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Clinical features of dehydration in an child

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

It may help to think of childhood dehydration in terms of borrowing from various sources. Thus mild dehydration results in thirst, oliguria and restlessness. Moderate dehydration borrows from reserves; severe dehydration results in circulatory collapse.

Symptoms and signs of clinical dehydration and shock include the following:

  • symptoms (remote and face-to-face assessments)

no clinically detectable
dehydration

clinical dehydration

shock

appears well

red flag - appears to be unwell or deteriorating

-

alert and responsive

red flag - altered responsiveness (for example, irritable, lethargic)

decreased level of
consciousness

normal urine output

decreased urine output

-

skin colour unchanged

skin colour unchanged

pale or mottled skin

warm extremities

warm extremities

cold extremities

 

  • signs (face-to-face assessments)

no clinically detectable
dehydration

clinical dehydration

shock

alert and responsive

red flag - altered responsiveness (e.g. - irritable, lethargic)

decreased level
of consciousness

skin colour unchanged

skin colour unchanged

pale or mottled skin

warm extremities

warm extremities

cold extremities

eyes not sunken

red flag - sunken eyes

-

moist mucous membranes (except after a drink)

dry mucous membranes
(except for 'mouth breather')

-

normal heart rate

red flag - tachycardia

tachycardia

normal breathing pattern

red flag - tachypnoea

tachypnoea

normal peripheral pulses

normal peripheral pulses

weak peripheral pulses

normal capillary refill time

normal capillary refill time

prolonged capillary refill time

normal skin turgor

red flag - reduced skin turgor

 

normal blood pressure

normal blood pressure

hypotension (decompensated shock)

Hypernatraemic dehydration should be suspected if the child has:

  • jittery movements
  • increased muscle tone
  • hyperreflexia
  • convulsions
  • drowsiness or coma (1)

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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