Experiences in case management of diarrhoea in large hospitals
Patwari, A.K.
Journal of the Indian Medical Association 93(6): 243-244; 236, 242
1995
ISSN/ISBN: 0019-5847 PMID: 7499899 Document Number: 448723
Scientific basis for oral rehydration therapy (ORT) has revolutionized the concepts and management of diarrheal diseases during the last 25 years. ORT is the only therapy needed in the majority of diarrhea cases. Sometimes, however, in more severe or complicated cases, the judicious use of IV therapy and antimicrobial agents is called for. This approach should form the practical guidelines for the management of diarrhea in hospitals. Indeed, such therapy practiced in Indian hospitals has resulted in fewer diarrhea-related hospital admissions and lower average expenditure per patient. Savings from the reduction in the use of IV fluid and antibiotics have been used to supply oral rehydration solution packets to mothers for use at home. Managing the more severe and complicated cases, large referral hospitals still play a central role in the practice and promotion of standard diarrhea case management (SDCM). Medical colleges and teaching hospitals have an additional responsibility to train doctors, nurses, and health workers in SDCM. The first full-fledged diarrhea training and treatment unit (DTTU) in the country was established in Kalawati Saran Children's Hospital in January 1989. That later served as the National Training Center for training key personnel from other medical colleges and large hospitals in SDCM. The Ministry of Health and Family Welfare trained senior physicians, pediatricians, hospital administrators, and senior nursing personnel from medical colleges, referral hospitals, and district hospitals in SDCM. There are now more than 80 DTTUs functioning in the country. Many more large/referral hospitals have no DTTU, but, nonetheless, actively practice and promote SDCM.