The New Emergency Health Kit 98: Drugs and Medical Supplies for 10,000 People for Approximately 3 Months: Annex 2: Assessment and treatment of diarrhoea: Annex 2a: Assessment of diarrhoeal patients for dehydration

The New Emergency Health Kit 98: Drugs and Medical Supplies for 10,000 People for Approximately 3 Months
(1998; 82 pages) [French] [Spanish]

Table of Contents

	Acknowledgments
	Introduction
	Chapter 1: Essential drugs and supplies in emergency situations
		What is an emergency?
		Quantification of drug requirements
		Contents of the kit
		Referral system
		Drug and supply management control
		Procurement of the kit
		Immunization in emergency
		Reproductive health
		Post emergency needs
	Chapter 2: Comments on the selection of drugs, medical supplies and equipment included in the kit
		Selection of the drugs
		Selection of renewable supplies
		Selection of equipment
		Major drug, equipment and supply changes since the 1990 edition
	Chapter 3: Composition of the New Emergency Health Kit 98
		Basic unit (for 1,000 persons, 3 months)
		Supplementary unit (for 10,000 persons for 3 months)
	Annex 1: Basic unit: treatment guidelines
	Annex 2: Assessment and treatment of diarrhoea
		Annex 2a: Assessment of diarrhoeal patients for dehydration
		Annex 2b: Treatment Plan A to treat diarrhoea at home
		Annex 2c: Treatment Plan B to treat dehydration
		Annex 2d: Treatment Plan C to treat severe dehydration quickly
	Annex 3: Management of the child with cough or difficult breathing
		Annex 3a: Child less than two months old
		Annex 3b: Child two months to five years old
		Annex 3c: Treatment instructions
	Annex 4: Sample data collection forms
	Annex 5: Sample health card
	Annex 6: Guidelines for suppliers
		Specifications for drugs and materials
		Packaging
		Packing list
		Information slips
	Annex 7: Other kits for emergency situations
		Immunization
		Nutritional support - feeding kits
		Reproductive health kits for emergencies
	Annex 8: Guidelines for Drug Donations⁴⁸
		Selection of drugs
		Quality assurance and shelf-life
		Presentation, packing and labelling
		Information and management
	Annex 9: Model Guidelines for the International Provision of Controlled Medicines for Emergency Medical Care⁵²
		Introduction
		Definitions
		Purpose and principle
		Scope of application
		Selection of suppliers
		Outline of standard agreement between suppliers⁵³ and control authorities of exporting countries
		Summary of the request procedure
		Model shipment request/notification form for emergency supplies of controlled substances
	Annex 10: References
		Drugs and drug management
		Gastrointestinal disease
		General public health
		HIV and STDs
		Immunization
		Laboratory support
		Malaria
		Materials
		Mental health
		Nutrition
		Reproductive health
		Respiratory tract infections
		Tuberculosis
	Annex 11: Useful addresses
	Organizations which have collaborated in the preparation of the New Emergency Health Kit 98
	Back Cover

Annex 2a: Assessment of diarrhoeal patients for dehydration

First assess your patient for dehydration
		A	B	C
1.	Look at: general condition	well, alert	*restless, irritable*	*lethargic or unconscious; floppy*
	eyes⁴⁴	normal	sunken	very sunken and dry
	tears	present	absent	absent
	mouth and tongue⁴⁵	moist	dry	very dry
	thirst	drinks normally, not thirsty	*thirsty, drinks eagerly*	*drinks poorly or not able to drink*
2.	Feel: skin pinch⁴⁶	goes back quickly	*goes back slowly*	*goes back very slowly*
3.	Decide:	The patient has no signs of dehydration	If the patient has two or more signs, including at least one *sign* there is some dehydration	If the patient has two or more signs, including at least one *sign* there is severe dehydration
4.	Treat:	Use Treatment Plan A	Weigh the patient, if possible and use Treatment Plan B	Weigh the patient and use Treatment Plan C urgently

Source: WHO. The treatment of diarrhoea, a manual for physicians and other senior health workers. Geneva: World Health Organization; 1995. WHO/CDR/95.3

⁴⁴In some infants and children the eyes normally appear somewhat sunken. It is helpful to ask the mother if the child’s eyes are normal or more sunken than usual.

⁴⁵Dryness of the mouth and tongue can also be palpated with a clean finger. The mouth may always be dry in a child who habitually breathes through the mouth. The mouth may be wet in a dehydrated patient owing to recent vomiting or drinking.

⁴⁶The skin pinch is less useful in infants or children with marasmus (severe wasting) or kwashiorkor (severe undernutrition with oedema) or in obese children.