How the body loses fluid
Water leaves in several ways: with urine, sweat, breathing and stool. Under normal conditions, losses are replenished with drink and food. The balance is upset when losses increase sharply or income decreases. With diarrhea and vomiting, not only water is lost, but also sodium, potassium, and chlorine, so replacing it with water alone can worsen electrolyte balance. In the heat and under stress, the body loses fluid through sweat, and at high temperatures, also through rapid breathing. A separate mechanism works when blood sugar is high: excess glucose is excreted in the urine and draws water with it.
- Vomiting and diarrhea are the most common causes
- High temperature and rapid breathing
- Heat and intense physical activity
- Uncontrolled diabetes mellitus
- Taking diuretics
- Insufficient drinking in elderly and bedridden patients
- Burns and large wound surfaces
Signs and degrees
With mild dehydration, thirst, dry mouth, darkening and decreased urine appear. The average degree adds weakness, dizziness when standing up, decreased skin elasticity, sunken eyes, and rapid pulse. Severe dehydration is manifested by severe lethargy or agitation, cold skin, very low blood pressure and almost complete absence of urine - this condition is life-threatening. In children, they are guided by activity, the presence of tears when crying, the wetness of the lips, the number of wet diapers and the condition of the fontanel. In older people, the feeling of thirst is reduced, and the first sign is often confusion.
- Thirst and dry mouth
- Dark concentrated urine
- Decreased urine output
- Dizziness when standing up
- Weakness and headache
- Sunken eyes, decreased skin elasticity
- Increased heart rate and low blood pressure
- Severe confusion
What and how to replenish fluid
For losses with vomiting and diarrhea, the best choice is pharmaceutical solutions for oral rehydration: in them the ratio of salts and glucose is selected so that water is absorbed as efficiently as possible. You need to drink often and in small portions, several sips every 5–10 minutes; when vomiting - literally a teaspoon, taking pauses. Sweet soda, juices and energy drinks are not suitable: excess sugar increases diarrhea. Strong coffee and alcohol increase losses. For losses from heat and stress, water with added salts and normal nutrition are sufficient.
- Oral rehydration solutions in small, frequent portions
- Continued breastfeeding in infants
- Avoiding sweet soda and juices
- Limiting coffee and alcohol
- Return to normal diet as you improve
- Controlling the amount and color of urine
- Cool room and peace
When are tests and IVs needed?
Mild dehydration does not require testing. Tests are prescribed for repeated vomiting, prolonged diarrhea, concomitant kidney and heart diseases, in the elderly and in young children. Electrolytes, creatinine and urea, which show kidney function, are determined, urine analysis and, if necessary, blood sugar are assessed. Intravenous fluid replacement is necessary when drinking is impossible due to vomiting, in severe cases with impaired consciousness and low blood pressure, as well as in severe electrolyte shifts. A dropper without indications has no advantages over drinking and carries unnecessary risks.
- Blood electrolytes: potassium, sodium, chlorine
- Creatinine and urea
- General urine test
- Blood glucose
- General blood test
- Intravenous infusions for severe cases
- Hospitalization of young children and the elderly in severe cases
Prevention
In hot weather, it is important to drink regularly before you become very thirsty, avoid physical activity during the hottest hours, and wear light, loose clothing. It is useful for older people to have water in sight and drink on a schedule, since their sense of thirst is weakened. In case of an intestinal infection, you need to start drinking from the first hours, and not when weakness appears. Those who take diuretics or have diabetes should discuss their drinking regime in hot weather with their doctor. During prolonged exercise, athletes need drinks containing salts, not just water.
- Drinking regularly in hot weather without waiting for thirst
- Scheduled drinking in older people
- Early start of rehydration for intestinal infection
- Avoiding exercise during hot hours
- Drinks with salts for prolonged exercise
- Discussion of drinking regime when taking diuretics
- Sugar control in diabetes
