No abstract

JOURNALwas our practice to give the infant the same kind of food as he had had before admission unless there was some definite contraindication. Vitamins A, B, C, and D were added to the feeds from the first day, and continued throughout the stay in hospital.3. The early correction of fluid loss. Fluids and proteins were administered intravenously in the form of half-strength serum or plasma (diluted with Hartmann's solution) as soon as there was clinical evidence of dehydration, and in quantities sufficient to restore fluid loss and maintain the infant's daily requirements. The usual allowance of 21 oz. per lb. per day was made, plus an allowance of 3 to 6% of body weight for dehydration in the first 24 to 48 hours. The intravenous drip was begun with half a bottle of Hartmann's + 2+ to 5% glucose, and serum or plasma then added (diluted to half-strength with Hartmann's). The drip was continued, giving alternate bottles of Hartmann's solution and half-strength serum or plasma, until dehydration was completely corrected and the infant was able to take and retain a dilute feed; this was generally in 1 to 3 days. Feeding was usually begun 12 to 24 hour-s after the commencement of intravenous therapy, and the quantity and strength of the milk feed gradually increased, the rate of the intravenous drip being adjusted accordingly.4. Energetic measures to combat shock in those infants admitted in a state of collapse. Warmth, stimulants such as brandy and cor-amine, and oxygen were given, and the intravenous drip was begun immediately. Treatment in these cases was considered as urgent as in " surgical shock." 5. The combating of anaemia by routine administration of iron (in the form of a ferrous sulphate mixture) and blood transfusions as required.6. The prevention of cross-infection; all infants were nursed in cell or barrier wards with strict bed-isolation technique, including the wearing of gowns and masks by all attendants. Summary and ConclusionsOne hundred and forty cases of diarrhoea and vomiting in infants under 15 months of age are analysed.The cases were of average severity as judged by incidence and degree of dehydration ; 69 (49.30/o) were dehydrated, the maximum incidence of severity occurring in the age group 0-9 months. There were 8 deaths, giving a case fatality of 5.700 for all cases, or 11.6% of dehydrated cases; 6 of the 8 deaths followed relapses.There were 27 relapses. The relapse rate in the open "barrier" ward was four times that in the cell wards.Evidence of parenteral infection was found in 124 cases, or 88.6%,h. The type of parenteral infection and incidence of infecting organisms are shown. The changes in body chemistry in dehydration occurring in diarrhoea and vomiting are discussed, and the need for further research in this field is stressed.The gratifying results obtained in this series may be attributed to: (1) the fact that the parenteral infections present were fairly easy to recognize and treat ; and (2) the attention paid to the prevention or early correction of dehydration, and early ...

No abstract

No abstract

The long convalescence was due to delayed hea,ling of wound May 4th. Good July 8th. Good October 29th. Good Jan. 2nd. Good. Prolonged convalescence owing to phlebitis April 25th.