Oral Rehydration Salts (ORS)

Rapid evacuation of fluids from the body, which can be caused by cholera or other diarrheal diseases, may lead to chronic dehydration and eventually death. Oral Rehydration Salts (ORS - also known as Oral Rehydration Therapy (ORT)) are a solution of sugars and salts which helps to slow the evacuation of fluids, allowing for the absorption of electrolytes in the intestines. Though approximately 80 percent of individuals affected by cholera could be treated successfully using ORS, only about 35 percent of families in diarrhea-stricken countries utilize the treatment because improvement is not seen immediately.

In countries affected by outbreaks of diarrheal illness, pre-mixed ORS sachets are frequently distributed to help halt the spread of the bacteria which can spread quickly in areas with poor sanitation or a lack of potable water (clean drinking water). ORS can also be useful for backpackers or climbers who may be affected by diarrheal illness or dehydration due to contaminated water, and pre-mixed sachets are frequently available at outdoor supply stores. When pre-mixed sachets are not available, an ORS solution can be made easily using common household ingredients.

_{Please Note: Information and recipes provided here are from The Rehydration Project and the Palo Alto Medical Foundation. Oral Rehydration Salts should be administered under supervision of an individual with appropriate training whenever possible and clean water MUST ALWAYS be used for all preparations. If you are unsure about the quality of the water you are using, PLEASE BE SURE TO BOIL it before using to help kill off any bacteria that may be present.}

Step 1: You'll Need. . .

Hardware:

• A large container to mix the solution (ensure that it has been cleaned well using uncontaminated water)
• Measuring spoons

Software:
The Palo Alto Medical Foundation suggests:

• 1 liter of purified water (Please Note: if you are unsure about the quality of the water you are using, please be sure to boil it before making the solution to kill off any bacteria that may be present)
• 1/2 teaspoon table salt
• 1/2 teaspoon baking soda
• 8 teaspoons white sugar
• 1/4 teaspoon salt substitute (optional but recommended - I didn't have any so it isn't pictured here) (note: provides potassium which is important for water balance in the body)

The Rehydration Project suggests:

• 1 liter of water (boiled and cooled)
• 1/2 teaspoon table salt
• 6 teaspoons white sugar

Step 2: How to Administer

After mixing all ingredients until the sugar and salt have fully dissolved, administer as follows.

For Children:
Start with small amounts given by teaspoon every 15 to 20 minutes - if the solution is well tolerated, the volume can be increased.

• During the first four to six hours, a one-year-old child should receive at least 4 ounces (8 tablespoons) per hour.
• After the first four hours, a one-year-old child should receive approximately 4 ounces of the solution per diarrheal stool, in addition to other routine fluids.
• Infants should be given less of the solution - approximately 3/4 to 1 1/2 ounce of solution per pound of body weight during the first four to six hours.

For Adults:
It is recommended that adults alternate sips between glasses (small sips taken from each glass one at a time) of the following:

• ORS solution.
• 8 ounce glasses of orange or apple juice combined with 1/2 teaspoon of honey (to provide glucose which is needed for the absorption of salts) and 1/4 teaspoon of table salt.
• 8 ounce glasses of purified (boiled and cooled) water with 1/8 teaspoon baking soda.

Step 3: Things to Note

1. Make sure to measure all ingredients in the ORS solutions carefully. Mis-measured solutions can be harmful to individuals experiencing dehydration.
2. ORS solutions should only be made using purified, cooled water. Do not use water that may be contaminated without boiling it well first. Boiled water should be allowed to cool fully before using it for ORS solutions.
3. Always have plenty of purified water on hand to administer to the individual receiving ORS as their diarrhea/dehydration subsides.
4. ORS solutions should be administered slowly - administering too much too quickly could worsen an individual's condition.
5. For individuals going camping/hiking/climbing/etc., the salt, sugar, and baking soda (and salt substitute if using) needed for ORS can be measured and mixed ahead of time and stored in a small baggie or other container for use if an individual begins experiencing diarrheal illness or dehydration.