Halo 194 (Jan 2019)
Dehidration in children caused by gastroenteritis
Abstract
Acute gastroenteritis (AGE) is a common cause of morbidity and mortality worldwide. There are various causes of AGE, but the most common are viruses and bacteria. A viral AGE can present with a very serious clinical picture, especially in newborns, small children and immunocompromised adults. It is most important to recognize and prevent complications, to treat dehidration in a timely manner and to adapt treatment to the severity of the clinical picture. Objective To determine the number of children who presented with signs of AGE and fever to the Children's Infirmary of the Emergency Medical Aid Department in the Community Health Center, Banja Luka (EMAD CHC BL) during a three month period, the therapy they received in prehospital settings and the number of children reffered to the hospital for further treatment. Methods Using retrospective analysis, data was collected from the Children's Infirmary Protocol on 478 children who reported to the EMAD CHC BL between 01.10.2017. and 31.12.2017. The following data was collected on each patient: age, sex, body temperature, lab results, diagnosis, therapy and referral to the hospital. Analysis was performed on patients with the diagnosis of Acute Gastroenteritis and High Fever, as well as High Fever accompanying any other diagnosis. Results of all the children included in the analysis, 245 (51.26%) were male and 233 (48.74%) were female. The greatest number of patients (161-33.68%) were schoolchildren over the age of 7. 316 children had fever, ranging from 37.5oCto 39oC.Out of 275 laboratory tests perfomed, 216 had pathological findings. 89,54% were treated with probiotics and oral rehidratation. Antibiotic therapy was prescribed to 37.87% of the patients, 3.35% of the children's parents received advice, 4.90% got antipyretics and only 0.42% were treated with i.v. fluids. Of all the children reffered to the hospital, 21 (4%) were reffered to the Clinic for Infectious Diseases, 29 (6%) to the Children's Department at the hospital, while 428 (90%) completed their treatment at the infirmary. Conclusion In treating viral AGE it is of the utmost importance to restore the balance of fluids and electrolytes in the body. Probiotics are prescribed to restore the normal gut microflora. In less severe cases, it is most important to alleviate the symptoms of the disease, while in more severe cases it is necessary to include i.v. fluids in order to prevent dehidration from developing and sometimes even hospitalization is necessary. The rotavirus vaccine should be made available to all, especially to high risk children.
