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6 Steps of ‘Skin Pinch’ Test for Assessing Dehydration

This skin pinch tests is an important tool for testing dehydration.
When a child is dehydrated, the skin loses elasticity.
To assess dehydration using the skin pinch:
1. ASK the mother to place the child on the examining table so that the child is flat on his back with his arms at his sides (not over his head) and his legs straight. Or, ask the mother to hold the child so he is lying flat on her lap.
2. USE YOUR THUMB AND FIRST FINGER to locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. Do not use your fingertips because this will cause pain. The fold of the skin should be in a line up and down the child’s body.
3. PICK UP all the layers of skin and the tissue underneath them.
4. HOLD the pinch for one second.
5.Then release it
6. LOOK to see if the skin pinch goes back
• Very slowly (more than 2 seconds),
• slowly, (less than 2 seconds, but not immediately), or
• Immediately.
If the skin stays up for even a brief time after you release it, decide that the skin pinch goes back slowly.
NOTE: The skin pinch test is not always an accurate sign.
• In a child with severe malnutrition, the skin may go back slowly even if the child is not dehydrated.
• In a child is overweight or has oedema, the skin may go back immediately even if the child is dehydrated.
However you should still use it to classify the child’s dehydration.
management of acute diarrhoea in children: http://www.ihatepsm.com/blog/management-acute-diarrhoea-children
sugar - salt solution for rehydration: http://www.ihatepsm.com/blog/sugar-salt-solution-rehydration
4 rules of home treatment for diarrhoea: http://www.ihatepsm.com/blog/4-rules-home-treatment-diarrhea-children
Reference:
Ref: WHO, 2014: Diarrhoea; IMCI INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS: Module 4, Distance Learning Course;