Tag Archives: Dehydration

Dehydration

Definition:
Water makes up around 75 per cent of the human body. It’s important for digestion, joint function, healthy skin and removal of waste products.
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Dehydration occurs when more fluid is lost from the body than is taken in. This causes an imbalance in important minerals, such as sodium and potassium, which are required for muscle and nerve function.

If there is a one per cent or greater loss in body weight because of fluid loss, dehydration occurs. This may be mild, moderate or severe, depending on the amount lost.

Infants and children are more susceptible to dehydration than adults because of their smaller body weights and higher turnover of water and electrolytes. The elderly and those with illnesses are also at higher risk.

Dehydration is classified as mild, moderate, or severe based on how much of the body’s fluid is lost or not replenished. When severe, dehydration is a life-threatening emergency.

Who are at Risk?
Anyone’s at risk of dehydration, but some people are more at risk than others.

•Babies and young children have relatively low body weights, making them more vulnerable to the effects of fluid loss.
•Older adults tend to eat less and may forget to eat and drink during the day. With increasing age, the body’s ability to conserve water decreases and a person’s sense of thirst becomes less acute. Illness and disability are also more common, which may make it harder to eat and drink enough.
•People with long-term medical conditions, such as kidney disease and alcoholism, are more at risk of dehydration.
•Short-term, acute health problems, such as viral infections, can result in dehydration because fever and increased sweating mean more fluid is lost from the body. Such illnesses may also make you feel less inclined to eat and drink.
•People living or working in hot climates or those who take part in sports or other strenuous physical activities are at greater risk of dehydration.

Symptoms:
The body’s initial responses to dehydration are thirst to increase water intake along with decreased urine output to try to conserve water. The urine will become concentrated and more yellow in color.

As the level of water loss increases, more symptoms can become apparent. The following are further signs and symptoms of dehydration:

•dry mouth,
•the eyes stop making tears,
•sweating may stop,
•muscle cramps,
•nausea and vomiting,
•heart palpitations, and
•lightheadedness (especially when standing).

The body tries to maintain cardiac output (the amount of blood that is pumped by the heart to the body); and if the amount of fluid in the intravascular space is decreased, the body tries to compensate for this decrease by increasing the heart rate and making blood vessels constrict to try to maintain blood pressure and blood flow to the vital organs of the body. This coping mechanism begins to fail as the level of dehydration increases.

With severe dehydration, confusion and weakness will occur as the brain and other body organs receive less blood. Finally, coma and organ failure, and death eventually will occur if the dehydration remains untreated.

Causes:
Around two-thirds of the water we need comes from drinks. Up to one-third comes from food (tomatoes, cucumber, fish and poultry are good sources). Some is also provided as a result of chemical reactions within the body.
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The average adult loses around 2.5 litres of water every day through the normal processes of breathing, sweating and waste removal. If we lose more fluid than usual this tips the balance towards dehydration.

Your body may lose too much fluids from:
•Vomiting or diarrhea
•Excessive urine output, such as with uncontrolled diabetes or diuretic use
•Excessive sweating (for example, from exercise)
•Fever

You might not drink enough fluids because of:
•Nausea
•Loss of appetite due to illness
•Sore throat or mouth sores

Dehydration in sick children is often a combination of both — refusing to eat or drink anything while also losing fluid from vomiting, diarrhea, or fever.

Lifestyle factors such as drinking too much alcohol, exercise, being in a hot environment or being too busy to drink liquid can also lead to dehydration.

Diagnosis:
Dehydration is often a clinical diagnosis. Aside from diagnosing the reason for dehydration, the health care practitioner’s examination of the patient will assess the level of dehydration. Initial evaluations may include:

•Mental status tests to evaluate whether the patient is awake, alert, and oriented. Infants and children may appear listless and have whiny cries and decreased muscle tone.

•Vital signs may include postural readings (blood pressure and pulse rate are taken lying down and standing). With dehydration, the pulse rate may increase and the blood pressure may drop because the intravascular space is depleted of fluid. People taking beta blocker medications for high blood pressure, heart disease, or other indications, occasionally lose the ability to increase their heart rate as a compensation mechanism since these medications block the adrenaline receptors in the body.

•Temperature may be measured to assess fever.

•Skin may be checked to see if sweat is present and to assess the degree of elasticity (turgor). As dehydration progresses, the skin loses its water content and becomes less elastic.

•Infants may have additional evaluations performed, including checking for a soft spot on the skull (sunken fontanelle), assessing the suck mechanism, muscle tone, or loss of sweat in the armpits and groin. All are signs of potential significant dehydration.

•Pediatric patients are often weighed during routine child visits, thus a body weight measurement may be helpful in assessing how much water has been lost with the acute illness.

Laboratory testing:-
The purpose of blood tests is to assess potential electrolyte abnormalities (especially sodium levels) associated with the dehydration. Tests may or may not be done on the patient depending upon the underlying cause of dehydration, the severity of illness, and the health care practitioner’s assessment of their needs.

Urinalysis may be done to determine urine concentration – the more concentrated the urine, the more dehydrated the patient.

Treatment:-
As is often the case in medicine, prevention is the important first step in the treatment of dehydration. (Please see the home treatment and prevention sections.)

Fluid replacement is the treatment for dehydration. This may be attempted by replacing fluid by mouth, but if this fails, intravenous fluid (IV) may be required. Should oral rehydration be attempted, frequent small amounts of clear fluids should be used.

Clear fluids include:
•water,
•clear broths,
•popsicles,
•Jell-O, and
•other replacement fluids that may contain electrolytes (Pedialyte, Gatorade, Powerade, etc.)
Decisions about the use of intravenous fluids depend upon the health care practitioner’s assessment of the extent of dehydration and the ability for the patient to recover from the underlying cause.

The success of the rehydration therapy can be monitored by urine output. When the body is dry, the kidneys try to hold on to as much fluid as possible, urine output is decreased, and the urine itself is concentrated. As treatment occurs, the kidneys sense the increased amount of fluid, and urine output increases.

Medications may be used to treat underlying illnesses and to control fever, vomiting, or diarrhea.

Home Treatment:
Dehydration occurs over time. If it can be recognized in its earliest stages, and if its cause can be addressed, home treatment may be beneficial and adequate.

Steps a person can take at home to prevent severe dehydration include:

•Individuals with vomiting and diarrhea can try to alter their diet and use medications to control symptoms to minimize water loss. Clear fluids often recommended as the diet of choice for the first 24 hours, with gradual progression to a BRAT diet (bananas, rice, apples, toast) and then adding more foods as tolerated.
•Loperamide (Imodium) may be considered to control diarrhea.
•Acetaminophen or ibuprofen may be used to control fever.
•Fluid replacements may be attempted by small, frequent amounts of clear fluids (see clear fluids information in previous section). The amount of fluid required to maintain hydration depends upon the individual’s weight. The average adult needs between 2 and 3 liters of fluid per day.
If the person becomes confused or lethargic; if there is persistent, uncontrolled fever, vomiting, or diarrhea; or if there are any other specific concerns, then medical care should be accessed.

Prevention:-
•Environment: Dehydration due to the weather is a preventable condition. If possible, activities should not be scheduled in the heat of the day. If they are, adequate fluids should be available, and cooler, shaded areas should be used if possible. Of course, people should be monitored to make certain they are safe. Those working in hot environments need to take care to rehydrate often.
•Exercise: People exercising in a hot environment need to drink adequate amounts of water.
•Age: The young and elderly are most at risk. During heat waves, attempts should be made to check on the elderly in their homes. During the Chicago heat wave of 1995, more than 600 people died in their homes from heat exposure.
•Heat related conditions: Know the signs and symptoms of heat cramps, heat rash, heat exhaustion, and heat stroke. Preventing dehydration is one step to avoid these conditions.

Carefully monitor someone who is ill, especially an infant, child, or older adult. If you believe that dehydration is developing, consult a doctor before the person becomes moderately or severely dehydrated. Begin fluid replacement as soon as vomiting and diarrhea start — DO NOT wait for signs of dehydration.

Always encourage the person to drink during an illness, and remember that a person’s fluid needs are greater when that person has fever, vomiting, or diarrhea. The easiest signs to monitor are urine output (there should be frequent wet diapers or trips to the bathroom), saliva in the mouth, and tears when crying.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/dehydration1.shtml
http://www.medicinenet.com/dehydration/page4.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000982.htm

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Morning Sickness, All Day Long

Pregnancy sometimes causes nausea and vomiting. It is dismissed as normal morning sickness. In some cultures, vomiting is actually taken as proof of pregnancy.
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Morning sickness, however, is not necessarily confined to the morning, though 80 per cent of pregnant women fall in this category
. It can occur at any time of the day or night. The remaining 20 per cent of the women may show other signs of pregnancy such as eating ravenously.

Vomiting usually starts around the sixth week — around two weeks after the period is missed. It settles around the twelfth week, and then disappears around the fifth month. Any strong smell can precipitate waves of nausea — be it garbage or spices being fried in the kitchen.

Baffled scientists put forward many theories to explain this strange phenomenon. It was touted as an unconscious rejection of the pregnancy. Women were unsympathetically told to “control themselves”. Some blamed it on the hormonal changes during the period, which causes relaxation of the smooth muscles of the oesophagus and gall bladder and slows digestion.

Scientists have now discovered that the nausea is due to sensitivity to a hormone called HCG (human chorionic gonadotrophin). The vomiting coincides with peak levels of this hormone (six to 12 weeks).

The sensitivity varies and is genetically determined. Women who vomit during pregnancy often have mothers and sisters who had the same problem. It also tends to recur in each succeeding pregnancy, though, if the tolerance levels to HCG build up, the vomiting in the second pregnancy can be less than that in the first.

Excessive vomiting causes 1 per cent of the women who vomit to become morbidly ill. They lose 5 per cent or more of their pre-pregnancy weight. The violent retching can cause tears in the esophagus, resulting in blood in the vomit. The inability to retain any food in the stomach can result in dehydration severe enough to affect the kidneys. Blood may begin to clot in the veins. The brain may be affected as a result of electrolyte imbalance or dehydration. Loss of vitamins, particularly thiamine, may cause delirium.

This severe vomiting is also known as hyperemesis gravidarum (in Latin, gravid means pregnant, and hyper is excessive). It is more likely in younger women who are underweight before the pregnancy, pre-diabetic (abnormal GTT values) or have migraine headaches.

Persistent hyperemesis can be a danger signal. It can occur if the levels of HCG are higher than normal. This occurs when it is a twin pregnancy or if the baby has a chromosomal abnormality like trisomy 18 or 21. Or, it may not be a pregnancy at all but a tumour called hydatidiform mole that mimics pregnancy. An ultrasound examination at this stage will pick up all the above abnormalities.

Well meaning advice to tackle morning sickness with bed rest is counterproductive. The reclining position may further aggravate reflux from the stomach. Moreover, inactivity may lead to loss of muscle mass. This may make it difficult to withstand the rigours of labour and childbirth.

• To tackle morning sickness, consider the following.

• A good diet with adequate vitamins, particularly folic acid.

• Exposure to fresh air. Try going for a walk outdoor for half an hour in the morning and evening.

• Eat several small meals instead of three regular ones.

• Avoid anything that triggers the vomiting even if it touted as being “good for the baby”.

Ginger helps as lozenges, ginger tea or lime juice. Supplements are available but since the other additives in the capsules are not known, it is probably better and safer to use the natural product.

Peppermint can be sucked as lozenges or peppermint oil used as inhalations.

Try acupressure. The pressure point to reduce nausea is located in the middle of the inner wrist, three finger-breadths away from the crease and between the two tendons. Locate and press firmly, one wrist at a time for three minutes.

Despite this, if uncontrollable vomiting occurs, with aversion to food, loss of weight, dark coloured urine, loss of consciousness, headache, confusion or fainting, it is better to seek medical help. Hyperemesis can be fatal.

An initial evaluation will rule out a correctable cause like a urinary tract infection, acid dyspepsia, chromosomal abnormalities or a hydatidiform mole. Intravenous fluids (IV) can be given to restore hydration, electrolytes, vitamins and nutrients.

If anti-nausea medications are used, the danger to the baby has to be weighed against the risk to the mother. Strict medical supervision and documentation of the dose and duration of treatment are required.

Source : The Telegraph ( Kolkata, India)

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The Dangers of Too Much Detox

A woman was left disabled after following a “detox” diet which involved drinking large quantities of water.

Although doctors stress the need to avoid dehydration by drinking enough fluids, drinking more than enough is a different matter.

The human body may be mostly water, but you can have too much of a good thing.

In the most serious cases, “water intoxication” can kill, and there is, say experts, scant evidence that drinking even slightly more water than usual can improve your health.

The current popularity of detox diets which recommend drinking many litres of water a day, and drinking even when not thirsty, could cause problems if taken to extremes, they say.

The claim is that drinking more than usual can do everything from improving your skin tone to “flushing out” toxins from your body.

However, the amount of water actually needed in a day varies from person to person, and depends on other factors such as climate, and exercise, says the British Dietetic Association.

“You shouldn’t be drinking massively over and above what you feel with comfortable with” says Ursula Arens, British Dietetic Association

Flawed industry

Ursula Arens, a dietician, said that there was a difference between normal consumption of one or two litres a day, not just in the form of water, but also from coffee, tea, and juice, and constant, ritualistic consumption of water throughout the day.

“You shouldn’t be drinking massively over and above what you feel with comfortable with, when you’re not thirsty, in a mechanical way.”

She said that the evidence supporting the whole “hydration industry” was flawed.

“If you’re a top sportsman, earning £10,000 for a single game, I can understand the need to focus intensely on your hydration, but not if you’re someone just doing a couple of lengths at the swimming pool.

“It’s just a great marketing opportunity, nothing more.”

She said that the science of detoxing was unsupported by evidence, partly because its precise effects on the body had never been defined.

She added: “The body already has perfectly good ways of getting rid of toxins – mainly in the liver, and it’s hard to see how consuming more water would affect these.”

No evidence’

Others are more scathing about the fashion for both detoxing and taking frequent sips from an ever-present bottle of mineral water.

Kidney specialist Professor Graham MacGregor said there was no evidence that either had any benefit.

He described how too much water could “overwhelm” the body’s natural mechanisms for keeping levels in balance.

“The body already has a brilliant system for doing this, but if water levels in the blood rise too high, it just can’t cope.”

If vast quantities of water are taken, salt in the blood gets too dilute, he explained. When the salt solution in the blood is weaker than the solution in the cells and organs it supplies, water passes into those cells and organs.

“People should drink when their body tells them to – when they get thirsty”…Says Prof Graham MacGregor, St George’s University of London

In extreme cases, this causes organs such as the brain to swell up, and can stop it working properly, putting the drinker in serious danger.

Professor MacGregor said: “This isn’t just a problem with water – we used to see patients who had been diagnosed with ‘water intoxication’ after drinking 20 pints of beer.”

“In normal circumstances, then people should drink when their body tells them to – when they get thirsty.

“Anything else is completely unnecessary, and will just leave you standing in the queue for the toilet.

“Detox diets are a complete con in that respect.”

You may click to see:->
->Woman left brain damaged by detox
->US woman dies after water contest

Sources: BBC NEWS:July 23, ’08

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Infant Fever

A mother holds her baby while it is immunized

Image via Wikipedia

Fevers are fact of life for most children. In most cases they are nothing to worry about, but it is important to monitor the symptoms closely and to seek medical advice if they persist.

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What is a fever?

Fever has been defined as a body temperature elevated to at least 1F above the ‘normal’ of 98.6F (37.0C).

A baby’s temperature normally varies by as much as 2F, depending on the temperature of his surroundings, clothing worn, degree of stress, level of activity or time of day.

What prompts a fever?

In most cases a fever is the body’s reaction to an acute viral or bacterial infection. Raising the temperature helps create an inhospitable environment for viral or bacterial invaders, it also stimulates the production of disease-fighting white blood cells.

Why are babies prone to fevers?

The body’s temperature control system is not well developed in babies.

Infant and childhood fevers can be caused by a number of different factors including:

* Overexertion
* Dehydration
* Mosquito bites
* Bee stings
* Allergic reactions
* Viral or bacteria infections

What are the symptoms?

Typical symptoms of a fever include coughing, aches or pains, an inability to sleep and shivering.

Other symptoms include poor appetite, lethargy and prolonged irritability.

In some cases breathing may be difficult.

What are the treatments?

Dehydration is a risk for infants, and a feverish baby should always be given lots of fluids.

A child with a temperature of less than 102F (38.8C) does not always require immediate medical attention. The child should be observed, and help sought if the symptoms appear to get worse, or the fever does not subside within 24 hours.

A child with a temperature of 102F or higher should be given paracetamol. A doctor or pharmacist should be consulted for a recommended dose.

A doctor’s advice should always be sought for a child whose temperature is 104F (40C) or higher.

Children should not be given aspirin. Several studies link aspirin use in children with Reye’s Syndrome a severe illness that often is fatal.

Are there danger signs?

Certain symptoms, when combined with a fever, warrant an immediate call to the doctor. These include:

* Red spots on the skin, sensitive eyes and runny nose (measles)
* Red, itchy spots (chicken pox)
* Stiffness in the neck or headache (a sign of a more severe infection)

Febrile seizures

Occasionally, a child with a fever will have a seizure. This is called a febrile seizure, and it demands immediate attention from a doctor.

The seizures do not seem to be related to the height of the fever, or to the rapidity with which it rises, but a small number of children seem to be predisposed to attacks.

About 50% of the children who suffer one febrile seizure will go on to have another one. About 33% will have a third one.

While waiting for a doctor to arrive, it is important to follow basic instructions:

* Keep the child upright and make sure they are breathing well
* Stay with the child and talk reassuringly
* Watch for changes in breathing, and make sure that the airways are kept open
* Clear the area to prevent injury
* Do not restrain as this can cause additional injury
* Try placing a soft pillow or blanket under the child’s head
* Loosen clothing to prevent injury and ease discomfort
* If vomiting occurs, turn the head to the side so there is no risk of his choking on inhaled vomit

You may click to learn more about Infant Fever:->Infants Fever

>Fever Quiz

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Sources:BBC NEWS:2nd.June,1999

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Hot Summer Risks

While most enjoy the summer sun, high temperatures can pose a signficant risk to health.

For people who spend a lot of time outdoors during the hot summer months either for play or work, here are a few tips to keep a cool head.

Heat illness –– the body’s inability to deal with heat and cool itself — can be deadly. Employers with workers who spend much of their day outside or individuals who participate in outdoor activities need to pay close attention to avoid health risks.

There are some symptoms to look for and preventative measures that individuals and employers can take to reduce the chances of heat illness.

Dehydration:…..CLICK & SEE
One of the biggest dangers of a heat wave is the increased risk of dehydration.
This is the loss of water from the body, and with it important blood salts like potassium and sodium which play a vital role in the function of organs such as the kidneys, brain and heart.
It can lead to confusion, lethargy and problems with breathing and heart rate.

Heat stroke or exhaustion:....CLICK & SEE
Under normal circumstances the sweat we produce when we get hot keeps us cool when it evaporates from the surface of our skin.
However, on extremely hot days, or when we over-exert ourselves, this system can fail, and body temperature can start to climb to dangerous levels.
This leads to heat stroke or exhaustion. This can cause headaches, dizziness and muscle cramps, but it can also be life-threatening.
It is particularly dangerous because symptoms can come on very rapidly, and – unless you are watching for the signs – very little warning.

Heat stroke is by far the most serious heat illness as the body stops sweating and the individual can become delirious, lose consciousness, and convulse. The body temperature typically reaches 106 degrees F or higher and the skin becomes hot and dry. It may also be red or bluish in color. Victims will die if not treated promptly.

Heat exhaustion results when the individual loses too much fluid through sweating. This is why drinking plenty of water and taking salt tablets is vital. The victim will typically experience weakness, giddiness, nausea, and/or headache. The skin will be clammy, the complexion pale and the body temperature may be slightly above normal.

Sunburn:…...CLICK & SEE
A sun tan may look nice, but it is actually a sign of damage to the skin.
Not only is sunburn painful, it can accelerate the ageing process, and increase the risk of skin cancer, including the potentially fatal form, melanoma.

Heat cramps:……...CLICK & SEE

Heat cramps are painful spasms caused by drinking large quantities of water without replacing lost salt.

Heat rash may occur when sweat doesn’t evaporate as in hot, humid environments. This is often known as prickly heat and is commonly seen in babies or small children.

Those at greatest risk are infants and children up to the age of 4, along with adults over the age of 65, those who are overweight, and people taking certain medications.

Avoiding strenuous exercise in hot weather will go a long way in preventing heat illness. When going outside, be sure to wear appropriate lightweight clothing along with a hat and sunglasses. If a problem does occur, remember to:

Recognize the problem. It is important that everyone be able to recognize the signs of heat illness within themselves and others. To lessen the likelihood of encountering issues, acclimate to the environment slowly, allowing the body to become accustomed to the heat.

Get prompt medical attention. Immediately get into shade and cool the body as quickly as possible while waiting for emergency help to arrive.

Drink lots of liquids:..
As you will be losing more fluid than normal, it is important to top up your supplies.

The best way to keep yourself hydrated is to drink water, and to sip it, rather than gulp it down.

On an average day, a person weighing 58kg (128lb) should drink eight average-sized glasses of water.

As a general rule, for every 2lbs (0.9kg) of body weight, you need one fluid ounce (28.4ml) of water.

In very hot weather, consumption should be increased. However, drinking excessive amounts can bring problems of its own.

You might think a cold beer is exactly what the doctor ordered, but in fact, alcohol dehydrates the body, and consumption should be kept to a minimum.

If you can’t face drinking lots of water, non-carbonated soft drinks, such as fruit juice, are a reasonable alternative

Don’t wait to be thirsty, drink at least one quart of liquid per hour.

Get shade and rest breaks. Be sure to have easily accessible shade and take frequent rests in order to maintain a normal body temperature.

Develop policies and procedures. For employers it is important to develop and implement written safety policies and procedures which include heat training. Educate managers and supervisors on heat illness prevention to protect workers.

Modify your diet:

Avoid hot, heavy food.

Salt pills are available to replace minerals lost in the sweat. However, most diets contain more than enough salt, and so this is unlikely to be necessary.

Stay out of the sun:

The best place to be on a blistering day is in the shade.

If you must sunbathe, then ensure that it is for short periods, and that you use sunscreen with a protection factor of at least 15.

If you start to feel queasy or ill then get out of direct sunlight as quickly as possible.

The sun is at its most dangerous between 11am and 3pm.

Be sensible about exercise:

Do not exercise vigorously during the hottest times of the day. Instead, run, jog or exercise closer to sunrise or sunset.

Take things slowly and adapt to the pace of life in the sun. If you feel breathless or your heart is pounding, stop what you are doing and try to cool your body down, for example, by taking a cool shower. Rest if you feel faint or dizzy.

Keep cool:

Wear light, loose-fitting clothing, such as cotton, so sweat can evaporate.

Dark, heavy clothes absorb heat, but remember that some thin materials do not provide a sufficient barrier to the sun’s dangerous UV rays.

It is also a good idea to wear a wide-brimmed sunhat, preferably with vents.

Wear sunglasses to protect your eyes.

Ventilate your home:

Keep windows open all day and all night and use fans.

This is particularly important at night, when the body cools down.

Avoid heat traps:

Try to avoid anywhere where shelter is minimal, and ventilation poor. Parked cars can be a particular hazard.

If you can, try to stay in an air-conditioned environment.

If you have no alternative, but to travel in a hot, stuffy environment – for instance on the Tube – then make sure you carry a bottle of water with you.

If you face a long journey, it may be wise to plan breaks to go above ground for some fresh air.

Take special care of the vulnerable:

Those most at risk from the sun include children under four, people over 65 whose bodies adapt more slowly to the change in temperature, overweight people whose bodies tend to retain heat more and people who are ill.

Babies are particularly vulnerable to heat as their sweat glands are not well-developed.

It is important not to wrap them up in blankets or heavy clothing when it is hot – but it is equally important to ensure that they are not exposed to direct sunlight.

Resources:
http://news.bbc.co.uk/2/hi/health/medical_notes/5190094.stm
http://first-aid.suite101.com/article.cfm/hot_summer_temps_and_health_risks .