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My 20 y.o. son went on a float trip Friday night, floated on…

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My 20 y.o. son went...
My 20 y.o. son went on a float trip Friday night, floated on Saturday morning and began to feel ill late Saturday-fever, chills. He began having loose stools yesterday, and cannot eat or drink without it going right through him. No nausea. No fever. Acute headache. Oriented X 3, walking,talking but I am concerned about heat exhaustion or Ecoli poisoning from the river water. Should I take him to the ER?
Submitted: 8 years ago.Category: Medical
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Answered in 9 minutes by:
6/22/2010
Doctor: Dr. D. Love, Doctor replied 8 years ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,851
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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The primary reason for him to be seen in the ER is if he is showing evidence of dehydration, such as lightheadedness. Dehydration could be indicated by a significant weight loss, but optimally needs to be compared to his weight before he got sick. If you have a BP cuff, you could check orthostatic vital signs to see if there is a significant change - a drop in BP or increase in HR of 20 points. If he is not becoming dehydrated, this is something that could be seen less emergently. It would be best to limit the oral intake to clear liquids until the watery diarrhea calms down. Fluids with natural salts, such as fruit juices or sports drinks, are better, except for apple juice, which can exacerbate diarrhea. Even if it seems that the fluids are going right through him, he may still be absorbing more than it seems. After the diarrhea eases, then the diet can be gently advanced, as tolerated.

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Customer reply replied 8 years ago
Is the headache a sign of dehydration that would need treatment immediately? Is there a danger in not seeking ER treatment tonight? He is up and about, no disorientation or significant weakness and then he wears out and begins to chill and goes to bed with blankets. He is up and down. No blood evident in stool, no real cramping/pain, just a feeling of churning. I will call the doctor in the morning, just need to know if it is necessary to seek ER treatment right now?
Doctor: Dr. D. Love, Doctor replied 8 years ago

The headache can occur with dehydration, but is not a sign of dehydration that would warrant emergency treatment. Lightheadedness would be worrisome. Other signs would be extreme thirst, little or no urine output, dry mouth or a rapid heart rate. If there is uncertainty, then discretion is the better part of valor.

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Customer reply replied 8 years ago
I checked his temp and it is 102 orally. Does this change things?
Doctor: Dr. D. Love, Doctor replied 8 years ago

No, it is consistent with an infection, and a fever does require a person to drink more fluids, but it is the other symptoms or signs that would indicate whether he should be seen emergently.

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