June 17, 2013 by Thomas Miller
In the survival and preparedness world, there is often a heavy emphasis on “cool stuff”: guns, bug out vehicles, hardening a structure, tactical response to scenarios, etc. What often get left out are the basic things that threaten lives every day, whether there is a crisis or not. The No. 5 cause of death in the world is diarrhea and diarrheal disease, which account for about 2.5 million deaths every year. Often, these deaths are a result of a continual downward spiral that starts with dehydration and could potentially be prevented with the use of an oral rehydration solution.
*I will apologize for the heavy use of quotes, but I feel that it is of the utmost importance that factual and authoritative sources are used for this subject. There is no better way to word some of these points than to quote them directly from the source.
Background: What Is Oral Rehydration?
Oral rehydration is not as basic as just drinking water and everything will go away. The chemistry of the body requires a delicate balance, referred to as homeostasis, that cannot be achieved solely by drinking water. True rehydration to maintain homeostasis requires the addition of glucose and electrolytes to water.
The World Health Organization (WHO) specifically states that oral rehydration therapy should begin at home with the use of a home-prepared sugar-and-salt solution that is given early during any episode of diarrhea to prevent dehydration. If the point of dehydration is reached, a pharmaceutically produced oral rehydration solution with a balance of sodium and glucose should be used. The WHO further states:
Oral Rehydration Salts (ORS) is the non-proprietary name for a balanced glucose-electrolyte mixture, first used in 1969 and approved, recommended, and distributed by UNICEF and WHO as a drug for the treatment of clinical dehydration throughout the world. In 1984, another mixture containing trisodium citrate instead of sodium hydrogen carbonate (sodium bicarbonate) was developed with the aim of improving the stability of ORS in hot and humid climates. For more than 20 years, WHO and UNICEF have recommended this single formulation of ORS to prevent or treat dehydration from diarrhoea irrespective of the cause or age group affected. This product, which provides a solution containing 90 mEq/l of sodium with a total osmolarity of 311 mOsm/l, has proven effective and without apparent adverse effects in worldwide use. It has contributed substantially to the dramatic global reduction in mortality from diarrhoeal disease during the period.
Dehydration can be prevented through the practice of giving extra fluids or through the use by mouth of an ORS that is simple, effective and cheap in treating all but the most severe cases. The practice of using an ORS to treat or prevent dehydration is called oral rehydration therapy, or ORT, which is considered the primary strategy in reducing diarrheal- and dehydration-related deaths by the WHO Department of Child and Adolescent Health and Development.
In fact, oral rehydration solution has been determined to be so effective that, according to the WHO, up to 80 percent of cholera cases can be treated simply through the use of ORS.
The following chart from the WHO breaks down the specific composition of the latest ORS formula with a further explanation of what the individual components do to assist the body in treating dehydration.
This ORS composition has passed extensive clinical evaluations and stability tests. The pharmacokinetics and therapeutic values of the substances are as follows:
- glucose facilitates the absorption of sodium (and hence water) on a 1:1 molar basis in the small intestine;
- sodium and potassium are needed to replace the body losses of these essential ions during diarrhoea (and vomiting);
- citrate corrects the acidosis that occurs as a result of diarrhoea and dehydration.
Solution: Oral Rehydration Solution
Now that the need has been established, how does one obtain an ORS for personal, family or group use? That is perhaps the easiest part of this entire concept. An ORS can easily be made in the home or on the road with precisely measured ingredients. It is important to note that failure to properly measure these ingredients could result in a dehydrated casualty not improving or perhaps even getting worse.
If you are not inclined to self-manufacture an ORS or question the effectiveness of doing such, there are several commercially produced products that can be purchased rather cheaply from your local pharmacy or sporting goods/outdoors store.
The most widely used recipe for ORS is:
Oral Rehydration Solution
6 teaspoons of sugar
½ teaspoon of salt
1 liter of clean drinking water
Pour the measured amounts of sugar and salt in the water and shake or stir until the ingredients are well mixed.
Oral Rehydration Solution II
(Recipe provided by The Washington Manual: Outpatient Medicine Survival Guide.)
½ teaspoon of salt
1 teaspoon of baking soda
8 teaspoons of sugar
8 ounces of orange juice
About 24 ounces of clean drinking water
- Into a 1-liter container, pour in salt.
- Add baking soda.
- Add sugar.
- Measure in orange juice.
- Add water until the 1-liter mark is reached.
- Stir or shake until all ingredients are well combined.
The consumption of ORS should be according to the age of the dehydrated person. The following amounts are good guidelines for rehydrating a patient:
- Children younger than 2: 75 milliliters after each watery stool (up to ½ liter per day)
- Children ages 2-12: 150 milliliters after each watery stool (up to 1 liter per day)
- Adolescents and adults: 250 milliliters after each watery stool (up to 3 liters per day)
Other Considerations: Zinc
Another consideration to keep in mind is that dehydration caused by diarrhea can lead to a deficiency in the body of zinc. Long-term preparations should include zinc supplements to overcome this deficiency. With readily available food supplies, extra zinc can be taken into the body through increases of lean red meats, seafood, peas and beans. It is recommended that the guidance of a physician is sought before adding any supplements to your daily intake. In the absence of a doctor, supplements can be purchased at the local pharmacy for less than $5 in most circumstances.
If the decision is made to add zinc to your diet, determine dosages by following daily values of zinc that are recommended in the United States, according to the Mayo Clinic:
- Infants and children, birth to 3 years of age: 5-10 mg
- Children, 4 to 6 years of age: 10 mg
- Children, 7 to 10 years of age: 10 mg
- Adolescent and adult males: 15 mg
- Adolescent and adult females: 12 mg
- Pregnant females: 15 mg
- Breast-feeding females: 16-19 mg
Several studies have shown that zinc supplementation has reduced diarrhea-related hospital admissions by about 25 percent.
Being able to make ORS depends on having the necessary supplies. Stock plentiful quantities of salt, sugar, baking soda, orange juice and clean drinking water if you plan on making your own ORS. It is also important to keep in mind that the information contained here is no substitution for the treatment that can be provided by a physician. Having the knowledge of how to properly rehydrate a person who is in poor health can make the difference between life and death, especially during difficult times.
Sources: World Health Organization, National Institutes of Health, Centers for Disease Control, The Mayo Clinic, The Washington Manual: Outpatient Medicine Survival Guide (2003) and Rehydrate.org