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Dehydration - Medical Malpractice
Dehydration is caused by a lack of bodily fluids, usually water, due to any number of conditions, including a lack of adequate intake or to an excess of bodily loss of fluids. We lose body fluids every day through the breath we exhale and through sweating, urination and stooling. Salts are lost along with water during this process. Losing too much water leads to dehydration and severe dehydration can lead to death if not treated immediately.
The causes of dehydration in adults include fever or heat exposure which causes excessive sweating. Too much exercise can cause the same thing. You can lose fluid through vomiting, diarrhoea and increased fluid loss in the urine because of infection. Diabetes can cause increased fluid loss as can decreased intake of water or food. People on a respirator who cannot drink have an increase risk of dehydration. If there are significant wounds or burns, or if you have severe skin diseases, you can lose more water than normal.
The symptoms of dehydration in adults include thirstiness, weakness, dry mouth, swollen tongue, dizziness, rapid heart rate or palpitations, confusion, inability to sweat, fainting or sluggishness, poor urine output and bright yellow urine. Dark amber urine can also be present.
You should see the doctor for dehydration any time you have persistent vomiting, fever greater than 101 degrees F, weight loss, diarrhoea lasting more than 2 days, poor urine output, weakness, confusion or fainting spells. Dehydration becomes an emergency if there is a fever higher than 103 degrees F, seizures, lethargy, confusion, severe headache, problems with chest pain or breathing and fainting spells.
Doctors do several tests to diagnose dehydration. A careful history and physical examination can show dehydration as can the vital signs, which may show tachycardia and fever. A urinalysis shows concentrated urine and possibly an increase in glucose in the urine (in diabetes). There can be an elevated sodium and potassium level in the serum and the BUN and creatinine can be elevated. A CBC can be ordered to check for possible infection and liver function enzymes may be abnormal.
If you have dehydration that can be managed at home, you need to sip fluids regularly to replace any losses. Pedialyte or sports drinks are a good thing to choose. You can suck on popsicles made from juice and sports drinks. Ice chips are good to suck on and you should dry to stay cool so you don't sweat too much. Remove excess clothing so you can stay cool and to prevent sweating. Try putting the person in front of air conditioning so they stay cool and dry. Place a wet towel around the person. Use spray misters to cool and humidify the skin. Avoid exposing the skin to excessive cold, as in ice packs, as this will decrease rather than increase the fluid loss.
If you need to see the doctor or go to the emergency room, certain other methods should be used to treat the dehydration. These can include bringing down the body's core temperature, giving IV fluids to restore fluid loss and addressing things like nausea and vomiting. Cooling blankets might need to be used to restore body temperature. If your condition improves rapidly, you could be sent home from the emergency room. If the condition doesn't improve, you may be hospitalized for supportive care and for more IV fluids until the situation stabilizes.
Medications that seem to work include Tylenol, ibuprofen and naproxen for fever. This reduces sweating and reduces fluid loss.
Prevention of dehydration is key to the whole process. You need to drink plenty of fluids when it is hot out and take medications to avoid nausea, vomiting or diarrhoea. Take extra fluid with you if you are going out into a hot or muggy climate outdoors and avoid exercise in the heat of the day. Make sure the elderly and babies are taking in enough water as they are at higher risk of dehydration. Avoid the consumption of alcohol, especially on hot days as you put out more urine when you drink alcohol.
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here