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    Appendix 11. Flow Chart For Cholera Case Management

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    Gerard Pio Wee
    This flow chart outlines the management of suspected cholera cases. It involves 3 treatment plans (A, B, C) depending on the level of dehydration. Plan C is for severe dehydration/shock and involves IV fluids. Plan B is for some dehydration and involves oral rehydration solution. Plan A is for no dehydration and involves oral rehydration solution. The chart also provides antibiotic treatment guidelines and criteria for discharge or continued observation and treatment.

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    Appendix 11. Flow Chart For Cholera Case Management

    Uploaded by

    Gerard Pio Wee
    240 views1 page
    This flow chart outlines the management of suspected cholera cases. It involves 3 treatment plans (A, B, C) depending on the level of dehydration. Plan C is for severe dehydration/shock and involves IV fluids. Plan B is for some dehydration and involves oral rehydration solution. Plan A is for no dehydration and involves oral rehydration solution. The chart also provides antibiotic treatment guidelines and criteria for discharge or continued observation and treatment.

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    Appendix 11. Flow chart for cholera case management (1)

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    This flow chart outlines the management of suspected cholera cases. It involves 3 treatment plans (A, B, C) depending on the level of dehydration. Plan C is for severe dehydration/shock and involves IV fluids. Plan B is for some dehydration and involves oral rehydration solution. Plan A is for no dehydration and involves oral rehydration solution. The chart also provides antibiotic treatment guidelines and criteria for discharge or continued observation and treatment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    240 views1 page

    Appendix 11. Flow Chart For Cholera Case Management

    Uploaded by

    Gerard Pio Wee
    This flow chart outlines the management of suspected cholera cases. It involves 3 treatment plans (A, B, C) depending on the level of dehydration. Plan C is for severe dehydration/shock and involves IV fluids. Plan B is for some dehydration and involves oral rehydration solution. Plan A is for no dehydration and involves oral rehydration solution. The chart also provides antibiotic treatment guidelines and criteria for discharge or continued observation and treatment.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    of 1

    Flow chart for cholera case management

    Suspected cholera case


    In areas where a cholera outbreak has not been declared: any patient >2 years presenting with acute watery diarrhea and severe dehydration or dying from acute watery diarrhea
    In areas where a cholera outbreak is declared: any person presenting with or dying from acute watery diarrhea

    Step 1
    Yes No Manage in OPD/IPD
    Does patient fit case
    definition?
    Assess for shock or severe dehydration
    Shock/severe dehydration: (Plan C)
    Patient has one or more danger sign: Some dehydration: (Plan B) No dehydration: (Plan A)
    • Lethargic or unconscious Patient has at least 2 of the following: • Awake and alert
    No No
    • Absent or weak pulse • Irritable or restless • Normal pulse
    • Respiratory distress • Sunken eyes • Normal thirst
    OR at least 2 of the following:
    • Rapid pulse • Eyes not sunken
    • Not able to drink or drinks poorly
    • Thirsty (drinks eagerly) • Skin pinch normal
    • Skin pinch goes back very slowly
    • Sunken eyes • Skin pinch goes back slowly

    Yes Yes Yes

    Give IV Ringer’s lactate (Plan C) Give ORS (Plan B) and observe for 4 hours – see table below
    (Consider dextrose bolus in paediatric patients for OR can also calculate at 75 ml/kg over 4 hours Give ORS (Plan A) – see table below
    hypoglycemia) + ongoing losses (see Plan A) Observe in observation or Plan A area for 4 hours
    <1 year of age: (over 6 hours) >1 year of age: (over 3 hours)
    1st 60 min: 30ml/kg 1st 30 min: 30ml/kg For first 4 hours: For first 4 hours:
    Next 5 hrs: 70ml/kg Next 2.5 hrs: 70ml/kg

    Next 5 hrs: 70ml/kg


    Reassess frequently (Every 15-30 min)

    Reassess hydration status •Observe for 6 - 12 hours •Observe for 6 - 12 hours


    •Awake AND •Continue feeding •Continue feeding
    •Able to drink AND Yes •Reassess dehydration status (hourly) •Reassess dehydration status (hourly)
    •Improved pulse strength Reassess
    •In case of frequent vomiting (>3frequently
    times in 1 hour): Treat with IV •In case of frequent vomiting (>3 times in 1
    fluid (At least every hour)
    hour): Treat with IV fluid
    Antibiotics for severe dehydration cases ONLY Consider discharge if:
    • • • Has no signs of dehydration
    First-line Alternative Reassess hydration status
    •Awake AND • Is able to take ORS without vomiting
    Adults (including doxycycline 300 mg azithromycin PO 1g • Has no watery stools for 4 hours
    • Severe dehydration • Awake AND
    pregnant women) as a single dose as a single dose • Is able to walk without assistance
    OR • Able to drink AND
    doxycycline 2-4 azithromycin PO • Is passing urine
    Children < 12 years old • Severe vomiting • Improved pulse strength
    mg/kg single dose 20mg/kg single dose

    Yes Yes

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