What are the signs and symptoms of mild, moderate, and severe dehydration?

According to the World Health Organization (WHO)’s editorial coined “Water Requirements, Impinging Factors, and Recommended Intakes” by Ann. Grandjean from The Center for Human Nutrition at the University of Nebraska (Omaha, Nebraska USA), the symptoms of acute and chronic inadequate water intake or dehydration may vary based on how much water deficit one has. For instance, please refer to the adverse consequences in regards to the degree of water deficit:

Water Deficit or Fluid LossAdverse Consequences
1% of body weightImpairment of thermoregulation Subjective feeling of “thirst”
2% – 3% of body weightIncreased thirst with dry mouth Vague discomfort Loss of appetite
4% of body weight20-30% reduction in work capacity Negative impact on productivity
5% of body weightDifficulty concentrating Headache Sleepiness
6% of body weightTingling and numbness of extremities
7% of body weightFainting and collapse Syncopal episodes Delirium
> 10% of body weightHypovolemic shock Organ failure Cardiac arrest Death

Obviously, the signs and symptoms of mild and moderate dehydration that Replenish 360 (R360) wants to address may start out as subjective “thirst” with dry mucosal membranes and impaired thermoregulation (i.e., for lay folks, being able to cool oneself appropriately and correctly due to the heat production caused by metabolic processes inside your body) as well as indistinct discomfort and even loss of your desire for food intake but, at 4% water deficit or fluid loss by body weight, an individual’s work capacity starts to decline by as much as 30% of their normal work capacity, which negatively impacts their peak performance and productivity in their daily activities of living. It spirals down after the 5% of body weight loss of fluids with increased neurological dysfunction of memory, concentration, critical thinking, gnawing headache, lethargy, peripheral paresthesia, and even as much as syncopal episodes and delirium which urgently requires oral or most likely intravenous fluid resuscitation in an inpatient setting, intensive care unit (ICU), and emergency department (ED). If the etiology and possible reversible causes of moderate to severe dehydration are not addressed, then hypovolemic shock occurs with impending organ failure and cardiac arrest that requires urgent cardiopulmonary resuscitation (CPR), advance cardiac life support, and immediate recognition of the reversible cause of hypotension. This may lead to increased morbidity to anyone who does not have immediate suitable replenishment of their fluids and recommended life support medical management by advance healthcare providers.

Replenish 360 (R360)’s parent company, Palm Desert Resuscitation Education LLC (PDRE), provides high-quality and professional training and certification in Basic Life Support (BLS), Advanced Cardiac Life Support (ALCS), Pediatric Advance Life Support (PALS), Neonatal Resuscitation Program (NRP) and other specialized and innovated instructions and curriculum for healthcare professionals as well as non-medical lay persons. The importance of prevention of cardiopulmonary arrest is the chief point that PDRE stresses upon when it comes to providing these basic and advanced resuscitation lessons and curriculums. However, the primary assessments and surveys utilized for ACLS, PALS, and NRP for instance are essential in integration to any fluid resuscitation attempt for unstable patients, more importantly, as well as preventative measures for healthy individuals who are just mildly to moderately dehydrated from their normal daily activities and life’s challenges in not being able to hydrate sufficiently and appropriately in a consistent manner. The latter, of course, is what Replenish 360 (R360)’s main goal desperately and enthusiastically desires to resolve in our plush and relaxing IV Hydration Therapy Clinics and/or out-of-site comprehensive wellness referral services. The former, however, is interesting to note to say the least.

Specifically, for conscious or semi-conscious patients who have hemodynamic instability the primary assessment survey of “ABCDE” (Airway, Breathing, Circulation, Disability/Differential Diagnosis, and Exposure) describes “Circulation” or “C” as one of the algorithms needed for effective cardiopulmonary resuscitation and explicitly points towards fluid resuscitation for any compromised circulatory and vascular systems. Obviously, the advance healthcare provider’s initial impression will require immediate “at or from the door” evaluation of the patient’s current medical condition as either a respiratory, cardiac, shock, and/or life threatening issue in order to provide the best, most appropriate, and initial medical and clinical intervention(s). For instance, if the patient’s initial appearance illustrates someone who is in respiratory distress or arrest with other grave symptoms such as pale skin, dry mucosal membranes, abnormal skin turgor, and increased capillary refill from a quick targeted physical examination; point-of-care vital signs suggesting hemodynamic instability, stark dehydration, and shock in a patient who is severely hypotensive, tachycardic/bradycardic, tachypneic/apneic, hypoxic, and hypothermic; his or her medical history proposes any degree of desiccation from severe nausea causing vomiting or retching, decreased oral intake of food and fluids, watery diarrhea, excessive blood loss, and other multitude causes of dehydration etiologies; and in addition to non-reassuring diagnostic testing, such as deviant electrocardiography (ECG) findings, then obvious and immediate fluid resuscitation and advance life support is indicated and, if delayed, may cause cardiac arrest, organ failure, long-term debilitation and death as stated previously in some cases.

Here are a few fundamental fluid resuscitation interventions for the different age groups that does not account for individual and unique medical and clinical histories in combination with modifiable and non-modifiable risk factors for fluid hydration requirements:

AGE GROUPSSYSTOLIC BP (INIDICATIVE OF SEVERE HYPOTENSION)IV/IO/CENTRAL LINE/ET TUBE/UMBILICAL VENOUS CATHFLUID
RESUSCITATION*
TYPE OF CRYSTALLOID FLUIDS USED INITIALLY (PREFERRED)
Adults**< 90 mmHg1 – 2 Liters (L)Isotonic
Children***70 + (2 x Age) mmHg20 ml/kgIsotonic
Infants****< 70 mmHg20 ml/kgIsotonic
Neonates*****< 60 mmHg10 ml/kgIsotonic

*IV = Intravenous; IO = Intraosseous; ET = Endotracheal tube
**At least pubertal stage and older defines the adult age group demographic
***From one year old to puberty defines the children age group demographic
****From 30 days old to one year old defines the infant age group demographic
***** From birth to 30 days old defines the neonatal age group demographic

Replenish 360 (R360)’s offices and/or professional IV hydration therapies, treatments, procedures, sessions, programs, and other wellness services may be open for scheduled and personalized FACILITY-BASED INDIVIDUAL & GROUP appointments through our website’s easy online registration, phone, email, or in person as a walk-in (if spaces are available). We have special requested PRIVATE/OUT-OF-SITE/MOBILE IV hydration therapies, treatments, procedures, sessions, programs, and other wellness services can be arranged at specified locations, dates and times:

  • IV Hydration Therapy Tier 1 – R360 Signature Hydration
  • IV Hydration Therapy Tier 2 – R360 Recovery Hydration
  • IV Hydration Therapy Tier 3 – R360 Lifeline Hydration
  • IV Hydration Therapy Tier 4 – R360 Personalized Hydration
  • IV Hydration Therapy Tier 5 – R360 After Hours Hydration
  • R360 Monthly Memberships
  • R360 Boost Shots

We also offer the following wellness referral services:

  • Nutrition
  • Personal Training
  • Massage Therapy
  • Acupuncture Therapy
  • Behavioral Therapy
  • Other Lifestyle modification and wellness strategies

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