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Triage of Children with Diarrhea

Indications for Immediate Evaluation
1. Severe Diarrhea (See Pediatric Diarrhea)
  1. Any Age
    1. Stools hourly for >5 hours
  2. Age under 1 year
    1. Stools >9 in 24 hours
  3. Age 1-2 years
    1. Stools >14 in 24 hours
  4. Age >2 years
    1. Stool >19 in 24 hours
2. Bloody Diarrhea
  1. More blood than a few flecks or streaks
  2. Assess for Shigella, Salmonella, and Campylobacter
3. Abdominal Pain >2 hours
  1. Pain more than mild abdominal cramps with Diarrhea
  2. Assess for pelvic Appendicitis
4. Dehydration
  1. Oliguria
    1. Age <1 year old: last urine >8 hours earlier
    2. Age >1 year old: last urine >12 hours earlier
  2. Decreased oral intake
  3. Mouth dry
  4. Decreased tears with crying
  5. Last Urine > 8h IF <1yo, >12h IF >1yo
5. Tachypnea
  1. Assess for Metabolic Acidosis
Indications for routine clinical evaluation
1. Recurrent Diarrhea
2. Signs of bacterial Diarrhea
  1. Flecks or streaks of blood in stool
  2. Diarrhea for longer than 1 week
    1. Not indicated for only peristant soft stools
    2. Also consider Lactose-Free Diet
  3. Mucus or pus in stool (suggests Salmonella, Shigella)
  4. Fever for longer than 72 hours
  5. Stool Incontinence (suggests Shigella)

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 8/14/2009. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.