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close this bookGuidelines for the Inpatient Treatment of Severely Malnourished Children (WHO; 2003; 52 pages) [FR] View the PDF document
View the documentPreface
View the documentAcknowledgements
View the documentIntroduction
open this folder and view contentsA. GENERAL PRINCIPLES FOR ROUTINE CARE (the ‘10 Steps’)2
open this folder and view contentsB. EMERGENCY TREATMENT OF SHOCK AND SEVERE ANAEMIA
open this folder and view contentsC. TREATMENT OF ASSOCIATED CONDITIONS
open this folder and view contentsD. FAILURE TO RESPOND TO TREATMENT
close this folderE. DISCHARGE BEFORE RECOVERY IS COMPLETE
View the documentAppendix 1 Weight-for-Height Reference Table
View the documentAppendix 2 Monitoring records (temperature, respiratory rate, and pulse rate)
View the documentAppendix 3 Recipes for ReSoMal & electrolyte/mineral solution
View the documentAppendix 4 Antibiotics reference table
View the documentAppendix 5 Recipes for starter and catch-up formulas
View the documentAppendix 6 Volume of F-75 to give for children of different weights
View the documentAppendix 7 Volume of F-75 for children with severe (+++) oedema
View the documentAppendix 8 Range of volumes for free feeding with F-100
View the documentAppendix 9 Weight record chart
View the documentAppendix 10 Structured play activities
View the documentAppendix 11 Discharge card
View the documentBack Cover
 

Appendix 3 Recipes for ReSoMal & electrolyte/mineral solution

Recipe for ReSoMal oral rehydration solution

Ingredient

Amount

Water (boiled & cooled)

2 litres

WHO-ORS

One 1 litre-packet*

Sugar

50 g

Electrolyte/mineral solution (see below)

40 ml

 

* 3.5g sodium chloride, 2.9g trisodium citrate dihydrate, 1.5g potassium chloride, 20g glucose.


ReSoMal contains approximately 45 mmol Na, 40 mmol K and 3 mmol Mg/litre.

Recipe for Electrolyte/mineral solution (used in the preparation of ReSoMal and milk feeds)

Weigh the following ingredients and make up to 2500 ml. Add 20 ml of electrolyte/mineral solution to 1000 ml of milk feed.

 

quantity g

molar content of 20 ml

Potassium Chloride: KCl

224

24 mmol

Tripotassium Citrate: C6H5K3O7.H2O

81

2 mmol

Magnesium Chloride: MgCl2.6H2O

76

3 mmol

Zinc Acetate: Zn(CH3COO)2.2H20

8.2

300 µmol

Copper Sulphate: CuSO4.5H2O

1.4

45 µmol

Water: make up to

2500 ml

 

Note: add selenium if available (sodium selenate 0.028 g, NaSeO4 10H20) and iodine (potassium iodide 0.012g, KI) per 2500 ml.


Preparation: Dissolve the ingredients in cooled boiled water. Store the solution in sterilised bottles in the fridge to retard deterioration. Discard if it turns cloudy. Make fresh each month.

If the preparation of this electrolyte/mineral solution is not possible and if premixed sachets (see step 4) are not available, give K, Mg and Zn separately.

Potassium:

• Make a 10% stock solution of potassium chloride (100 g KCl in 1 litre of water):

• For oral rehydration solution, use 45 ml of stock KCl solution instead of 40 ml electrolyte/mineral solution

• For milk feeds, add 22.5 ml of stock KCl solution instead of 20 ml of the electrolyte/mineral solution


• If KCl is not available, give Slow K (½ crushed tablet/kg/day)


Magnesium:

• Give 50% magnesium sulphate intramuscularly once (0.3 ml/kg up to a maximum of 2 ml)


Zinc:

• Make a 1.5% solution of zinc acetate (15 g zinc acetate in 1 litre of water). Give the 1.5% zinc acetate solution orally, 1 ml/kg/day

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