07. Assessment of dehydration

Last update: 2022-09-14

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Patients with diarrhoea, especially children, can lose a lot of fluid from their bodies and suffer dehydration.
Dehydration can cause very severe illness and sometimes death, especially in association with acute watery diarrhoea and cholera.

How to assess whether a patient has dehydration, and its extent

Dehydration stage	Signs	Treatment
No dehydration	Skin recovers its shape normally when pinched; thirst has subsided; urine has been passed; the pulse is strong.	Oral rehydration solution (ORS) at home; zinc supplements for children up to 15 years of age.
Moderate dehydration	Restlessness and irritability; sunken eyes, dry mouth and tongue, increased thirst; skin recovers its normal shape slowly when pinched; reduced urine; decreased tears; depressed fontanels (soft membranes on head) in infants.	ORS and very close surveillance; zinc supplements for children up to 15 years of age.
Severe dehydration	Lethargy or unconsciousness; very dry mouth and tongue; skin recovers shape very slowly when pinched (“tenting”); weak or absent pulse; low blood pressure; minimal or no urine.	In a health facility or in a hospital: IV therapy plus antibiotics plus ORS; zinc supplements for children up to 15 years of age.

After the assessment, and according to the degree of dehydration, the following actions should be taken:

Assessment of dehydration table

Signs of dehydration