A

B

C

1. Look at:

Condition^a

Well, alert

Restless, irritable

Lethargic or unconscious

Eyes^b

Normal

Sunken

Sunken

Thirst

Drinks normally, not thirsty

Thirsty, drinks eagerly

Drinks poorly or not able to drink

2. Feel:

Skin pinch^c

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 in B, there is some dehydration

If the patient has two or more signs in C, 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

^a Being lethargic and sleepy are not the same. A lethargic child is not simply asleep: the child's mental state is dull and the child cannot be fully awakened; the child may appear to be drifting into unconsciousness.
^b In 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.
^c The skin pinch is less useful in infants or children with marasmus or kwashiorkor or in obese children.