Summary
Assess pediatric dehydration by integrating history with physical exam findings—specifically, looking for signs such as weight loss estimates, prolonged capillary refill, abnormal skin turgor, sunken eyes or fontanelle, altered mental status, and poor oral intake. No single sign is diagnostic; rather, a combination of findings improves accuracy ^1^2.
At-a-glance
| Parameter | Mild/Moderate Dehydration | Severe Dehydration |
|---|
| Weight Loss | ~5–10% loss | >10% loss |
| Capillary Refill | Prolonged (>2 secs in moderate cases) | Markedly prolonged (>3 secs) |
| Skin Turgor | Delayed (skin pinch visible for <2 seconds) | Very slow (>2 seconds; “skin pinch” remains elevated) |
| Mental Status | Restlessness or irritability | Lethargy, altered consciousness |
| Eyes/Fontanelle | Sunken eyes (or fontanelle in infants) | Deeply sunken with additional features |
| Oral Intake/Thirst | Eager drinker but thirsty | Drinking poorly or not at all |
| Other Findings | Dry mucous membranes, decreased tears | Signs of shock: weak, rapid pulse, cool/mottled extremities |
Evidence from FOAM sources highlights that using a combination of these clinical indicators—not just one isolated sign—helps accurately assess the degree of dehydration ^1^2/^3. Additional tools like the CHANDLER assessment can also be used to flag red flags beyond dehydration, particularly when making hospitalization decisions ^5.