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Score five Clinical Dehydration Scale exam domains (each 0–2): general appearance, sunken eyes, mucous membranes, tears, and skin pinch/turgor. Sum 0–10 maps to minimal / mild / moderate / severe teaching bands with ORS Plan A/B/C context. Pair with our maintenance fluid calculator. Not percent dehydration, not WHO IMCI certification, not emergency triage.
Last updated: June 5, 2026
Lethargy, shock, bilious vomiting, or infant fever need emergency care regardless of score. This tool supports education—not home triage without a clinician.
Moderate pattern (total 5–7, educational)
5 / 10
General
1
Eyes
1
Mucosa
1
Tears
1
Skin
1
Moderate dehydration concern (total 5–7): same-day pediatric evaluation is commonly taught; oral rehydration solution in small frequent volumes may be appropriate only when prescribed and tolerated—watch for vomiting, lethargy, and decreased urine.
Infants under 3 months with fever, bilious vomiting, bloody stool, or poor feeding need urgent evaluation regardless of score. This tool does not replace IMCI/PECARN pathways.
Default — all domains 1
5/10
moderate
Minimal — all 0
0/10
minimal
Mild — total 4
4/10
mild
Moderate — lethargy +1s
6/10
moderate
Severe — all domains 2
10/10
severe
Five exam items commonly taught with Gorelick-type clinical dehydration scales.
| Domain | 0 | 1 | 2 |
|---|---|---|---|
| General appearance | Normal, alert, appropriate interaction | Restless, thirsty, fatigued but responsive | Lethargic, limp, or not responding appropriately |
| Sunken eyes | No sunken appearance | Mildly sunken | Marked sunken eyes |
| Mucous membranes | Moist mouth/lips | Sticky or slightly dry | Dry mucosa |
| Tears | Tears present when crying | Decreased tears | No tears with cry |
| Skin pinch / turgor | Instant recoil | Delayed recoil <2 s (teaching) | Tenting or very delayed return |
| Total score | Category | Teaching action |
|---|---|---|
| 0–2 | Minimal | Close monitoring; ORS if vomiting/diarrhea with good intake |
| 3–4 | Mild | ORS small frequent volumes; reassess wet diapers/voids hourly early on |
| 5–7 | Moderate | Same-day pediatric visit commonly taught; supervised ORS if tolerating |
| 8–10 | Severe | Emergency assessment—IV fluids may be needed; oral alone may be unsafe |
| Plan | Volume theme | When discussed |
|---|---|---|
| Plan A (minimal–mild teaching) | Continue feeding + extra ORS after each loose stool | CDS total ≤4 with alert child tolerating fluids |
| Plan B (moderate teaching) | ORS 50–100 mL/kg over 4 h (clinician-directed) | Some dehydration signs, no shock—supervised setting |
| Plan C (severe / shock teaching) | IV isotonic bolus per protocol | Lethargy, poor perfusion, CDS 8–10—emergency care |
| Sign | Action |
|---|---|
| Lethargy or unresponsive | Emergency—possible severe dehydration or sepsis |
| Bilious (green) vomiting | Emergency—surgical obstruction concern |
| Blood in stool (significant) | Urgent evaluation—invasive bacterial diarrhea, IBD flare |
| No urine ≥8 h (infant) / ≥12 h (child) | Urgent—oliguria with dehydration |
| Fever in infant <3 months | Emergency neonatal sepsis pathway |
| When | Focus |
|---|---|
| Every 1–2 h early | |
| After ORS trial | |
| Before discharge teaching | |
| 48–72 h follow-up |
Plan B teaching: supervised ORS rehydration (~50–100 mL/kg over 4 h per protocols) if child is alert and not in shock—clinician directs volume.
Plan A+ teaching: continue age-appropriate diet + extra ORS after each diarrheal stool; monitor voids.
Educational use only. This calculator does not replace pediatric emergency assessment, IMCI training, or clinician-directed fluid orders. Call emergency services for unresponsive child, seizure, or suspected shock.
Help students and caregivers understand CDS scoring and ORS teaching language
Suggested hashtags: #Pediatrics #Dehydration #ORS #Gastroenteritis #MedEd