Dehydration occurs when the body loses too much water from things such as diarrhea, sweat, urine, vomiting etc.
Volume shock, specifically hypovolemic shock, is when the body loses too much fluid, i.e., blood and/or water.
Severe dehydration can lead to volume shock, and if volume shock is left untreated it will lead to death.
Most people (adults) require 2 to 3 liters of fluid replacement each day. This of course is highly dependent on many factors, e.g., size, environment, physical exertion, illness.
Common sense will help prevent dehydration. If you are losing more fluid than normal then replace it. The clearer your urine, the better. If it is dark and/or pungent, drink water.
Mild dehydration occurs when 2 % of a person’s water content is lost:
Anxiety.
Concentrated Urine (darker).
Decreased work efficiency.
Loss of appetite.
Increased rate of pulse and/or respiration.
Moderate dehydration occurs when 4 % of a person’s water content is lost:
As well as the symptoms of mild dehydration, the patient will also experience:
Decreased blood pressure.
Dizziness.
Fatigue.
Mood swings.
Nausea.
Vomiting.
Severe dehydration occurs when 6 % of a person’s water content is lost:
As well as the symptoms of mild and moderate dehydration, the patient will also experience:
Loss of coordination.
Decreased skin turgor (when the skin is pulled up for a few seconds and does not return to its original state).
Incoherence.
Minimal or no urine output.
Further decline of vitals.
Treat cause.
Rehydrate; Diagnoses and Treatments – Circulatory System – Dehydration and Volume Shock – Rehydration Plan.
Volume shock occurs when there is a major loss of fluid from the body, i.e., blood and/or water loss. It is a deadly complication of a variety of underlying problems, most commonly dehydration or major hemorrhage.
Decreased mental status.
Decreased urine output.
Fast breathing.
Pale, cool and sweaty skin.
Weak, fast pulse.
Treat the cause.
Rehydrate; Diagnoses and Treatments – Circulatory System – Dehydration and Volume Shock – Rehydration Plan.
Intravenous therapy may be needed, e.g., a blood transfusion.
Only use oral rehydration if the patient is capable or it may cause more harm than good, e.g., if the water goes into the airways.
Oral rehydration solutions are available commercially or can be easily made by combining 6 teaspoons sugar, 0.5 teaspoon salt and 1 liter of drinkable water.
Intake 50 to 200 ml/kg/24 hours (the stomach can only absorb 1 liter of liquid per hour).
If oral rehydration is not possible due to patient condition, intravenous therapy may be required.
When the patient is able, advance to BRAT foods: Bananas, Rice, Applesauce, Toast or crackers (plain)
Finally, give the patient solid foods.