Question

A child presented with a history of loose stools with an increase in frequency of 4 days. On examination, he is drowsy, unable to feed, and skin on pinching goes back very slowly. According to the integrated management of neonatal and childhood illness (IMNCI), this child will be classified as having

• A. Mild dehydration
• B. Some dehydration
• C. Severe dehydration
• D. Moderate dehydration

Answer 1

The Correct Option is C

The child in the case presents with specific symptoms following a history of increased frequency of loose stools for four days. To classify the level of dehydration according to the Integrated Management of Neonatal and Childhood Illness (IMNCI) guidelines, we assess the following signs: drowsiness, inability to feed, and skin returning slowly when pinched, which are critical indicators of the child's condition.

• Drowsiness: This indicates a potential alteration of mental status, suggesting severe dehydration.
• Inability to feed: A significant symptom in infants and young children, showing severe dehydration, as mild or moderate levels typically allow feeding ability.
• Skin pinch test: When the skin on pinching goes back very slowly, it is a classic sign of loss of skin elasticity due to severe dehydration. In cases of moderate dehydration, the skin would return slowly, but not 'very slowly'.

Based on these clinical signs outlined in the IMNCI guidelines, the child is classified as having severe dehydration. These guidelines categorize dehydration severity to ensure appropriate treatment, such as intravenous fluid therapy for severe cases, which is crucial to prevent further complications or possible mortality.