How to Assess Dehydration

How to assess dehydration? Dehydration is a state in which a person has less fluid volume than is required to maintain homeostasis. A number of factors can lead to dehydration, including: fluid loss through vomiting, diarrhoea, fever dyspnoea, polyuria, burns and excessive diaphoresis (sweating). Decrease fluid or food intake due to poor diet, advanced age and immobility can also lead to dehydration.

Signs and Symptoms of Dehydration:

The following are common signs and symptoms of dehydration. As a paramedic, it is important to be aware of these signs and symptoms so that you can identify both the subtle and major physiological changes associated with acute dehydration. Recognising the early signs and symptoms of dehydration and correcting the dehydration is much easier than treating end stage absolute dehydration.

Looks for the following signs and symptoms of dehydration:

Tachycardia
Hypotension
Postural changes in blood pressure
Decrease Mean Arterial Pressure (MAP)
Narrowing Pulse Pressure
Dry Tongue
Sunken Eyes
Decreased Skin Turgor (the way the skin responds)
Thirst
Dry Mucus Membranes
Syncope
Decreased Urine Output; and
Inability to Sweat (due to profound dehydration).

Dehydration in Infants

The following are the most common signs of dehydration in infants:

1. Quiet baby or decreased level of consciousness

2. Sunken fontanel

3. Dry nappies

4. Decreased fluid intake 

Dehydration in the Elderly

Elderly patients are much more vulnerable to dehydration because they have approximately 10-15% less body water than a young or middle age adult. Dehydration is much more common in the elderly because of:

1. Concurrent use of medications such as antihypertensives and diuretics

2. Unstable blood glucose levels and higher resting blood glucose levels

3. Decreased mobility

4. Increased confusion

5. Current urinary tract infections.

Signs of dehydration in the elderly include:

1. Decreased level of consciousness

2. Increased confusion

3. Constipation.