Oral rehydration therapy as an alternative to intravenous therapy in dehydrated older people (original) (raw)

2016, Annals of Long-Term Care

Outbreaks of diarrhea are common in long-term care settings. 1 An example of such an outbreak was the Gould nursing home diarrhea outbreak that occurred in Baltimore from July 26 to August 3, 1970. It resulted in a 72% attack rate among patients, 29% among staff, and was noted to be due to salmonella food poisoning. The mortality among patients was 23%, with no deaths in younger healthy staff. Diarrhea can be very severe and life threatening without prompt hydration. National data in the United States demonstrate that the risk of a fatal outcome due to diarrhea increases with age, with the majority of deaths occurring over the age of 55 years. Furthermore, fluid loss for prolonged periods from ileostomies or colostomies are common and require recurring visits to emergency rooms and hospitalizations. Water and electrolyte losses from the gastrointestinal tract due to diarrhea or high output ileostomies and/or colostomies in older people commonly cause loss of circulating blood volume...