because they no longer have skin to act as a barrier to
evaporation.
Dehydration can be mild, moderate or severe.
Mild dehydration occurs when fluid losses equal 3–
5%. At this point, the thirst sensation is felt, and is
often accompanied by dry mouth and thick saliva.
Moderate dehydration occurs when fluid losses
equal 6–9% of their body weight. This can occur
rapidly in young children who are vomiting and/or
have diarrhea. In an infant, a loss of as little as 2–3
cups of liquids can result in moderate dehydration.
Signs of moderate dehydration include intense thirst,
severely reduced urine production, sunken eyes, head-
ache, dizziness, irritability, and decreased activity.
Severe dehydration occurs when fluid losses are
10% or more of their body weight. Severe dehydration
is a medical emergency for individuals of any age. A
loss of fluids equaling 20% of a person’s body weight
is fatal. Signs of severe dehydration include all those of
moderate dehydration as well as lack of sweating, little
or no urine production, dry skin that has little elastic-
ity, low blood pressure, rapid heartbeat, fever, delir-
ium, or coma.
DiagnosisDehydration is diagnosed by physical symptoms.
A healthcare professional or observant adult can usu-
ally tell by looking at someone that they are moderately
or severely dehydrated. Blood tests and a urinalysis
may be done to check for electrolyte imbalances and
to determine if the kidneys are damaged. However,
visual signs are enough to begin treatment.
TreatmentThe goal of treatment is to restore fluid and electro-
lyte balance. For individuals with mild dehydration,
this can be done in infants and children by giving
them oral rehydration solutions such as Pedialyte, Infa-
lyte, Naturalyte, Oralyte, or Rehydralyte. These are
available in supermarkets and pharmacies without a
prescription. These solutions have the proper balance
of salts and sugars to restore the electrolyte balance.
Water, apple juice, chicken broth, sodas, and similar
fluids are effective in treating mild dehydration. Oral
rehydration fluids can be given young children in small
sips as soon as vomiting and diarrhea start. They may
continue to vomit and have diarrhea, but some of the
fluid will be absorbed. Breastfed infants should con-
tinue to nurse on demand. Babies who are formula fed
should continue to get their regular formula unless
directed otherwise by a pediatrician.
Older children who are dehydrated can be given
oral rehydration solutions or sports drinks such as
Gatorade for moderate and severe dehydration, other-
wise general fluids are fine. Athletes who are dehy-
drated should be given sports drinks. According to the
American College of Sports Medicine, sports drinks are
effective in supplying energy for muscles, maintaining
blood sugar levels, preventing dehydration, and replac-
ing electrolytes lost in sweat. Adults who are mildly or
moderately dehydrated usually improve by drinking
water and avoiding coffee, tea, and soft drinks that do
not containcaffeine.
Individuals of all ages who are seriously dehy-
drated need to be treated by a medical professional. In
the case of severe dehydration, the individual may be
hospitalized and fluids given intravenously (IV; directly
into the vein).Nutrition/Dietetic concerns
Dehydration is usually an acute condition, and once
fluid balance is restored, there are no additional nutri-
tional concerns. In the mobility-impaired elderly, the
main concern is making sure that they have adequate
access to fluids.Prognosis
Most people recover from dehydration with few
complications so long as rehydration fluids are avail-
able and treatment begins before the condition becomes
severe. However, severe dehydration can be fatal.Prevention
The best way to prevent dehydration is to be alert
to situations in which it could occur, such as exercising
in hot weather or vomiting and diarrhea in infants and
young children. Athletes and people who work in hot
conditions should drink regularly, whether or not they
feel thirsty. Rehydration of young children should
begin at the first sign of fluid loss. A healthcare pro-
vider should be consulted before the situation becomes
serious. Caregivers of the mobility impaired elderly
and infants and young children who cannot get water
for themselves should be offered fluids on a regular
basis.Resources
BOOKS
Batmanghelidj, F.Water: For Health, for Healing, for Life:
You’re Not Sick, You’re Thirsty!.New York: Warner
Books, 2003.
Panel on Dietary Reference Intakes for Electrolytes and
Water, Standing Committee on the ScientificDehydration