🏥
SickChild Guide
ORS · DEHYDRATION · FEVER · WHEN TO GO TO HOSPITAL
👨‍⚕️
Dr. B.S. Chakravarthy
Professor & Head, Department of Paediatrics
Andhra Medical College / King George Hospital, Visakhapatnam
📞 For queries & feedback: +91 98482 53535 · 💬 WhatsApp
💧 ORS Dosage Calculator
Based on WHO / IAP guidelines for diarrhoea management
📋 How to Prepare ORS
1️⃣Take 1 litre of clean water (boiled and cooled)
2️⃣Add 1 ORS packet (commercial) — OR home ORS: 6 level teaspoons sugar + ½ teaspoon salt
3️⃣Stir well until fully dissolved
4️⃣Discard after 24 hours — prepare fresh daily
5️⃣Give small sips frequently — do not force large amounts at once
⚠️ Never give: sports drinks, soft drinks, fruit juice, or salted water as ORS substitutes.
🍌 Feeding During Diarrhoea (IMNCI / IAP)
Continue breastfeeding — breast milk is the best fluid and nutrition for infants
Continue age-appropriate feeds — do not starve the child
Give extra meal daily for 2 weeks after illness ends (catch-up feeding)
Zinc supplementation: 20 mg/day for 14 days (10 mg for under 6 months)
Do NOT give anti-diarrhoeal drugs to children under 5
Do NOT dilute feeds or withhold milk
📋 Severe dehydration requires IV fluids. If child is lethargic, has sunken eyes, is not drinking, or has bloody stools — go to hospital immediately.
🔍 Assess Dehydration Level
Tap the level that matches your child's signs
🔴 Severe Dehydration
• Lethargic or unconscious
• Sunken eyes (severely)
• Skin pinch goes back very slowly (>2 sec)
• Unable to drink or drink poorly
• No urine for many hours
• Dry mouth + no tears
🚨 GO TO HOSPITAL NOW — NEEDS IV FLUIDS
🟡 Moderate Dehydration
• Restless, irritable
• Sunken eyes (noticeable)
• Skin pinch goes back slowly (1–2 sec)
• Drinks eagerly / thirsty
• Reduced urine, dark yellow
⚠️ ORS at home + watch closely — hospital if not improving in 4 hours
🟢 No / Mild Dehydration
• Alert and active
• Eyes normal
• Skin pinch goes back immediately
• Drinks normally
• Normal or slightly reduced urine
✅ Manage at home with ORS — continue feeds
🩺 Skin Pinch Test
1️⃣Pinch the skin on the child's abdomen between two fingers
2️⃣Hold for 1 second, then release
3️⃣Goes back immediately → Normal
4️⃣Goes back in 1–2 seconds → Some dehydration
5️⃣Goes back very slowly (>2 sec) → Severe dehydration — hospital
🌡️ Fever — What to Do
✅ 37.5°C – 38.5°C (Low Grade)
Tepid sponging · Fluids · Light clothing · Continue feeds · Monitor. Paracetamol not always needed.
⚠️ 38.5°C – 39.5°C (Moderate)
Paracetamol: 15 mg/kg/dose, every 4–6 hours as needed. Max 5 doses in 24 hours. Tepid sponging. Push fluids.
🔴 Above 39.5°C (High Fever)
Give Paracetamol immediately. Tepid sponging. See doctor if not controlled in 1–2 hours, or if child is <3 months, or has febrile convulsion, rash, breathing difficulty.
🚨 Any fever in child <3 months
Go to hospital immediately. Temperature ≥38°C in a baby under 3 months is a medical emergency.
💊 Paracetamol Dose Calculator
❌ What NOT to Do in Fever
Do NOT use Aspirin in children — risk of Reye's syndrome
Do NOT use Nimesulide (banned for children under 12)
Do NOT use cold water / ice packs — use lukewarm water only
Do NOT over-wrap child — light clothing allows heat dissipation
Do NOT give antibiotics for every fever — most are viral
Push fluids — ORS, coconut water, dal water, breast milk
Continue feeding — fever increases calorie needs by 10% per °C
⚡ Febrile Convulsion — What to Do
1️⃣Stay calm. Most febrile seizures stop on their own in <5 minutes
2️⃣Place child on their side (recovery position) — prevents choking
3️⃣Do NOT put anything in the mouth
4️⃣Do NOT restrain the child forcefully
5️⃣Note the time the seizure started
6️⃣If seizure lasts >5 minutes — call emergency help immediately
7️⃣Go to hospital after any febrile convulsion for evaluation
🚨 Go to Hospital IMMEDIATELY if you see ANY of these
Do not wait. Do not try home treatment first.
🔴 Emergency Danger Signs
Unable to drink or breastfeed
Child refuses all fluids — severe dehydration
Vomiting everything
Cannot keep any fluid down — dehydration worsening
Convulsions / Fits
Any seizure activity — febrile or otherwise
Lethargic / Unconscious
Cannot be woken, very difficult to rouse
Fast / Difficult breathing
Nostrils flaring, chest retracting, grunting, stridor
Bluish lips or fingernails (Cyanosis)
Sign of oxygen deficiency — critical emergency
Rash with fever
Red spots that don't blanch — possible meningococcal disease
Bulging fontanelle in infants
Raised intracranial pressure — meningitis concern
Bloody diarrhoea
Dysentery — needs immediate evaluation and treatment
Any fever in baby under 3 months
Temperature ≥38°C — always a hospital emergency in young infants
Severe abdominal pain or distension
Hard, rigid, or very tender abdomen — surgical emergency possible
🟡 Go to Doctor Same Day (urgent, not emergency)
Fever for more than 3 days
Diarrhoea not improving after 2 days
Ear pain or ear discharge
Child not eating for more than 1 day
Persistent cough with fast breathing
Eye redness with discharge
📋 Note: This guide is for parent education only. When in doubt — always consult your paediatrician. It is always better to seek help early.
🏠 Home Care for Common Illnesses
🤧 Common Cold / URTI
Saline nasal drops — 2 drops each nostril, 3–4 times/day
Steam inhalation (supervised) for children above 2 years
Honey — 1 tsp at bedtime for cough (only above 1 year)
Push fluids — warm water, dal water, warm soups
Do NOT give cough syrups / antihistamines below 2 years
Antibiotics are NOT needed for viral colds
🤢 Vomiting
Small frequent sips of ORS — 5 ml every 5 minutes to start
Continue breastfeeding in infants
After 2 hours tolerating ORS, gradually reintroduce feeds
Do NOT give anti-emetics without doctor's advice
🚨Projectile vomiting in newborn / green / blood in vomit → hospital immediately
💧 Diarrhoea
ORS after every loose stool (see calculator)
Zinc 20 mg daily for 14 days
Continue feeding — normal diet is fine
Good hand hygiene — prevents spread
Do NOT give anti-diarrhoeal medications to children under 5
🤕 Minor Injuries
Clean wound with running water for 5–10 minutes
Apply antiseptic and clean bandage
Check tetanus immunisation status
🚨Animal bite / deep wound / heavy bleeding → hospital immediately
💊 Safe Medicines Cabinet for Children
Paracetamol syrup — 15 mg/kg/dose (fever, pain)
ORS sachets — always keep at home
Zinc syrup — for diarrhoea (20 mg/day for 14 days)
Saline nasal drops — for blocked nose
Thermometer — digital, axillary
Never self-administer antibiotics, steroids, or anti-emetics without prescription
📋 Reminder: This guide is for home education only. All medications should be given as per your paediatrician's prescription.
💬 Send Us Your Feedback
Your feedback helps us improve this app and serve parents better. Please share your experience, suggestions, or any errors you noticed.
Opens WhatsApp with your message pre-filled
⭐ Rate This App
How useful did you find SickChildGuide?
Feedback