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Saanen
06-22-2008, 05:06 PM
I've got a character who's been kidnapped without food or water for just over three days. What kind of treatment would he need when he's rescued, beyond being given plenty of water to drink and small nourishing meals?

Since this is a fantasy, my characters' medical resources are limited. What did people do in the old days for dehydrated victims before IV drips and saline solutions and so forth were available?

I appreciate any suggestions! Thanks!

sheadakota
06-22-2008, 06:27 PM
I would think you have it covered with getting fluids into him by drinking and keeping him warm- If he is severly dehydrated he could go into seizures, but 3 days isn't all that long- so i think you are all right there.

Elaine Margarett
06-22-2008, 06:37 PM
I've got a character who's been kidnapped without food or water for just over three days. What kind of treatment would he need when he's rescued, beyond being given plenty of water to drink and small nourishing meals?

!

He'd be given small drinks of water spaced out over a period of time so his body can absorb it and he doesn't throw it up. Once he's keeping liquids down, he'll be able to eat; again, small meals over a period of time.

Incidently, I've heard it said people can go three days without water and three weeks without food...

FWIW,
EM

Kitty Pryde
06-22-2008, 08:22 PM
Actually, 'plenty of water' is not the standard treatment for dehydration. since the 1950s scientists have been using oral rehydration therapy-water with glucose and salts to replace not only the water, but also the electrolytes! chugging loads of water can cause hypovolemia (too much water, not enough salt) which will kill you even faster! ORT is particularly effective for gastroenteritis-related dehydration, but works in general. Think of it as super-powered gatorade.

Libbie
06-22-2008, 08:32 PM
I've got a character who's been kidnapped without food or water for just over three days. What kind of treatment would he need when he's rescued, beyond being given plenty of water to drink and small nourishing meals?

Since this is a fantasy, my characters' medical resources are limited. What did people do in the old days for dehydrated victims before IV drips and saline solutions and so forth were available?

I appreciate any suggestions! Thanks!

I once landed in the hospital when I managed to severely dehydrate myself. I had an IV of water and electrolytes in my arm for about five hours, and then had to lie still for another couple of hours. I had to do that thing where I stand up from a lying position, then sit from a lying position, and they monitored my blood pressure and heart rate to make sure it was returning to normal levels. What's that called? I want to say orthotics, but I know that's not correct.

For limited resources, my guess would be tiny sips of water, lying down so there's minimal movement, and then some means of checking whether he seems to be recovering internally--checking his pulse if you can't check his blood pressure. When I was relatively more dehydrated I felt extremely dizzy and weak whenever I'd stand or sit up, so maybe his relative weakness or strength could clue in those around him about his rate of recovery. As mentioned, the electrolytes and salts are of key importance, so maybe making him suck on a chunk of salt would help, too.

Saanen
06-22-2008, 09:28 PM
Thanks, everyone! This is just what I was hoping for!

I picked three days because that didn't seem too excessive a time, but he is locked in a small, stuffy room and it's very hot, so he'll have been sweating too. I didn't think about the electrolytes thing. Sounds like he'll need more time to recover than I thought, but that works out fine for the plot.

Keyan
06-22-2008, 09:32 PM
The traditional rehydration solution is I think water with a couple of spoons of sugar and a pinch of salt. If this is a pre-sugar world, I expect honey would work. Boiled for sterility if the water supply is dicey.

Phil DeBlanque
06-22-2008, 09:41 PM
What Keyan said. Often, during the high summer time, the government here run ads and panphlets teaching people to do this "home-made solution", that can save lives in an emergency. One liter of water, two spoons of sugar, a pinch of salt. In one particular year, a special spoon was distributed, with the exact measure of salt and sugar to be mixed in the liter of water. Hopefully, your fantasy world would have the decency of using liters, unlike some countries we know :p

Shwebb
06-22-2008, 09:57 PM
Incidentally, when one's blood pressure drops when the person stands up, that's called "orthostatic hypotension." So the "orthotic" thing was close!

And here's a recipe I found here (http://www.oley.org/lifeline/95-045.html) that you might be able to adjust (if that knowledge is really necessary for your book) to the specific time and place of the setting:


Oral/enteral fluid replacement has been advanced by knowledge gained from rehydration treatment of victims of infectious diarrheal epidemics in third world countries. The term applied is "oral rehydration therapy." As long as there is sufficient functioning GI tract to absorb fluid, oral rehydration therapy can be accomplished despite ongoing diarrheal losses.
Oral rehydration therapy solutions are specifically designed to promote water and sodium absorption. Water by itself is not effective because the GI tract requires sodium, sugar and/or amino acids to absorb the water. In fact, water alone may cause more loss. "Sport drinks" (see Table 2) promote water absorption by providing sodium and sugar, but in the face of major GI losses, their sodium content is too low for them to be used for oral rehydration therapy. Water containing appropriate sodium, sugar and amino acids must be given in specific amounts for optimal absorption. The exact best composition is still unsettled but the amount of sodium is very important. Simple ingredients available in the grocery store can be used. For example, the World Health Organization (WHO) formula can be mixed using 1 liter of water, 3/4 tsp. table salt, 1/2 tsp. baking soda, 1 cup orange juice, 4 Tbs. table sugar or 2 Tbs. honey; sugar free flavoring may be added to make this salty drink more palatable. (Alpers, Manual of Nutritional Therapeutics, 1995). The WHO formula and several other hydration products are available commercially (see Table 2). However, before choosing a commercial hydration product, be sure to check the sodium concentration. This should approach or exceed 90 mEq/L. The sugar concentration should exceed 20 gm sugar/L, preferably around 40 gm/L. Rice-based formulas may have additional absorption advantages because they contain amino acids in addition to sugar and sodium.

johnnysannie
06-22-2008, 09:59 PM
The traditional rehydration solution is I think water with a couple of spoons of sugar and a pinch of salt. If this is a pre-sugar world, I expect honey would work. Boiled for sterility if the water supply is dicey.

Honey water was often used in earlier periods of history to restore electrolytes and hydrate.

Saanen
06-22-2008, 11:58 PM
Now I wish this was a larger part of the book! This is fascinating stuff. The dehydrated character is studying to be a healer, and will in fact be taken to this world's (rather primitive) version of a hospital for treatment, so I can have him tell the main character what it is he's being given to sip on.

Schwebb, I'm particularly excited to see the mention of rice in the section you quoted. My characters are in an area of their world famous for rice production. :) I'm thinking the dehydrated guy will get a decoction of rice mixed with a little orange juice, salt, sugar, and soda. I've already established that all these things are available in the nearby port city.

MadScientistMatt
06-23-2008, 03:19 AM
One book (of all things, on theology) contained an interview with doctors in rural India. Sometimes they have to treat dehydration without a proper IV setup but with some of their tools. So a doctor would take an IV line and run it from the patient to a coconut. If you're in a tropical area they might use coconut milk instead of water.

Keyan
06-23-2008, 02:09 PM
One book (of all things, on theology) contained an interview with doctors in rural India. Sometimes they have to treat dehydration without a proper IV setup but with some of their tools. So a doctor would take an IV line and run it from the patient to a coconut. If you're in a tropical area they might use coconut milk instead of water.

You mean giving coconut water intravenously? That sounds awfully risky. It's a soup of organic substances. They'd be safer boiling and filtering water to create homemade saline.

Or giving coconut water by mouth as oral rehydration? (which would, IMO, be safer).

Keyan
06-23-2008, 02:12 PM
Now I wish this was a larger part of the book! This is fascinating stuff. The dehydrated character is studying to be a healer, and will in fact be taken to this world's (rather primitive) version of a hospital for treatment, so I can have him tell the main character what it is he's being given to sip on.

Schwebb, I'm particularly excited to see the mention of rice in the section you quoted. My characters are in an area of their world famous for rice production. :) I'm thinking the dehydrated guy will get a decoction of rice mixed with a little orange juice, salt, sugar, and soda. I've already established that all these things are available in the nearby port city.

Soda? Where/ when is this world?

Rice water (the whitish water in which rice has been boiled) is a good starting point for rehydration. It's used in some places as a treatment for diarrhea, where there's always a dehydration risk.

HeronW
06-23-2008, 02:40 PM
If he's losing extra fluids and salts due to excessive heat he could be hallucinating, have terrible headaches, would be passing in and out of consciousness, dry mouth so he couldn't talk, chapped cracked lips, inflated heart rate and blood pressure until he passes out.

One way--if he's resourceful--and in the right climate is to lick the condensation off the walls just before dawn so the heat doesn't dry it up.

L M Ashton
06-23-2008, 03:25 PM
King coconut water by mouth. King coconut is not the brown coconut you see in the grocery stores in North America with the white meat that you have to prise out of the coconut shell. King coconut is orange in color with a much softer husk, very little meat inside (which is actually sort of gelatinous), and a lot more water.

It's not very sweet, so most people add sugar to the king coconut water before they drink it, and yes, it's considered highly nutritious. I don't know for a fact that it's used as an electrolyte drink, but it wouldn't surprise me.

Younger coconuts generally tend to have more water than older coconuts, and it's the young king coconuts that are prized for drinking.

Saanen
06-23-2008, 04:53 PM
Soda? Where/ when is this world?

It's not a medieval fantasy, if that's what you mean. The world is pretty well advanced in some areas--they have electricity, for instance--but medical technology is primitive by today's standards. I'm struggling at the moment with how much they would know about the transmittal of diseases, particularly tuberculosis. I think they're fairly sophisticated when it comes to treating the disease in the early stages, but they think it's spread by touch so many healers are afraid to help those who have it.

Keyan
06-24-2008, 12:29 PM
King coconut water by mouth. King coconut is not the brown coconut you see in the grocery stores in North America with the white meat that you have to prise out of the coconut shell. King coconut is orange in color with a much softer husk, very little meat inside (which is actually sort of gelatinous), and a lot more water.

Sounds like young coconut...isn't it the same thing? The meat hasn't had time to form. You sip the water through a straw (or make two holes in the eyes and drain it into a glass), and when you're done, split it open with a machete and use a bit of the shell to scoop up the gelatinous flesh.

Keyan
06-24-2008, 12:31 PM
Hmm. A standard carbonated lemon drink with sugar and salt works for emergency rehydration. (Something to keep in mind when traveling in tropical third world countries!)

L M Ashton
06-24-2008, 12:37 PM
Sounds like young coconut...isn't it the same thing? The meat hasn't had time to form. You sip the water through a straw (or make two holes in the eyes and drain it into a glass), and when you're done, split it open with a machete and use a bit of the shell to scoop up the gelatinous flesh.
No, it's a different variety of coconut.

sunandshadow
06-24-2008, 01:02 PM
A meat broth can also be good for dehydration/starvation because it will have some salts, a little sugar, and some fats (fats are important to skin and hair condition, counteracting the constipation that can be caused by dehydration, ability to stay warm in the cold, etc.) Tea is also common especially medicinal or painkilling tea if the person is injured in addition to being hungry and thirsty. Sugar or something else sweet is particularly important if the person is in shock, cold, and/or shivering.

MadScientistMatt
06-25-2008, 03:29 AM
They coconut juice was given intervenously, something that Philip Yancey also found rather shocking. It is evidently something a doctor would use if the patient has cholera and there is no sterile water available. Yancey commented, "Still, it is a bit jarring to see a long rubber tube snaking up from a patient's arm to a shiny green coconut."

chevbrock
06-25-2008, 06:18 AM
I read somewhere that coconut is a passable alternative to blood plasma.

I believe that rice water is the most highly recommended treatment/prevention for dehydration. It is recommended for babies with gastro, even today.

Danger Jane
06-25-2008, 06:30 AM
Funny I should see this thread...I'm watching a documentary on world health and they just talked about a campaign to reduce child mortality due to dehydration.

The sugar water mix would be a plausible treatment for the healers, but not the "common people" to know, definitely.

Keyan
06-25-2008, 12:02 PM
They coconut juice was given intervenously, something that Philip Yancey also found rather shocking. It is evidently something a doctor would use if the patient has cholera and there is no sterile water available. Yancey commented, "Still, it is a bit jarring to see a long rubber tube snaking up from a patient's arm to a shiny green coconut."

You're right. It works.

http://www.ncbi.nlm.nih.gov/pubmed/10674546

L M Ashton
06-25-2008, 04:51 PM
The sugar water mix would be a plausible treatment for the healers, but not the "common people" to know, definitely.I dunno. It's pretty widely known here to give someone salt and sugar water here, even among poor villagers (usually with freshly squeezed lime, perhaps ginger). I've had that offered to me by otherwise poorly educated women when they saw how dizzy and flushed I was (it happens to me a lot). But perhaps the difference is that this is a tropical country, so a long and drawn-out experience with dehydration as opposed to northerners from cold countries.

Libbie
06-25-2008, 06:59 PM
Incidentally, when one's blood pressure drops when the person stands up, that's called "orthostatic hypotension." So the "orthotic" thing was close!



Aha! Thank you! It's been many years, so all the specifics have fled me.