MDCalc

Novel, Innovative Research for Understanding Dehydration in Adults and Kids (NIRUDAK) Score

Classifies dehydration in patients ≥5 years with acute diarrhea.

  • This tool is intended for use in patients aged ≥5 years (including adults) in resource-limited settings.
  • For patients <5 years of age, the DHAKA Score may be more appropriate.

Skin pinch

Eye level

Respiration depth

Urine output

Radial pulse

Result:

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Advice

This tool should not replace clinical judgment—signs of shock or altered mental status warrant urgent intervention regardless of the score.

Management

No dehydration (score 0–3):

  • Encourage fluid intake and continue a normal diet.
  • Provide education on warning signs for deterioration.

Some dehydration (score 4–6):

  • Initiate oral rehydration solution (ORS).
  • Consider short-term observation in a healthcare setting.

Severe dehydration (score ≥7):

  • Initiate IV rehydration immediately.
  • Hospitalize if resources allow.
  • Monitor for complications (e.g., electrolyte abnormalities, worsening dehydration).