Oral rehydration therapy

2016-01-12T08:16:20Z

2A02:8109:1DC0:43EC:FCE8:5205:B6B:CCA7: used simpler words and sentences

[[File:Cholera rehydration nurses.jpg|thumb|A cholera patient is given an ORT drink.]]

'''Oral rehydration therapy''' is a treatment for [[dehydration]]: the sick person drinks [[water]] mixed with [[sugar]] and [[salt]]. They don't stop eathing food. There is a mixture that is used for severe dehydration: This mixture also includes [[zinc]]. Those who take care of the sick person are taught how they can see it if the dehydration gets worse. The [[World Health Organization]] and [[UNICEF]] specify indications, preparations and procedures for ORT.<ref name="WHO (2005)">{{cite web|url=http://whqlibdoc.who.int/publications/2005/9241593180.pdf|title="The treatment of diarrhea, a manual for physicians and other senior health workers."|publisher="World Health Organization|year=2005|format=PDF}}</ref>

The therapy was developed in the second half of the 20th century. It has helped lower the number of human deaths from dehydration in [[vomit]]ing and [[diarrhea]]l illnesses, especially in [[cholera]] [[epidemic]]s occurring in children. It is sign for [[public health]] getting better all over the world. It is on the [[World Health Organization's List of Essential Medicines]], a list of the most important medication needed in a basic [[health system]].<ref>{{cite web|title=WHO Model List of EssentialMedicines|url=http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf?ua=1|work=World Health Organization|accessdate=22 April 2014|date=October 2013}}</ref>

Before ORT was used often, most of the [[infant mortality|children who died]] in [[developing nation]]s, died from diarrhea. Between 1980 and 2006, the introduction of ORT is thought to have lowered the number of young children who died anywhere in the world from 5 to 3 million every year.<ref>{{cite news |last=Gerline |first=A. |title=A simple solution |agency= |work= |newspaper=Time |pages= |page= |date=8 October 2006 |url=http://www.time.com/time/printout/0,8816,1543876,00.html}}</ref><ref>{{cite journal |title=Water with sugar and salt |journal=Lancet |volume=312 |issue=8084 |pages=300–1 |date=August 1978 |doi=10.1016/S0140-6736(78)91698-7 |url=http://www.sciencedirect.com/science/article/pii/S0140673678916987}}</ref> However, in 2008, diarrhea is still the second most common cause of death in children under five years (17 percent), (after [[pneumonia]] (19 percent)).<ref>{{cite book |author= |title=The state of the world's children: child survival |publisher=UNICEF |location= |date=December 2007 |isbn=978-92-806-4191-2 |page=8 |url=http://www.unicef.org/sowc08/docs/sowc08.pdf |format=PDF}}</ref> Moreover, by the same year, the use of ORT in children under five had declined.<ref>{{cite journal |author=Ram PK, Choi M, Blum LS, Wamae AW, Mintz ED, Bartlett AV |title=Declines in case management of diarrhoea among children less than five years old |journal=Bull. World Health Organ. |volume=86 |issue=3 |pages=E–F |date=March 2008 |pmid=18368194 |pmc=2647400 |url=http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000300024&lng=en&nrm=iso&tlng=en}}</ref>

== Preparation ==

WHO and [[UNICEF]] developed official guidelines for how to make ORS. Depending on what materials are available, they propose different alternative preparations. Commercial preparations are available as either pre-prepared fluids or packets of oral rehydration salts (ORS) ready for mixing with the fluid.<ref>[http://rehydrate.org/resources/suppliers.htm "Oral rehydration salts and solutions and rice-based solutions worldwide manufacturers and suppliers."] Rehydration Project website. Accessed 3 January 2014.</ref><ref>[http://www.guideline.gov/content.aspx?id=38900 "Oral rehydration therapy (ORT) in children."] US Department of Health and Human Services. Accessed 1 January 2014.</ref>

WHO/UNICEF's formula is {{convert|2.6|g}} salt (NaCal), {{convert|2.9|g}} trisodium citrate dihydrate {{chem|C|6H|5|Na|3|O|7,|2|H|2|O}}, {{convert|1.5|g}} KCl, {{convert|13.5|g}} anhydrous glucose (<math>C_{6}H_{12}O_{6}</math>) per litre of fluid.<ref>[http://www.who.int/medicines/publications/pharmacopoeia/Oralrehydrationsalts.pdf Oral rehydration salts]</ref>

A basic oral rehydration therapy solution is composed of salt, sugar, and water in [[solution]], made using a standard ratio and is appropriate for use in situations when ORS must be prepared without the standard ingredients.<ref name="who.int">, [http://www.who.int/cholera/technical/en/ "WHO position paper on Oral Rehydration Salts to reduce mortality from cholera."] World Health Organization, Global Task Force on Cholera Control.</ref><ref name=wikihow_ors>[[:wikihow:Make-an-Oral-Rehydration-Salts-Drink-(ORS)|"How to Make an Oral Rehydration Salts Drink (ORS)."]] Wikihow. Accessed 26 February 2011.</ref>

* 30 ml sugar : 2.5 ml salt : 1 [[liter]] fluid
* 6 teaspoons (tsp). sugar : 0.5 tsp. salt : 1 [[quart]] fluid

The Rehydration Project says that making it a bit too thin (using more than 1 liter of fluid) is not bad for the sick person.<ref>[http://rehydrate.org/ Rehydration Project]</ref>

The best fluid is plain, clean water. However, fluids such as [[rice water]], [[coconut water]], vegetable broth, [[yogurt]], weak unsweetened tea, unsweetened fresh [[fruit juice]] or even non-drinking water are recommended when plain, clean water is unavailable. Water can be made safe with [[chlorine]], or by boiling it. However, ORS should still be given even if the water is maybe unsafe. Rehydration is more important. <ref name="WHO (2005)"/>

The [[molar concentration|molar]] [[ratio]] of sugar to salt should be 1:1 and the solution should not be [[molarity|hyperosmolar]].<ref>{{cite journal |author=Churgay CA, Aftab Z |title=Gastroenteritis in children: part II, prevention and management |journal=Am Fam Physician |volume=85 |issue=11 |pages=1066–70 |date=1 June 2012 |pmid=22962878 |url=http://www.aafp.org/afp/2012/0601/p1066.html}}</ref> The [[Mayo clinic]] suggests half a teaspoon of salt, six level teaspoons of sugar and {{convert|1|L|usoz}} water.<ref>[http://www.mayoclinic.com/health/dehydration/DS00561/DSECTION=treatments-and-drugs "Dehydration, treatments and drugs."] Mayo Clinic. Accessed 1 January 2014.</ref> The [[British Columbia]] health service suggests 1 part fruit juice without sugar, mixed with 4 parts water.<ref>[http://www.bcguidelines.ca/pdf/ort_parent_education_and_resources.pdf "Oral rehydration therapy."] Parent education and resources, British Columbia Guidelines, [[Canada]]. Accessed 1 January 2014.</ref>

==References==
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[[Category:Public health]]

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Oral rehydration therapy