Table 1.
World Health Organization guidelines for assessing dehydration in children with acute gastroenteritis40
| A | B | C |
|---|---|---|
| Condition* | ||
| Well, alert | Restless, irritable | Lethargic or unconscious |
| Eyes† | ||
| Normal | Sunken | Sunken |
| Thirst | ||
| Drinks normally, not thirsty | Thirsty, drinks eagerly | Drinks poorly, or not able to drink |
| Skin pinch‡ | ||
| Skin goes back quickly | Skin goes back slowly | Skin goes back very slowly |
| Decision | ||
| No signs of dehydration | Some dehydration if there are ≥2 signs in B | Severe dehydration if there are ≥2 signs in C |
*
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.
†
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.
‡
The skin pinch is less useful in infants or children with marasmus or kwashiorkor, and in obese children.