Pediatric Dehydration Score Calculator
Assess dehydration severity in children using the clinical dehydration scale. Enter values for instant results with step-by-step formulas.
Formula
CDS Score = General Appearance + Eyes + Mucous Membranes + Tears (range 0-8)
Each of four clinical parameters (general appearance, eyes, mucous membranes/tongue, tears) is scored 0, 1, or 2. Total score ranges from 0 (no dehydration) to 8 (severe dehydration). Score 0 = no dehydration (<3% weight loss), Score 1-4 = mild-moderate (3-6%), Score 5-8 = moderate-severe (6-9%+).
Worked Examples
Example 1: Toddler with Mild Gastroenteritis Dehydration
Problem: An 18-month-old (12 kg) presents with 2 days of vomiting and diarrhea. The child appears thirsty and restless, eyes are slightly sunken, mucous membranes are sticky, and tears are decreased when crying. Pre-illness weight from clinic visit 3 days ago was 12.5 kg.
Solution: Clinical Dehydration Scale:\nGeneral Appearance: Thirsty/Restless = 1\nEyes: Slightly sunken = 1\nMucous Membranes: Sticky = 1\nTears: Decreased = 1\nTotal CDS Score = 4 (Mild-Moderate)\n\nWeight-based: (12.5 - 12) / 12.5 = 4% dehydration\nFluid deficit: 0.5 kg = 500 mL\nORT target: 50-100 mL/kg = 600-1200 mL over 3-4 hours
Result: CDS Score 4 | Mild-Moderate Dehydration (4%) | ORT: 600-1200 mL ORS over 3-4 hours
Example 2: Infant with Severe Dehydration
Problem: A 9-month-old (8 kg) presents with 3 days of rotavirus gastroenteritis. The child is drowsy and limp, eyes are very sunken, mucous membranes are dry, and no tears are produced when crying.
Solution: Clinical Dehydration Scale:\nGeneral Appearance: Drowsy/Limp = 2\nEyes: Very sunken = 2\nMucous Membranes: Dry = 2\nTears: Absent = 2\nTotal CDS Score = 8 (Moderate-Severe)\n\nEstimated fluid deficit: ~6-9% = 480-720 mL\nImmediate: 20 mL/kg NS bolus = 160 mL\nMaintenance (Holliday-Segar): 8 x 100 = 800 mL/day
Result: CDS Score 8 | Moderate-Severe Dehydration | IV fluids required, admit for monitoring
Frequently Asked Questions
What is the Clinical Dehydration Scale (CDS) used in pediatric assessment?
The Clinical Dehydration Scale (CDS), also known as the Gorelick scale, is a validated clinical scoring tool designed to objectively assess the degree of dehydration in children aged 1 month to 5 years presenting with acute gastroenteritis or other causes of fluid loss. The scale evaluates four clinical parameters: general appearance, eyes (degree of sunkenness), mucous membranes and tongue moisture, and tear production. Each parameter is scored from 0 (normal) to 2 (severely abnormal), producing a total score ranging from 0 to 8. The CDS was developed to standardize the assessment of dehydration severity because individual clinical signs have limited accuracy when used in isolation, but their combination improves diagnostic reliability.
How is the Clinical Dehydration Scale scored and interpreted?
The Clinical Dehydration Scale is scored by summing the individual scores for four clinical parameters, each rated 0, 1, or 2. A total score of 0 indicates no clinical dehydration, corresponding to less than 3 percent body weight loss, and these children typically require only maintenance fluids and ongoing hydration. Scores of 1 to 4 indicate mild to moderate dehydration, corresponding to approximately 3 to 6 percent body weight loss, and these children should receive oral rehydration therapy with 50 to 100 mL per kilogram of oral rehydration solution over 3 to 4 hours. Scores of 5 to 8 indicate moderate to severe dehydration, corresponding to 6 to 9 percent or greater body weight loss, and these children often require intravenous fluid resuscitation and hospital admission for monitoring and correction of fluid deficits.
What laboratory tests are useful in evaluating pediatric dehydration?
While dehydration is primarily a clinical diagnosis, certain laboratory tests can support assessment and guide management. Serum electrolytes (sodium, potassium, chloride, bicarbonate) help identify the type of dehydration (isonatremic, hyponatremic, or hypernatremic) and detect dangerous electrolyte imbalances. Blood urea nitrogen (BUN) elevation, typically with a BUN-to-creatinine ratio greater than 20, suggests significant dehydration. Serum bicarbonate less than 17 mEq/L has been shown to correlate with 5 percent or greater dehydration. Urine specific gravity greater than 1.025 suggests concentrated urine from dehydration. Point-of-care blood gas can quickly assess acid-base status. However, routine laboratory testing is generally NOT recommended for mild dehydration managed with ORT, and is most useful in moderate-to-severe cases, when IV fluids are being administered, or when electrolyte imbalance is suspected.
What are the dangers of hypernatremic dehydration in children?
Hypernatremic dehydration (serum sodium greater than 145 mEq/L) is the most dangerous form of dehydration in children because of the risk of neurological complications during both the dehydrated state and the correction phase. During hypernatremia, water shifts out of brain cells causing cellular shrinkage, which can lead to cerebral vein tearing and intracranial hemorrhage. If hypernatremia is corrected too rapidly (faster than 0.5 mEq/L/hour or more than 12 mEq/L in 24 hours), rapid water influx into brain cells causes cerebral edema, which can result in seizures, permanent brain damage, or death. Correction should be gradual over 48 to 72 hours using isotonic fluids initially, with frequent sodium monitoring every 4 to 6 hours. Hypernatremic dehydration is particularly common in breastfeeding failure and in children given inappropriately prepared formula.
How do pediatric calculations differ from adult calculations?
Pediatric dosing is weight-based (mg/kg) or BSA-based (mg/m^2) because children are not small adults — they have different pharmacokinetics. Use actual body weight, check age-appropriate ranges, and never exceed adult maximum doses. The Young formula (age/(age+12) * adult dose) and Clark formula (weight/150 * adult dose) provide rough estimates only.
Can I use Pediatric Dehydration Score Calculator on a mobile device?
Yes. All calculators on NovaCalculator are fully responsive and work on smartphones, tablets, and desktops. The layout adapts automatically to your screen size.