Oral Saline-I

Indications

Oral rehydration salt (ORS) is used to prevent and treat dehydration (loss of water and salts from the body) caused by diarrhoea, including cholera, vomiting, heavy sweating, fever or heat stroke. It is the first treatment for diarrhoea in children and adults.

How It Works

ORS contains glucose and the salts sodium, potassium and citrate or bicarbonate in a set balance. Glucose helps the gut absorb sodium, and water follows the sodium into the body. This replaces the fluid and salts lost in loose stools much faster than plain water.

Dosage and Administration

Wash your hands. Empty one sachet into a clean container and add exactly the amount of clean drinking water written on the pack (for most packs, half a litre or 500 ml). Stir until dissolved. Do not add sugar, salt, milk or juice, and do not use less water.

• Children under 2 years: about 50 to 100 ml (a quarter to half a cup) after each loose stool, given slowly by spoon.
• Children 2 to 10 years: about 100 to 200 ml (half to one cup) after each loose stool.
• Older children and adults: drink as much as wanted, usually at least 200 to 400 ml after each loose stool.

If the person vomits, wait 10 minutes and then give it more slowly. Use the made-up solution within 12 hours, or the time stated on the pack, then throw it away and make fresh. Keep breastfeeding and normal feeding during diarrhoea.

Interactions

No important interactions with other medicines. Children with diarrhoea are often also given Zinc as advised by a doctor.

Contraindications

• Severe dehydration with shock or unconsciousness (needs fluids into a vein in hospital).
• Blocked intestine, or a person who cannot swallow.
• Severe kidney failure with little or no urine, unless a doctor advises it.

Side Effects

Usually none when made correctly. Drinking too quickly can cause vomiting. A solution made too strong (too little water) can raise the sodium level in the blood.

Get urgent medical help if there is blood in the stool, the person cannot drink or keeps vomiting, is very sleepy or hard to wake, has sunken eyes, a very dry mouth, passes no urine for 6 hours or more, has a high fever, or diarrhoea does not improve after 2 days. In babies, a sunken soft spot on the head is a danger sign.

Pregnancy and Lactation

Safe to use during pregnancy and breastfeeding. Mothers should continue breastfeeding.

Precautions and Warnings

• Always use the exact amount of water stated on the pack.
• People with diabetes, heart failure or kidney disease should ask a doctor how much to drink; glucose-based ORS contains sugar.
• ORS replaces fluid but does not stop diarrhoea itself.

Overdose

Drinking far too much, or a solution that is too strong, can cause high sodium levels with thirst, irritability, confusion, puffiness or fits. Stop and seek medical help.

Therapeutic Class

Oral rehydration and electrolyte replacement.

Storage

Store sachets below 30°C in a dry place, away from light and out of the reach of children. Use the made-up solution within 12 hours, or as stated on the pack.