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Triage of Children with Diarrhea
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Triage of Children with Diarrhea
, Pediatric Diarrhea Red Flags
See Also
Pediatric Diarrhea
Diarrhea Management in Children
Pediatric Diarrhea Fluid Replacement
Oral Rehydration Solution
Pediatric Dehydration
Traveler's Diarrhea Management
Traveler's Diarrhea Prophylaxis
Traveler's Diarrhea Prevention
Waterborne Illness
Foodborne Illness
Chronic Diarrhea
Pediatric Vomiting
Diarrhea
Indications
Urgent or emergent evaluation for red flag symptoms and signs
Fever
Age <3 months:
Temperature
> 100.4 F (38 C)
Age >3 months:
Temperature
> 104 F (40 C)
Caregiver
report of
Dehydration
signs
See
Pediatric Dehydration
Decreased tearing (sensitive parent reported marker for
Dehydration
)
Decreased fluid intake
Decreased
Urine Output
Age <1 year old: last urine >8 hours earlier
Age >1 year old: last urine >12 hours earlier
Dry mucous membranes
Cyanosis
Poor peripheral perfusion
Mental status changes
Lethargy
Excessive irritability or inconsolable crying
Altered Level of Consciousness
Ill appearance
Toxic appearance
Tachypnea
Petechiae
Failure of
Oral Rehydration Solution
Persistent
Vomiting
Failure to improve with
Oral Rehydration Solution
Inflammatory Diarrhea
signs
Tenesmus
Bloody
Diarrhea
Vomiting
characteristics
Bilious Vomiting
Bloody
Vomiting
(
Hematemesis
)
High-risk child
Younger than 6 months of age or less than 17 pounds (7-8 kg)
Premature Infant
Chronic comorbidity
Moderate to severe
Diarrhea
More than 10 stools per day
Substantial volume
Prolonged course longer than 2 weeks
References
(2003) King MMWR Recomm Rep 52(RR-16): 1-16 [PubMed]
Van Den Bruel (2010) Lancet 375(9717): 834-45 [PubMed]
Indications
Routine clinical evaluation
Recurrent
Diarrhea
or persistent
Diarrhea
>2 weeks
Suggests parasitic
Diarrhea
Inflammatory Diarrhea
(
Bacterial Diarrhea
)
Flecks or streaks of blood in stool
Diarrhea
for longer than 1 week
Not indicated for only persistent soft stools
Also consider
Lactose-Free Diet
Mucus or pus in stool
Fever
for longer than 72 hours
Stool Incontinence
Management
Home recommendations
See
Pediatric Diarrhea
Management
See
Pediatric Diarrhea Fluid Replacement
References
Churgay (2012) Am Fam Physician 85(11): 1066-70 [PubMed]
Hartman (2019) Am Fam Physician 99(3):159-65 [PubMed]
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