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World Health Organization (WHO) scale for dehydration

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World Health Organization (WHO) scale for dehydration

It is important to determine the degree of dehydration in order to select the appropriate plan to treat or prevent dehydration.

Clinical assessment for degree of dehydration associated with diarrhoea is as follows




general appearance

well, alert

restless, irritable

lethargic or unconscious






drinks normally, not thirsty

thirsty, drinks eagerly

drinks poorly, or not able to drink

skin turgor

goes back quickly

goes back slowly

goes back very slowly

  • if two or more of the signs in column C are present - the patient has "severe dehydration"
  • if two or more signs from column B (and C) are present - the patient has "some dehydration".
  • patients who fall under column A -  "no signs of dehydration"

Estimation of fluid deficit (and the requirement) in children with some dehydration or severe dehydration should be carried out by weighing them without clothing. (if weighing is not possible, a child's age may be used to estimate the weight) (1).


fluid deficit as % of body weight

fluid deficit in ml/kg body weight


no signs of dehydration


<50 ml/kg

use treatment plan A

some dehydration


50-100 ml/kg

use treatment plan B

severe dehydration


>100 ml/kg

use treatment plan C


  • treatment should never be delayed because a scale is not readily available (1)
  • the three most useful predictors of 5% or more dehydration are abnormal capillary refill, abnormal skin turgor, and abnormal respiratory pattern (2)



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