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Pediatric Dehydration Assessment — Free Online Calculator

Clinical Signs

Dehydration Assessment

None / Minimal

No or minimal dehydration (< 3% fluid deficit)

About This Calculator

The Pediatric Dehydration Assessment is based on the WHO clinical dehydration scale. It evaluates six clinical signs to classify dehydration severity in children with diarrhea or vomiting. The assessment guides fluid replacement therapy: minimal dehydration can be managed with oral rehydration at home, moderate dehydration requires supervised oral rehydration therapy (ORT), and severe dehydration requires immediate IV fluid resuscitation.

Formula

Score = Sum of 6 clinical sign scores (0–12)
0–2: No/minimal dehydration (<3%)
3–6: Some dehydration (~5%)
7–12: Severe dehydration (≥10%)

Interpretation

ScoreSeverityFluid DeficitTreatment
0 – 2Minimal< 3%Home oral rehydration
3 – 6Moderate (~5%)~50 mL/kgSupervised ORT (4 hours)
7 – 12Severe (≥10%)≥100 mL/kgIV fluids immediately

References

  1. World Health Organization. The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. WHO; 2005.
  2. Freedman SB, et al. Diagnosing clinically significant dehydration in children with acute gastroenteritis using non-invasive methods: a meta-analysis. J Pediatr. 2015;166(4):908-916.

Frequently Asked Questions

How accurate is clinical dehydration assessment?

Clinical signs have moderate sensitivity and specificity. No single sign is highly accurate alone. Combinations of signs (prolonged capillary refill, abnormal skin turgor, absent tears, altered mental status) improve accuracy. Weight loss compared to a recent baseline weight remains the gold standard.

What is the best single clinical sign for dehydration?

Prolonged capillary refill time (>2 seconds) and abnormal skin turgor are considered the most useful individual signs. However, meta-analyses show that a combination of clinical signs performs better than any single sign for classifying dehydration severity.

When should IV fluids be given instead of oral rehydration?

IV fluids are indicated for severe dehydration (≥10%), inability to tolerate oral fluids (persistent vomiting), altered mental status, hemodynamic instability, or failure of oral rehydration therapy. Most children with mild to moderate dehydration can be successfully treated with oral rehydration solution (ORS).

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⚠ Medical Disclaimer

This tool is for educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for clinical decisions.