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Oral Rehydration Therapy Manual

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Food intoxication and viral gastrointestinal infections are the leading cause of diarrhea (and dehydration) in the U.S. While the adults can tolerate it quite well, elderly and children are much more sensitive (diarrhea is the second leading cause of death under the age of 5 globally). The Oral Rehydration Therapy saved millions of lives throughout Europe, Asia, and Africa in the last 100 years reducing the diarrhea mortality by up to 93% (depending on the condition treated).

Dehydrated Marine receives IV by James McKenzie | Public Domain

By the end of this article, you will learn everything you need to know about Oral Rehydration Therapy so you can use commercially available ORT packages or prepare it yourself at your home and administer it to an adult, senior or a child in case of an emergency.

What is the purpose of Oral Rehydration Therapy (ORT)?

Oral Rehydration Therapy is used for the treatment and prevention of mild to moderate dehydration. Why not severe dehydration, you may ask? Simply, ORT is not enough, and intravenous solutions are the therapy of choice in such cases. I remember “old school” infectious diseases professor used to teach us during my college days: “As long as you can completely rehydrate the patient with oral therapy, go for oral therapy.”

Losing more than 9% of body weight is a criterion for severe dehydration. Other symptoms include confusion, dizziness, headache, and dry skin. A patient with signs of severe dehydration needs to transport to the healthcare facility as soon as possible!

The most popular, but not the only commercially available product for oral rehydration in the U.S. is Pedialyte. It’s best to have a few packages available at home, just in case. If you plan to travel to a third world country, you should get yourself a few packs (although those products are widely available in the areas of the world where diarrhea is a common problem). Commercially available products come with the instructions how to prepare them (dissolving it in a specific volume of water, usually one liter).  

The recipe

This formula was developed in the 20th century to help medical professionals fight against cholera and other conditions which were characterized by dehydration.

In case you find yourself on camping, somewhere remote, or there is a distribution issue that caused the supply of OTC medicines to diminish, and you need Oral Rehydration Therapy, here is a basic recipe for it:

–    6 level teaspoons of sugar (approximately 25.2 gr)

–    ½ teaspoons of salt (roughly 2.1 gr)

–    1 liter of water

The teaspoon is standardized measurement, and that’s why it should be a piece of equipment in every survival kit. In the ORT recipe, some ingredients may seem roughly determined, but there is a lot of science behind those numbers. To prepare an Oral Rehydration Therapy that works, the molar ratio between sugar and salt should be 1:1. Also, the volume of one liter should also be available in emergency situations. In case you can’t measure the amount of 1L, it is useful to know that there are 203 teaspoons in one liter.

Boiling water

If you believe the water available is contaminated, the process of boiling will ensure elimination of all microorganisms in it (bacteria, viruses, protozoa, and fungi). Bring it to the rolling boil for 1 minute. In case you are on the altitude greater than 2000 m (6.562 feet), it should boil for 3 minutes. Boiling kills the microorganisms, but it will not destroy chemical compounds (some of which may be toxic to humans) in the water. Keep in mind that chemical contamination may be the issue when utilizing water from human-made reservoirs or if contaminated by a human-made waste.

What to do if you can’t boil the water

In case of mild to moderate dehydration which threatens to develop further (diarrhea caused by an infective agent), rehydration is what makes the difference between life and death. Although boiled water is preferable, using possibly contaminated water is better than not attempting rehydration at all!

How to administer the Oral Rehydration therapy?

Here is a World Health Organization guide for the use of the ORT:

What to do after the first 4 hours? Continue with the rehydration by compensating any additional water loss. Gradual lightening of the urine (and increased regularity) color is a sign of successful rehydration.

What are the contraindications to the use of ORT?

   In certain situations, due to the severity of the illness, Oral Rehydration Therapy alone can’t help. Immediate professional medical help is needed if:

–    The condition is worsening, and it’s impossible to keep up with the tempo of fluid loss

–    The patient vomits despite the efforts to introduce ORT in small portions

–    Unconscious patient

–    The patient has ileus- a condition in which the intestinal movements are interrupted, usually painful. If the patient has bowel movements, you can assume that he or she does not have ileus.

Readers take away

Now you know how to prepare an Oral Rehydration Solution when to use it, when not to use it, and how to dose it. Also, you learned how to recognize severe dehydration- a condition that requires immediate medical treatment.

The knowledge you got reading this article has the power to save someone’s life. Stick to the recommended treatment, and you should get dehydration under control within a few hours!

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