Dehydration In Children Calculator

How does this dehydration in children calculator work?

This health tool is based on the clinical dehydration scale of Goldman and comprises of four clinical features of the pediatric patient which are analyzed and compared with the scale items:

■ General appearance;

■ Eyes;

■ Mucous membranes (tongue);

■ Tears.

The following table introduces the clinical dehydration in children scale by Goldman items and the weight they carry in the final score:

The scale is aimed at children below 3 years of age and has been validated for this age range with accurate results.

It has focused on a cohort of patients suffering from gastroenteritis. The patients were scored during the diagnosis of dehydration and after rehydration was considered complete.

Dehydration scale interpretation

Body fluids are lost every day through urine, sweat, stool and tears. Replacement fluids normally come from dietary intake of foods and drinks.

Metabolic processes are in charge with the fine balance between fluids lost and replaced and the maintenance of normal values for sodium, potassium and chloride.

The dehydration assessment in pediatrics according to the clinical dehydration scale has three degrees:

Other clinical features that can be analyzed for signs of dehydration include:

■ Radial pulse;

■ Systolic blood pressure;

■ Skin elasticity;

■ Urine flow;

■ Percentage of body weight loss.

Dehydration guidelines

This condition can be caused by insufficient water intake or sickness symptoms such as vomiting, diarrhea and fever. The severity of dehydration and the rate at which it occurs depend on the amount of fluids lost, the type of loss and the age of the pediatric patient.

As a rule, infants and younger children are more likely to become dehydrated because of the smaller fluid reserves they carry and due to the fact that they might not accept to be breast fed or formula fed.

Older children and teenagers tend to have similar reserves to those of adults and also have better biological mechanisms to handle fluid imbalances.

The most common signs of dehydration in children include:

■ Cracked lips and dry mouth;

■ Drowsiness;

■ Cold or dry skin;

■ Weakness, low energy levels;

■ Sunken eyes, lack of tears;

■ Decrease or cessation of urine output.

References

1) Friedman JN, Goldman RD, Srivastava R, Parkin PC. (2004) Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr; 145(2):201-7.

2) Goldman RD, Friedman JN, Parkin PC. (2008) Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics; 122(3):545-9.

3) Woolley WL, Burton JH. (2009) Pediatric Acute Gastroenteritis: Clinical Assessment, Oral Rehydration and Antiemetic Therapy. Pediatr Health; 3(2):191-197.

4) Tam RK, Wong H, Plint A, Lepage N, Filler G. (2014) Comparison of clinical and biochemical markers of dehydration with the clinical dehydration scale in children: a case comparison trial. BMC Pediatrics 14:149.