ORAL REHYDRATION SALTS = ORS

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    Last updated: October 2024

     

    Indications

    • Prevention and treatment of dehydration from acute diarrhoea, cholera, etc.

    Forms and strengths

    • Sachet of powder to be diluted in 1 litre of clean water.
    • WHO formulation:

    Dosage

    Prevention of dehydration (WHO - Treatment plan A)

    • Child under 24 months: 50 to 100 ml after each loose stool (approximately 500 ml daily)
    • Child from 2 to 10 years: 100 to 200 ml after each loose stool (approximately 1000 ml daily)
    • Child over 10 years and adult: 200 to 400 ml after each loose stool (approximately 2000 ml daily)
       

    Treatment of moderate dehydration (WHO - Treatment plan B)

    Child and adult:

    • Over the first four hours:

     

    Age

    under
    4 months

    4 to 11
    months

    12 to 23
    months

    2 to 4
    years

    5 to 14
    years

    15 years
    and over

    Weight

    under 5 kg

    5 to 7.9 kg

    8 to 10.9 kg

    11 to 15.9 kg

    16 to 29.9 kg

    30 kg and over

    ORS in ml

    200 to 400

    400 to 600

    600 to 800

    800 to 1200

    1200 to 2200

    2200 to 4000

     

    • After four hours:
      If there are no signs of dehydration: follow Treatment plan A.
      If there are signs of moderate dehydration: repeat Treatment plan B.
      If there are signs of severe dehydration: start IV therapy (Treatment plan C).
       

    Treatment of severe dehydration (WHO - Treatment plan C)

    In combination with IV therapy and only to a conscious patient:

    Child and adult: 5 ml/kg per hour

    After 3 hours (6 hours in infants), reassess and choose the appropriate plan A, B or C.

    Duration

    • As long as diarrhoea and signs of dehydration persist.

    Contra-indications, adverse effects, precautions

    • If the eyelids become puffy during the treatment: stop ORS, give plain water then, resume ORS according to Treatment plan A when the puffiness is gone.
    • If case of vomiting, stop ORS for 10 min and then resume at a slower rate (very small, frequent, amounts); do not stop rehydration.
    • Pregnancy: no contra-indication
    • Breast-feeding: no contra-indication

    Remarks

    • A special ORS-formula, ReSoMal, is used under medical supervision, for severely malnourished children only. However, in malnourished children with cholera, standard ORS- formula is used instead of ReSoMal.
    • Comes in flavoured and unflavoured ORS sachets.

    Storage

     
    – Below 25 °C

    Do not use the powder if it has turned into a yellow-brownish sticky substance.
    Once prepared, the solution must be used within 24 hours.

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