Five tips to keep patients hydrated

Sunshine, sweating and air-conditioning in summer, and wind and heating in winter, can cause fluid loss in children, the elderly and athletes. Here are five tips to prevent dehydration.

1. Keeping children cool in the summer months

Children’s temperature regulation and sweat glands are still developing, so they are more likely to overheat.1 Kids aged 4–18 need about 1.4–1.9 litres of fluids a day depending on gender.2 Water is best, but if they are playing sport outside on a hot day, an electrolyte sports drink will provide energy, fluids, sodium and potassium which is lost through sweating.3

2. Hydration for children with vomiting and diarrhoea

While water is essential, an oral rehydration solution containing electrolytes and glucose is also needed to rebalance losses. Avoid full-strength juices or flat lemonade, as they may make dehydration worse due to their sugar concentration. However, you can dilute them one cup to four cups of water. 

Offer a mouthful of fluids every 10–15 minutes when children are sick.4


3. Keeping the elderly hydrated

The older we get, the less notice we take of thirst until we are quite dehydrated. On hot days, older people should drink small amounts more often, particularly if you think residents or patients are restricting fluid intake due to the effects of medication, incontinence, or mental or physical disability.5

4. Dehydration in athletes and defence personnel

Dehydration of just 2% of body weight can affect performance.2,6 Training is the ideal time to determine sweat losses. One kilogram of weight loss after exercise equals about the same amount of fluid lost through sweating.6 Therefore, over an hour, about 250 ml of fluids every 15 minutes of exercise – particularly in hot weather – should be drunk.6 Water is the best choice for exercise under an hour, but on hot days an electrolyte sports drink may be required.6

5. Can you drink too much?

Hyponatraemia, where blood sodium concentrations drop too low due to overhydration, can lead to headaches, unconsciousness and coma.7 It is more commonly seen in endurance athletes, particularly slight females.8 Avoid over-drinking by measuring sweat losses and aiming to replace lost fluids. To replace sodium lost through sweat, drink sweet electrolyte drinks8 or eat salty foods such as miso soup, peanut butter or Vegemite sandwiches.

References 

Falk, B. Effects of thermal stress during rest and exercise in the paediatric population. Sports Med 1998; 25: 221-40

Australian Government National Health and Medical Research Council Nutrient Reference Values for Australia and New Zealand. www.nrv.gov.au Water chapter 2006 cited 31.12.10

Sports Dietitians Australia fact sheet – Fuelling and cooling the junior athlete December 2008. cited 31.12.10 

http://www.sportsdietitians.com.au/resources/upload/Fuelling_and_cooling_the_junior_athlete.pdf 

State Government Victoria Department of Human Services Emergency Department Fact sheet – Gastroenteritis in children June 2008 http://www.health.vic.gov.au/edfactsheets/gastro-kids.pdf cited 31.12.10

Schols, JM, De Groot, CP, van der Cammen, TJ, Olde Rikkert, MG. Preventing and treating dehydration in the elderly during periods of illness and warm weather. J Nutr Health Aging 2009; 13:150-7

Sports Dietitians Australia fact sheet – Fluids in sport June 2009 cited 31.12.10 

http://www.sportsdietitians.com.au/resources/upload/file/Fluids%20in%20Sport%20Aug10%20adjDental.pdf 

Rosner MH. Exercise-associated hyponatremia. Phys Sportsmed 2008; 36: 55-61

Hsieh M. Recommendations for treatment of hyponatremia at endurance events. Sports Med 2004; 34: 231-8