
• "ORS works because SGLT1 still functions."

References1ShowHide

1. [1]World Health Organization The treatment of diarrhoea: a manual for physicians and other senior health workers. 4th revision. World Health Organization, 2005.Source