#ORS

[macgyvermedical]

Treating Diarrheal Illness

Someone recently sent me an ask about vomiting and diarrhea. I got almost all the way through writing it and then tumblr ate it. Didn't save it as a draft, didn't even put the ask back in my inbox, just poof'd it into oblivion.

But it was a good ask, and not one I get very often, so I still want to answer it- it essentially said the following:

How could a non-medical person in an apocalyptic setting treat someone who had severe diarrhea and vomiting, assuming the person in gastrointestinal distress was a doctor and could give them some direction? Can/should they give antidiarrheal medication and how would they go about doing that since the patient would probably throw it up?

So very glad you asked:

Diarrhea

The nice thing about most diarrheal illness is that as long as the person stays hydrated, they have a really good chance at surviving. Water is okay for hydration, but if the caregiver can get their hands on some salt, some potassium-based salt substitute, and some sugar, they can make a really easy and effective oral rehydration solution. The recipe is as follows:

Mix together:

1 liter of water

1/2 tsp salt (you want this to be slightly less salty than tears)

1/8 tsp potassium-based salt substitute (if you have this, great, if not, you can leave it out and it will still be effective)

8 tsp sugar

The goal is to get them to drink more volume of ORS than they are pooping- think at least a cup of ORS per poop.

Vomiting

The nice thing about uncontrollable vomiting is, again, that as long as the person stays hydrated, they will probably survive. Hydrating someone who can't keep anything down is a little trickier for the lay caregiver. Fortunately, there's another entrance to the GI tract.

The colon absorbs water. That's the colon's job. It takes the liquid coming from the small intestine and pulls water out of it until it becomes solid poop. A lay caregiver can take advantage of this process to hydrate someone if necessary by inserting a flexible tube (enema tip, catheter tip, NG tube, IV tubing, whatever relatively clean tube you have lying around that fits) a few inches into the rectum and SLOWLY instilling saline (1 liter water to 1/2 tsp salt). The colon can absorb between 2 and 6 liters of water this way per 24-hour period, which can absolutely keep a person hydrated even without an IV.

Diarrhea AND Vomiting

The annoying thing is that when diarrhea comes with vomiting severe enough to prevent being able to keep liquids down, neither of these really work.

So either your caregiver character needs a method that doesn't involve the GI tract at all, or they need to get creative.

IV hydration has a lot of drawbacks in the apocalypse. For one thing, it involves a lot of specialized equipment- the tiny catheters that sit in the vein, sterile tubing with a drip chamber, sterile fluids, and saline locks- all of which are nearly impossible to improvise. Plus, in the case of this ask specifically- doctors generally don't know how to start IVs. That's a nursing skill and unless a doctor is an anesthesiologist they probably haven't put an IV in since med school (where they did it exactly once).

Subcutaneous (subq) hydration is slower and requires all the same supplies. The nice thing about subq though is that unlike an IV catheter, which has to sit in the vein and takes skill/experience to place, in subq hydration the caregiver only has to place a catheter into the patient's fat (something a lot easier to talk someone through). This can instill about 60ml/hr (about 1.5 liters/24 hr). If they have the supplies and can throw more than one catheter in the person, they can probably keep them hydrated this way.

Recommendations

What I would recommend for this story, however, is to pile a bunch of anti-nausea remedies on top of each other to try to get the puking under control, then work on the diarrhea.

If this were my patient and I was in the apocalypse, I would start by putting a cool rag on the back of my patient's neck and have them smell an alcohol pad or some mint, help them wash out their mouth so it doesn't taste like puke, and try to keep them from puking for about an hour. If they make it that long, I'd start with having them drink about an ounce of clean water. If they don't throw it up over the course of the next half hour, I'd give an ounce of coca cola (I don't usually do brand names, but coca cola has a high concentration of phosphoric acid, which is a great anti-emetic plus the bubbles can help with nausea as well).

I'd then drop to an ounce every 15 mins, then an ounce every 10, alternating water and coke, or ORS and coke. The goal is very small amounts of liquid with time in between. If they become severely nauseous, back off and start again after a half hour. If they throw up, start the whole thing over again.

If at any point during this they had a prescription medication available like ondansetron, compazine, or promethazine, they could crush it and have the patient put it under their tongue- that way they wouldn't have to swallow it and risk throwing it back up. Some of it would absorb, and if they happened to swallow some, that would also be great.

Once the vomiting is moderately under control, they could give bismouth subsalicylate (pepto-bismol) and loperamide. Both work against diarrhea. For loperamide, the dosing is two tablets after the first loose stool, then one after each subsequent loose stool. Bismouth subsalicylate and loperamide can be taken together.

Stopping Things Up

A question a lot of people ask is whether you should take anything to stop diarrhea. This usually comes with the idea that the person with diarrhea must be pooping for a reason, and stopping it up is trapping an infection in there and making it worse.

If the diarrhea is being caused by a bacteria or virus, that infection is in the walls of the digestive tract, and it spreads to other people via infectious poop. Pooping does not get rid of the infection. It just makes it more likely that someone else will catch it, and that the patient will become dehydrated. So taking medication to slow down the poopcano is generally a good idea here, since the goal is basically just to wait until the immune system kicks the infection or antibiotics wipe it out, and pooping doesn't help with that.

Now. If the diarrhea is being caused by a toxin, including a toxin from, say, c-diff (an infection from a bacteria that takes over the gut after some antibiotics and causes life-threatening diarrhea/colitis), taking a medication to stop the poop is a bad idea- since the toxin will get trapped and continue to cause problems. Same if it's something like a food allergy or intolerance- it's going to keep messing you up until it's out, so better to let it get out.

How can you tell? Well, here's where I refer you to a doctor. In this situation, the doctor might be able to make an informed choice on whether they wanted to take an anti-diarrheal medication based on what they thought was causing the vomiting and diarrhea.

[our-rewritten-symphony]

Name: Wilbur Soot Minecraftia

Age: 15 when joining the server, and due to weird limbo bullshit, somehow 43 upon its end

Height: 5'11

Origin: Deathling

Description

Born of a mortal man and the goddess of death, his life was always followed closely by his mothers realm. He was never ment to live, never ment to exist, but due to Kristens magic, he was granted many years beyond what the gods originally gave him. Pain started to follow his movements when he turned 14, each step, each breath, becoming difficult. He and Phil tried everything, every medication, every pain releiver. And nothing worked. after a year of nothing working, Phil advised him to leave the hardcore world of his birth, as maybe being far from Kristen's realm would assist him. And for a long time, it did. But as death started appearing at every corner, the pain only grew stronger and stronger. Driving him mad, as he tried for any reason he could find to get the fighting to stop. Lmanburg, Pogtopia, anything and everything. At the final control room, he collapsed into his fathers arms, begging him, at 18, to be killed. That he couldn't bare this pain any longer. But that Tommy would be destroyed if he found the reason for his brothers death.

He pressed the button, and Phil, to end his poor baby's suffering, allowed him the mercy of being held in his dads arms as he let out his final breath.

In limbo, he was trapped within a train station. No one around him, not even his mother. He had tried so hard to get rid of the pain, that he forgot what mattered within the world. His family. 13 years he spent in this limbo. at his revial, his body adjusted to the time he spent in limbo. So the man who was 18 at his death, was now 31, only 9 months later. Offically making him the Big Brother of SBI.

[beespackingheat]

old school runescape drawings related to vampires and other fun things, 2021

[proudfreakmetarusonikku]

I think there’s a very fine line between just sharing experiences and actively talking over ppl and that’s where all the discourse comes from tbh. Like, there are dickheads talking over people with other disabilities and there’s also people who have different disabilities but want to share and relate in a way that’s supportive and kind, but a lot of people lump them in together and either get mad at people for talking about any disability that isn’t theirs or vice versa and they end up saying the wildest ableist shit. and like. neither of those are healthy nor good. lashing out at other disabled people who are genuinely trying to relate isn’t helpful, even if their disabilities are less severe or very different is just cruel and unhelpful and often crosses the line into lateral ableism. defending people who place their needs first and talk over everyone and treat their own disabilities like the only ones that exist is very cruel and crosses the line into lateral ableism too.

[jaywinaustin]

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[techdriveplay]

How to Get Hydrated Quickly After an Intense Workout

After a challenging workout, rehydration is crucial to restore the body’s balance, replace lost fluids, and ensure proper recovery. Knowing how to get hydrated quickly after an intense workout can make all the difference in reducing fatigue, improving muscle recovery, and maintaining overall performance. Whether you’re a seasoned athlete or someone just starting their fitness journey, hydration…

[chhatrapati-mahavirhospital]

World ORS Day!

Stay hydrated and healthy on World ORS Day! Oral Rehydration Solution is a simple and effective way to combat dehydration. Let's spread awareness and save lives.

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☎️ Call: 89843 09777 / 90048 36313 / 02522-227115 / 16

[miraclehospital]

World ORS Day

Celebrate World ORS Day by recognizing the importance of Oral Rehydration Solution in treating dehydration. Keep ORS handy and stay hydrated! 💦🌟

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☎️ Call: +91 98335 66782 / 77188 51603

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[hjhchezakria]

ORS: Replenishing Fluids and Electrolytes for Heat Dehydration

How Effective is Oral Rehydration Solution (ORS) in Combating Heat Dehydration? Credit:AiWP Bismillah ,Dehydration is a common health issue that can occur due to various reasons, including exposure to excessive heat. One of the most recommended solutions for dehydration is the consumption of Oral Rehydration Solution (ORS). This article explores the effectiveness of ORS in addressing heat-induced…

[alicantodrugsinfo]

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[roe-oo]

rip funny ore mound I’ll miss you funny ore mound

[oracle-fae]

x

[spicymotte]

patiently waiting until I get to kiss the dragon