Gastroenteritis (Diarrhoea and Vomiting) Parent and Carers Guide Children s Services Women and Children s Services This leaflet has been designed to give you important information about your child s condition, and to answer some common queries that you may have.
Introduction The aim of this leaflet is to provide you as carers or parents all the relevant information regarding gastroenteritis (diarrhoea and vomiting). Benefits By monitoring your child s fluid intake, and any vomiting or diarrhoea, staff are able to treat the gastroenteritis appropriately, ensuring they remain hydrated. Risks In children there is an increased risk of dehydration and shock resulting from gastroenteritis. Other complications can include damage to the mucosa (sticky lining) of the intestines, causing prolonged watery diarrhoea even after the initial infection has gone. Some people experience a temporary lactose intolerance (reacting badly to dairy foods) because of increased sensitivity of the lining of the intestines. Alternatives Unfortunately there are no alternatives. Antibiotics are not usually helpful in gastroenteritis, because viruses cause most cases in the United Kingdom. However if specific bacteria are involved antibiotics may be given. These are not an ideal treatment because they can kill the friendly bacteria in the gut that aid digestion. We do not give any medicines to stop the vomiting or diarrhoea as these medicines have side effects for children. What is gastroenteritis? Gastroenteritis is the diagnosis which describes the onset of symptoms such as diarrhoea, vomiting, a temperature and sometimes stomach cramps (tummy ache). It means inflammation (swelling and irritation) of the stomach and the intestines (gut). It is one of the most common reasons for children to be admitted to hospital, and can vary in severity from mild to severe symptoms. What causes gastroenteritis? In the UK Gastroenteritis is usually caused by a viral infection but it can also be caused by bacteria and parasites. The most common virus is called Rotavirus. Bacterial infections are not as common but are caused by bugs such as Salmonella, Campylobacter and E Coli. How is gastroenteritis caught? The most common ways of catching Gastroenteritis are from: Unwashed hands, particularly after using the toilet, toileting children or changing nappies Person to person contact, particularly in playgroups / nurseries Viruses present in the air Eating contaminated foods such as meat, poultry and eggs Animals to humans Why might my child need to be admitted to hospital? If your child is suffering from severe vomiting and diarrhoea this may lead to dehydration. Dehydration occurs when a person loses more fluid through diarrhoea and / or
vomiting than they are able to take in by mouth. Signs that your child may be dehydrated include: Pale appearance Lethargy (unusually tired) Dry mouth Dark or sunken eyes Not passing urine in 4 hours for babies under 1 year old, and in 4-6 hours for older children Not interested in playing with toys -even for a short while Vomiting is more of a concern than diarrhoea because if your child vomits they are not getting the benefit from the fluids they have drunk. If they have diarrhoea only, at least some of the fluid has been absorbed as it passes through the body. What happens on admission to hospital? A doctor will see your child and assess whether they are dehydrated or not. If they are not dehydrated or the dehydration is only mild, then encouraging fluids by mouth, i.e. water or juice, may be all that your child requires. A sample may be taken from your child s stool (diarrhoea). This will be sent to the laboratory to try and identify the virus or bacteria responsible for causing your child s symptoms. These results may take up to 48 hours, and sometimes no particular bug is identified. While your child is in hospital a record will be kept on a fluid chart of any stools passed, any vomiting and the amount your child has to drink. This helps the doctors and nurses to assess your child s condition and progress accurately. If your child has a temperature then you will be advised to nurse them in their underwear / nappy only, with a fan on. Doctors may prescribe medicines to help reduce their temperature. Infection Control (preventing the spread of infection to yourselves and others) If your child has been admitted to hospital with diarrhoea and / or vomiting, they will be nursed in a room of their own. This is to prevent the spread of infection to other children. The following measures should be also be used: Your child should stay in their room unless you are informed otherwise by nursing staff Please make sure anybody taking your child to the toilet washes your child s hands afterwards as well as their own After changing your child s nappy please ensure it is disposed of correctly and your hands are washed We advise restricting visitors to close family All visitors should wash their hands before leaving the room What should I give my child to drink? Your child should be given plenty of clear fluids to drink in small, frequent amounts to try and prevent any further vomiting and solve any mild dehydration. A rehydration
powder called Dioralyte can be added to water/juice. This contains essential salts that are lost by the body through diarrhoea and vomiting. If your child refuses this then another clear fluid such as juice or sugared water can be offered. Breastfeeding mothers may continue to feed their baby who has gastroenteritis, as long as they are remaining hydrated. If your child has not vomited for 4 hours after drinking clear fluids or Dioralyte, milk or light food such as cereal, toast or sandwiches can be offered. These foods can help the temporary damage done to the lining of the bowel by the diarrhoea. However, if your child vomits after eating food or drinking milk they should be offered clear fluids or Dioralyte until they are free from vomiting for another 4 hours. After this time you may wish to try your child again with milk or light foods. What happens if my child is dehydrated or cannot tolerate oral fluids? If the doctor decides your child is dehydrated or does not drink enough or, despite all efforts, your child continues to vomit and is in danger of becoming dehydrated, they may require fluids to be given through a nasogastric tube (small tube passed through the nose to the stomach) or a drip. What happens if my child needs a drip? If your child requires a drip a small plastic tube called a cannula is inserted into the vein by a doctor or specially trained nurse. This will require a needle, and therefore if there is time a local anaesthetic cream or spray will be applied prior to the procedure to numb the area. When the doctor or nurse puts the cannula into the vein they will also take some blood samples to check the levels of the salts in your child s blood, which may have altered due to the diarrhoea and vomiting. The drip going into your child s vein will be secured with bandages and / or a splint. This is delicate and may easily come out; therefore please prevent your child from pulling or chewing it. The drip will go through a machine, which makes sure your child receives the correct amount of fluids. It will also measure the pressure needed to push the fluid into the vein and will sound an alarm if there are any problems. The nurses will check the machine every hour and record the amount of fluids your child has received and the pressure readings. Can my child drink while they are on the drip? While your child is on the drip they may have small amounts of fluids to drink. When they are feeling better and have stopped vomiting, the amount of fluids taken by mouth can be increased. At the same time nursing staff may reduce the amount of fluid being given by the drip, until it can be removed. When can my child go home? The length of stay depends on how ill your child is and how long it takes for them to stop vomiting. Your child will be discharged when the consultant is happy that they can drink enough without vomiting. Your child may be discharged even if they still have diarrhea.
As long as your child is drinking well then they will be able to cope with the diarrhoea without getting dehydrated. The diarrhoea may continue for as long as 2-3 weeks. It may take a little while for your child s appetite to return to normal, but try not to worry about this, as they will eat when they are ready. What should I do at home? Once you have been discharged you should follow the advice given by the nurses and doctors. Your child needs to continue taking plenty of oral fluids to prevent dehydration. If your child begins to vomits again, then follow the advice in this leaflet. However, if you have any concerns about your child s fluid intake or condition once you are home then contact either your GP or NHS 111 for advice. www.nhsdirect.nhs.uk Will my child need any follow up? A consultant will not usually follow up your child, However they may be referred to the Children s Community Nurses for follow up support and advice at home. Contact Details If you have any further questions please do not hesitate to speak to a member of nursing or medical staff. References Northern Lincolnshire & Goole NHS Foundation Trust, Gastroenteritis Guideline Children s Services. Concerns and Queries If you have any concerns / queries about any of the services offered by the Trust, in the first instance, please speak to the person providing your care. For Diana, Princess of Wales Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01472) 875403 or at the PALS office which is situated near the main entrance. For Scunthorpe General Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01724) 290132 or at the PALS office which situated on C Floor. Alternatively you can email: nlg-tr.pals@nhs.net Confidentiality Information on NHS patients is collected in a variety of ways and for a variety of reasons (e.g. providing care and treatment, managing and planning the NHS, training and educating staff, research etc.). Everyone working for the NHS has a legal duty to keep information about you confidential. Information will only ever be shared with people who have a genuine need for it (e.g. your GP or other professionals from whom you have been receiving care) or if the law requires it, for example, to notify a birth. Please be assured however that anyone who receives information from us is also under a legal duty to keep it confidential. Zero Tolerance - Violent, Threatening and Abusive Behaviour The Trust and its staff are committed to providing high quality care to patients within the department. However, we wish to advise all patients / visitors that the following inappropriate behaviour will not be tolerated: Swearing
Threatening / abusive behaviour Verbal / physical abuse The Trust reserves the right to withdraw from treating patients whom are threatening / abusive / violent and ensuring the removal of those persons from the premises. All acts of criminal violence and aggression will be notified to the Police immediately. Risk Management Strategy The Trust welcomes comments and suggestions from patients and visitors that could help to reduce risk. Perhaps you have experienced something whilst in hospital, whilst attending as an outpatient or as a visitor and you felt at risk. Please tell a member of staff on the ward or in the department you are attending / visiting. Scunthorpe General Hospital Cliff Gardens Scunthorpe 01724 282282 Goole & District Hospital Woodland Avenue Goole 01405 720720 www.nlg.nhs.uk Date of issue: September, 2014 Review Period: September, 2017 Author: Children s Governance Group IFP-336 v3.1 NLGFT 2014 Moving & Handling The Trust operates a Minimal Lifting Policy, which in essence means patients are only ever lifted by nursing staff in an emergency situation. Patients are always encouraged to help themselves as much as possible when mobilising, and if unable to do so, equipment may be used to assist in their safe transfer. If you have any questions regarding moving and handling of patients within the Trust, please speak to a member of staff in the ward or department you are visiting. Northern Lincolnshire and Goole NHS Foundation Trust Diana Princess of Wales Hospital Scartho Road Grimsby 01472 874111