A Change of Guard

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Tuesday 29 September 2009

How to treat H1N1?

By Ittipuls Seyma Kinanuwattany, BSN, RN

Is there effective way of teaching the public in Cambodia about the pandemic H1N1 flu? Since you both are the administrators of the KI, you may know a way to inform the our Khmer citizens, especially the impoverished rural people.
Younger/older population are at higher risk if they caught the flu. In the medical field, we Only treat the symptoms. Treat the imbalance to maintain body Homeostasis. The human body can survived without foods for 8 weeks, and DEATH is imminent without Fluid for 3 days.
The fluid requirement is based on age milliliter/Kilogram body weight/day.
Am't of Water Age mL/Kg body wt/day
1 week 80-100mL
2 weeks 125-150mL
3 months 140-160mL
6 months 130-155mL
9 months 125-145mL
1 year 120-135mL
2 yrs and above 115-125mL

For instance, the fluid needs SHOULD be equivalent to 2/3 of the body weight. For example, if you weight 60 pounds, that comes out to be 30 Ounces of water, or 900mL per day.
In the metric system, a person weight 60kg, a person weight's SHOULD be divisible by 30. The result would be 2liters per day. And so in order to meet the criteria, a person should drink at least every 2 hrs approx. 240mL each time.
This formula is applicable only for a healthy person. Consult the MD if you have fluid restriction. In a warmer climate, you might want to add 5-10% more of water consumption.
Intraveneous fluid (lactate ringer) is preferably the choice to treat the dehydration. It's a challenge for the impoverished mom/dad of children living in the rural area in Cambodia. There are a few ways of introducing fluid that can help children who doesn't want to drink. Proctoclysis is feasible in Cambodia's rural. The technique introducing fluid through the rectum, using #10Fr5mL bulb Foley catheter and a gravity bag.
The procedure for putting the Foley catheter in the rectum is inserting the lubricated tip 6 inches or 15.3cm inside the rectum, then inflate the tube balloon to 3mL. Next attached the gravity bag to the tube, fill the bag with fluid based on age milliliter/kg body weight/day, and adjust the clamp on the gravity bag for drip rate at least 75mL/min (75 drops/min). Replaced the imbalance, pedialyte fluid is preferably, but in Cambodia is not obtainable. But, one can purchase electrolytes package that treated diarrhea in a polypharmacy in Cambodia (use 1 package without fruit flavor) -- mix with 1L bottle water, and pour into the gravity bag. If no improvement in 48 hrs, seek medical help immediately.
Sincerely,
Ittipuls Seyma Kinanuwattany, BSN, RN
State of Wisconsin
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The Telltale Signs of H1N1 (Swine Flu)

The following are the signs or symptoms to alert anyone to seek medical care immediately:

Emergency Warning Signs in Children:

    1. Fast breathing or trouble breathing
    2. Bluish skin color
    3. Not drinking enough fluids
    4. Not waking up or not interacting
    5. Being so irritable that the child does not want to be held
    6. Flu-like symptoms improve but then return with fever and worse cough
    7. Fever with a rash

      In Adults:

    1. Difficulty breathing or shortness of breath (SOB)
    2. Pain or pressure in the chest or abdomen
    3. Sudden dizziness
    4. Confusion
    5. Severe or persistent vomiting


    Flu symptoms can Include:

      1. Fever
      2. Cough
      3. Sore throat
      4. Runny or Stuffy nose
      5. Body aches
      6. Headache
      7. Chills
      8. Fatique
      9. Sometimes diarrhea and vomiting

*It’s important to note that not everyone with flu will have a fever.*

www.cdc.gov/h1n1flu or www.flu.gov

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