Gastroenteritis

At Mater Children's Hospitals, we aim to provide quality and caring health care. The aim of this booklet is to answer some of the questions you may have about your child's stay at Mater Children's Hospitals, and what you and your child may expect after discharge from hospital. This booklet is a guideline only. Each child will have their own needs. If you have any questions about your child, please speak to your child's doctor or nurse.

Our pastoral care team will visit you during your child's stay, and are able to meet with you at your request.

Gastroenteritis

Date of admission:

 

Planned discharge date:

 

Actual discharge date:

 

Senior doctor of team caring for your child:

 

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Our expectations

Prior to discharge (for children who were otherwise well before the onset of gastroenteritis), we would expect your child to be:

  • taking enough fluid orally to maintain their hydration
  • able to take a small amount of solid food (although their normal appetite may not return until they are at home in familiar surroundings)
  • no longer vomiting
  • passing adequate amounts of urine
  • passing a decreasing number of loose bowel motions.

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Your expectations and goals

What are your expectations of your child's hospital stay and recovery? (this section to be completed shortly following admission)

 

 

Admitting nurse to complete and sign (including printed name)

___________________________  Date: ____ / ____ / ________

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Questions

If at anytime during your child's hospitalisation you have questions regarding treatment, or you are unsure of anything that concerns your child; please ask to speak to the nurse or the medical team caring for your child.

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Follow up

Please bring this booklet to any follow up appointments your child may have. This booklet will assist your general practitioner or doctor in knowing what care has been provided for your child whilst at Mater Children's Hospitals.

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What is gastroenteritis?

Gastroenteritis (gastro) is a very common illness in infants and children. It is usually caused by viruses that infect the bowel (stomach and intestines). These viruses cause diarrhoea. They can also cause vomiting, and in some cases, high temperatures (fever), stomach (tummy) pain, a runny nose or sore throat.

Gastro usually settles by running its course, and the length of illness can vary from child to child.

The most common ways of catching gastro are from unwashed hands (especially after using the toilet, toileting children, or changing nappies), or from person to person.

To stop the spread of the virus, your child will be nursed in isolation to prevent contact with other children. Your child (and any visiting children) should stay in this room for the duration of their admission, unless told otherwise by staff. This includes staying out of kitchen and play areas.

Hand hygiene is the most important and effective way of preventing the spread of the infection. Please wash your hands each time you leave your child's room, after toileting or changing a nappy, and before and after handling food. Please ensure visitors to do the same. Antibacterial hand spray/gel is available for use (for adults and children) on entering and leaving the ward.

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Admission to hospital

  • On admission the staff will show you to your child's room in the ward. The nurse will talk with you about the ward facilities you may use. We will provide a bed for one parent if you wish to stay with your child overnight
  • Your admitting nurse will apply an identification armband, which stays on all through your child's admission.
  • Your admitting nurse will ask about your child's medical/surgical history and any particular needs your child may have while they are in hospital. It is important for you to provide the staff with detailed and accurate information about your child's past clinical history, so that the staff can properly plan your child's treatment.

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Care of your child in hospital

Infants and young children with gastro can become dehydrated very quickly. Dehydration is a very serious and potentially life threatening condition. Signs of dehydration include:

  • not passing as much urine as usual
  • having dark coloured or smelly urine
  • dry lips and mouth
  • sunken eyes
  • no tears
  • cold hands and feet
  • drowsiness (being very sleepy or not waking for feeds).

Rehydration while in hospital can occur:

  • orally
  • via a nasogastric (NG) tube. Fluid is slowly fed through this tube which passes through their nose into their stomach. This is most useful when the child is not/no longer vomiting, but is unwilling to drink adequately, or not well enough to drink properly
  • intravenously. Fluid is put directly into their vein via a cannula (drip). This is best only when the child is continually vomiting or is too unwell to drink.

Suitable fluids should be given to the infant in regular small amounts, waiting 10 to15 minutes after a vomit. These fluids include:

  • ORS (Oral Rehydration Solution), available in the hospital or over the counter at the chemist. Children lose salts and other nutrients with vomiting and diarrhoea, and as water does not contain these nutrients, ORS replaces them
  • clear fluids (liquids you can see through), for example, juice, cordial, soft drink, and sports drinks. These fluids usually have a high sugar content, and are generally not encouraged as they can make diarrhoea worse. If used when the child's recovery is well underway, they should be diluted with water 1:4, for example, one part juice to four parts water.

Breastfed babies with gastro can continue with breast feeds on demand or at least offered every two hours. Offer ORS or water between feeds. Babies on formula should be given suitable fluids (see above) and aim to be back on their usual milk/formula (undiluted) within 24 hours, but may need to be offered smaller amounts more frequently.

When able to tolerate food, your child is best offered plain foods such as rice, wheat, potatoes, breads, cereals, lean meats and chicken, fruit and vegetables. Avoid foods high in fat as they are hard to digest.

Paracetamol may be administered by staff if your child experiences discomfort. Medications to stop diarrhoea are not routinely used as they can be harmful. Antibiotics will not help viral gastroenteritis, though they may be given for less commonly occurring bacterial gastroenteritis.

Staff will be monitoring your child's progress daily. When you are with your child, it is helpful if you ask nursing staff for a pen and paper to record even the small amounts of food or fluids your child is taking. Please also let nursing staff know how many dirty nappies or visits to the toilet they have, and whether you have seen blood or mucous in your child's bowel motions.

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Transition to home

Prior to discharge (for children who were otherwise well before the onset of gastroenteritis), we would expect your child to be:

  • taking enough fluid orally to maintain their hydration
  • able to take a small amount of solid food (although their normal appetite may not return for a few days after discharge)
  • no longer vomiting
  • passing adequate amounts of urine
  • passing a decreasing number of loose bowel motions.

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Care at home

Your child's appetite and bowel motions usually return to normal within a week. Continue to offer small amounts of food and fluid regularly. If possible, try to offer ORS as described earlier. Monitor your child's intake, as well as diarrhoea, vomiting, and urine output.

Public health guidelines generally recommend that your child be excluded from school or day care until 24 hours after diarrhoea has completely settled and they are otherwise well.

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How to seek medical advice

For emergency medical treatment, call Queensland Ambulance Services on 000.

Ensure you have your address details ready and the reason for your call.

For general advice about your child’s condition, promptly contact any of the following:

  • 13 HEALTH (13 43 25 84)
  • For medical review of your child, including concerns relating to your child’s recent admission in Mater Children’s Hospital, please present at Mater Children’s Emergency, your local GP, or your local hospital.

Any questions/concerns you have about your child’s condition should be followed up by you immediately.

Seek medical advice if:

  • your child becomes unwell again with poor intake, increased diarrhoea or vomiting, or ongoing temperatures.

Seek urgent medical advice if:

  • your child is not passing as much urine as usual, or is passing dark coloured or smelly urine
  • signs of dehydration—dry lips and mouth, sunken eyes, no tears
  • cold hands and feet
  • drowsiness (being very sleepy or not waking for feeds).

Please bring this booklet to any follow up appointments your baby may have. This booklet will assist your baby’s doctor to know what care has been provided for them at Mater Children’s Hospitals.

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© 2010 Mater Misericordiae Health Services Brisbane Limited. ACN 096 708 922.

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Last modified 2:08 PM, 14 June 2013