HEALTH Treating Afflicted During a Famine

Voortrekker

Veteran Member
This thread is one of those what if's and how to-should do situations. Home Remedies Department.

Considering that after an extended period of time during a famine, natural or man made; how would we treat someone whom has suffered starvation?

Malnourishment can be treated by providing a normal meal and several days of treatment, but starvation of over a week, over two weeks and over three weeks are the considerations for this thread.

The human body when starved will adapt in a natural survival mode, the stomach shrinks. Feeding someone a full meal whom has been starving will cause regurgitation and shock. Food must be introduced in smaller increments periodically.

Rice is the best material as almost no one in a billion is allergic to rice. The rice must be fortified with a fat, butter, gravy, grease, whole milk.
About a cup of cooked rice will not shock their body and the fats helps them digest. This should be served to the starving person about every two hours is they are digesting it.

For people having reached the near terminal limit, whole raw milk is also good, a glass drank slowly and allowed to digest.
Another is a soup broth with fats in it, not bouillon or chunky soups.

After a few days of so if the patient can digest, introduce a small amount of vegetable and meat such as peas and chicken, or fish.
Treating people suffering from starvation is a lengthy process and requires patience.

This thread is not an official paper, but suggestions as to how to treat a patient, the reasons for treating are varied and not relevant to this thread. Also, include what not to feed the patient and what to avoid in their first stage of recovery.
 
Last edited:

Sacajawea

Has No Life - Lives on TB
There used to a lot of public health info on convalescent menus that would be pertinant. Say 1940s. But the meat broth would be an issue for someone wedded to a vegetarian/vegan diet... then what?
 

tnphil

Don't screw with an engineer
Would chicken broth, from boiling the bones, be good for this? As well as rice cooked in said broth?
I think after weeks with no food one would want to avoid solid food immediately, even rice. Use nutritious liquids to re-expand the stomach. After a short time, introduce rice cooked in broth (maybe even some very soft-cooked chicken) in small amounts to the diet, to avoid stomach upset and allow the internal waste disposal system to crank back up slowly.
But... I'm no doctor nor nutritionist, I've just dealt with sick dogs on many occasions and extrapolating from those experiences.
 

AlfaMan

Has No Life - Lives on TB
First off, I'd start them off with a ready to eat food like Plumpy Nut. That and some ORS (oral rehydration solution).

Never heard of Plumpy Nut? Below is information on this product. Easy to make (think of Nutella without the cocoa and adding in milk proteins and vitamins) and cheap. And apparently quite effective. I would start any person of any age people suffering from malnutrition on a regimen of this. Regular foods after starvation could be hard to digest, hard for the body to metabolize, a possible shock to a weakened body and could cause yet more problems. In the case of the malnourished, easy does it is the prudent treatment option.

Plumpy'nut - Wikipedia

Oral Rehydration Solution Uses, Benefits, Precautions, Recipe


Only after showing the start of weight gain and stabilization of any other problems would I start feeding what we consider a "regular diet". That diet should be high in protein and fats, and given in the course of 5-6 small portion feedings in the course of a day.
 

Tristan

Has No Life - Lives on TB
I think after weeks with no food one would want to avoid solid food immediately, even rice. Use nutritious liquids to re-expand the stomach. After a short time, introduce rice cooked in broth (maybe even some very soft-cooked chicken) in small amounts to the diet, to avoid stomach upset and allow the internal waste disposal system to crank back up slowly.
But... I'm no doctor nor nutritionist, I've just dealt with sick dogs on many occasions and extrapolating from those experiences.

An ancient remedy is Juk, i.e. rice cooked in a rather large quantity of water until it's simply a thick broth; this can have added ingredients as deemed appropriate such as broth, fats, cooked and ground vegetables or meats, etc.
 

moldy

Veteran Member
... and very small frequent meals, like a bit every 2-3 hours.

I'm not sure how I feel about even moderate amounts of fat right off. I wonder if the gallbladder could handle it. There have been stories (on the internet, so you know it's true) of WWII refugees eating a large meal of normal foods as their first 'post starvation ' meal and dying shortly thereafter.
 

tnphil

Don't screw with an engineer
An ancient remedy is Juk, i.e. rice cooked in a rather large quantity of water until it's simply a thick broth; this can have added ingredients as deemed appropriate such as broth, fats, cooked and ground vegetables or meats, etc.
And that seems reasonable... I think you want little-to-no "solid" content or anything that takes work to digest. Start with a lot of broth, some rice cooked until it falls apart, maybe even a little canned chicken that's been mashed to very small shreds to get more protein. But anything, even broth, should be small portions every couple of hours.
 

Tristan

Has No Life - Lives on TB
My version of ORS, just to compare.

Thank you for that!
 

Tristan

Has No Life - Lives on TB
And that seems reasonable... I think you want little-to-no "solid" content or anything that takes work to digest. Start with a lot of broth, some rice cooked until it falls apart, maybe even a little canned chicken that's been mashed to very small shreds to get more protein. But anything, even broth, should be small portions every couple of hours.


I'm wondering if there's any research regarding kick-starting the gut flora in the severely malnourished?

:hmm:

Anyone know?
 

Cardinal

Chickministrator
_______________
Ring after a period of starvation -true starvation, needs to be handled carefully.
Y'all need to read up on what Doctors say.
"Refeeding syndrome" is a thing. Your organs can shut down if you do it wrong.



Prolonged Fasting Refeeding is a complex journey.



Navigating it correctly can be the difference between reaping health benefits and falling prey to dangerous complications.



The transition from fasting back to normal eating, often called prolonged fasting refeeding, requires careful planning and execution.



Understanding this process is crucial for anyone venturing into extended periods of fasting.

Understanding Refeeding Syndrome



Refeeding syndrome is a medical condition that can occur after an extended fast or long-term calorie restriction. This severe and potentially fatal phenomenon happens when you start to increase your calorie intake, consuming larger meals after a period of fasting.



In the refeeding process, carbohydrate metabolism becomes active again as food reintroduction triggers it. The body transitions from burning fat for energy during fasting to using carbohydrates once more.



This shift can cause severe electrolyte imbalances and fluid shifts, which may lead to complications like heart failure or seizures if not managed properly.

Nutrient Deficiency: A Key Factor

A crucial factor contributing to refeeding syndrome is nutrient deficiency developed during prolonged periods without food intake - fasting periods.



Studies have shown that hypophosphatemia occurs when nutrients such as phosphorus and potassium are rapidly depleted due to their use in glucose (sugar) metabolization upon resuming eating habits post-fasting phase.



Hypophosphatemia refers to dangerously low levels of these vital minerals in the bloodstream, forming one aspect of what we know today as 'refeeding syndrome.'

Symptoms Of Refeeding Syndrome To Watch Out For

  1. If you've been practicing intermittent or continuous forms of extended fasting, being able to identify physical signs associated with the onset of refeeding syndrome early on could be lifesaving.
  2. Familiarizing yourself with typical symptoms, including weakness caused by muscle loss during the fast, bloating resulting from water retention, and heart palpitations stemming from electrolyte imbalance, will help prevent further health deterioration related to the disorder.
  3. Besides physical indicators, there are psychological ones that need attention, especially since they impact overall well-being significantly, according to research.


Recognizing Symptoms of Refeeding Syndrome



Identifying the symptoms associated with the refeeding syndrome is vital for those who engage in extended fasting or long-term calorie restriction. Early detection can mitigate severe complications and promote a healthier transition to regular eating habits.

Identifying Physical Signs

In physical indicators, several signs could hint at the onset of refeeding syndrome during your post-fasting period. For instance, weakness may become evident as your body recalibrates its carbohydrate metabolism after an extended fast.



This bloating often occurs because you're beginning to consume larger meals again after a phase where food intake was significantly reduced.



Apart from these symptoms, heart palpitations are also indicative signals that should not be overlooked.



These occur when there's a sudden shift in electrolytes within your system - something commonly observed when transitioning from fasting to standard dietary patterns.

Understanding Psychological Indicators

  1. Mental confusion: Confusion may arise due to fluctuations in blood sugar levels resulting from changes made following an extended fast.
  2. Mood swings: Mood alterations are common occurrences while breaking prolonged periods without food consumption and gradually reintroducing foods into one's diet regime.


Remember: While experiencing discomfort upon resuming the eating routine is typical (especially if it followed an extensive fasting period), any persistent distress should prompt immediate medical attention.



In essence, recognizing physical and psychological signs related to refeeding syndrome will allow individuals to practice intermittent or prolonged fasting techniques to avoid unnecessary health risks with improper dietary transitions post-fast.

Unraveling the Role of Nutrient Deficiencies in Refeeding Syndrome



The onset and seriousness of refeeding syndrome, a disorder that can appear after long stretches of fasting, are often associated with pre-existing nutrient shortages.



These nutritional gaps are crucial for understanding this potentially dangerous phenomenon.

Potassium and Phosphorus: Essential Elements at Risk During Fasting

Within our bodies' complex systems, potassium holds significant sway over fluid balance regulation, nerve signal transmission, and muscle contraction coordination.



When an individual embarks on an extended fast without adequate potassium intake or reserves, symptoms such as fatigue or heart palpitations may occur during refeeding.



Akin to its elemental counterpart, potassium, phosphorus is vital in our bodily functions - particularly energy production and bone health maintenance.



Extended calorie restriction through prolonged fasting could substantially decrease phosphorous levels, thereby elevating risks associated with developing refeeding syndrome upon breaking your fast.

Magnesium & B1 (Thiamine): Their Crucial Contributions & Associated Risks Upon Depletion

In terms of importance among nutrients necessary for healthy body function, magnesium stands tall, given it aids over 300 enzyme reactions, including protein synthesis and carbohydrate metabolism processes, which become increasingly important when one begins putting weight back onto their diet post-fasting period by gradually increasing calorie intake again.



Vitamin B1 also known commonly as Thiamine forms another critical cog aiding the conversion of food consumed into usable energy - especially glucose metabolism directly related to ensuring the successful completion gentle food reintroduction process following any long-term break from regular eating habits be they intentional or otherwise.



If there is already a Vitamin B deficiency before the fasting period, the likelihood of experiencing severe complications increases significantly. This is because there is a sudden nutrient shift in the blood cells during the early stages of refeeding, which plays a crucial role in facilitating essential metabolic activity closely associated with processing.

Fasting Safely - Preventing Nutrient Depletion



When you embark on an extended fast, you must know about the potential nutrient depletion. But fear not. Strategies are in place to help ensure your body remains nourished during this period.

Avoiding Deficiencies through Suitable Supplements

Let's discuss the importance of supplements to maintain health while fasting. They are crucial in supporting various bodily functions, such as energy production and nerve function, when fasting.



B vitamins, vitamin C, magnesium, and potassium are just some examples of what might need supplementing.



You don't have to figure out all these details by yourself; plenty of guidance is available for choosing appropriate supplements while fasting. Always remember: consulting a healthcare professional before starting any new supplement regimen is critical.



And if you're thinking long-term or considering prolonged periods of calorie restriction, receive advice tailored specifically for those circumstances too. For example, omega-3 fatty acids, which support brain health, or probiotics aiding digestion could be beneficial additions.

Maintaining Hydration with Electrolytes & Sea Salt

The importance of hydration extends beyond simply drinking water during fasting; maintaining electrolyte balance also plays an essential part.



These minerals in our bodies carry out several critical tasks, including regulating heartbeat rhythms and assisting muscle contractions, crucial processes, especially when undergoing something as intense as extended fasting.



Suppose fruits like bananas or oranges don't fit into your diet due to their sugar content, but you still want to maintain healthy electrolytes; consider supplementation instead. In that case, they offer the same benefits without the risk of disrupting the fast.



Subscribe to the monthly newsletter, which covers more information about managing the refeeding process effectively to avoid experiencing symptoms after breaking extended fasts. Sign up now. Interested?



In addition, staying hydrated throughout the day by adding sea salt is another effective way to prevent dehydration because it contains trace amounts of many different types of minerals besides sodium, calcium, and magnesium, which help fluid level cells, thus helping prevent a condition called refeeding syndrome upon gentle food reintroduction back to average eating habits p >

Breaking Your Fast - The Keto-friendly Way



Refeeding after an extended fast is a critical phase that requires meticulous planning and careful food reintroduction. This stage, if not appropriately managed, can lead to a condition called refeeding syndrome.

Incorporating the Right Foods Post-Fast

Your fasting period has ended; now it's time for your body to increase calorie intake again gradually. Begin by consuming liquid foods or small quantities of gentle food like green juices and bone broth, which are easily digestible and packed with essential nutrients.



As you progress in your refeeding period, include protein-rich foods such as eggs or fish. These aid muscle recovery post-fasting without causing any drastic changes in carbohydrate metabolism.

Avoiding Certain Foods During the Refeeding Phase

To prevent experiencing the adverse effects of the sudden nutrient shift from blood to cells during the initial stages of feeding after prolonged fasting (refeeding syndrome), avoid highly processed or carb-dense foods when ending an extended fast.



It's crucial not just to begin putting weight back onto previously restricted dietary items but to carefully monitor how much one eats initially before consuming larger meals later within this transitionary timeframe.



Remember that everyone responds in dissimilar ways to diverse diets, so consult a healthcare professional before starting any new program, particularly those involving long-term calorie control.



Receive our monthly newsletter that covers fasting tips and tricks, ensuring a safe and healthy experience throughout the journey into intermittent restrictions and daily caloric intake habits.

Transitioning into Extended Fasting: A Step-by-Step Guide



The journey toward extended fasting is not an overnight endeavor. It requires careful planning and a gradual transition to prevent refeeding syndrome, which can occur when you reintroduce foods after long-term calorie restriction.



A gentle approach ensures your body adapts seamlessly from regular food intake to periods of no meals or reduced frequency in eating. This process is vital for maintaining balance in carbohydrate metabolism and other bodily functions during fasting.
 

Voortrekker

Veteran Member
Wow! You guys are really on track with this. The fasting post and rejuvenating has some good info.

Now I was talking about involuntary starvation and how to treat a patient, after a few weeks I did suggest just soup broth or raw milk initially. Bethshaya and Moldy, YES! Alfaman--thank you! I'm going to look into this more closely.

I believe that all of us may need to treat someone soon for starvation. Pick your patient before they pick you.
 

Cardinal

Chickministrator
_______________
Wow! You guys are really on track with this. The fasting post and rejuvenating has some good info.

Now I was talking about involuntary starvation and how to treat a patient, after a few weeks I did suggest just soup broth or raw milk initially. Bethshaya and Moldy, YES! Alfaman--thank you! I'm going to look into this more closely.

I believe that all of us may need to treat someone soon for starvation. Pick your patient before they pick you.
There is no physiological difference between "fasting" and "starving."
They are both terms for the body having no food.
If you try to start feeding again when a body has had no electrolytes the organs will shut down.
 

Voortrekker

Veteran Member
"...If you try to start feeding again when a body has had no electrolytes the organs will shut down..."
That was something I thought of after posting. Brawndo has electrolytes. Sugar, salt, citrus juice and sodium bicarbonate? We can all make a bottle of that.
 

bassgirl

Veteran Member
Clear broths and Electrolyte solutions will help tremendously. There is a lot of info on long fasting and breaking the fast.

Edited to add, think of Alcoholic treatments. They give them what is called Banana bags. It is loaded with Electrolytes, B-Vitamins, Glucose. Given slowly IV. Same principle with eating, just go slow.
 
Last edited:

JMG91

Veteran Member
Yup. If I was dealing with someone who was severely malnourished, I would start off possibly even for the first few days with an electrolyte solution, then move up to bone broth, and very gradually up to soft foods as the body adjusted. My children have an extremely high metabolism just like their father, and even skipping one meal can lead to serious vomiting followed by extreme intolerance of re-introduction of even an electrolyte solution. Even something as soft as baby food puree—hours after the initial vomiting—can lead to more regurgitation if I’m not careful.
 

moldy

Veteran Member
@tnphil - I think the best way to reintroduce gut flora would be yogurt. Just talking off the top of my head, though, without any research to back it up. The salt and fiber in fermented vegetables I would think would be harder to take when reintroducing food. yogurt or kefir could be thinned out and without the fiber would digest a little faster. Kombucha - I think the acid and alcohol would be hard to take.

For herbs, I would do marshmallow and calendula tea. Sweet, healing to tissues.... adding some elecampane or alfalfa would help to increase appetite if that was a concern. And all those herbal constituents extract well in water.
 

Reasonable Rascal

Veteran Member
... and very small frequent meals, like a bit every 2-3 hours.

I'm not sure how I feel about even moderate amounts of fat right off. I wonder if the gallbladder could handle it. There have been stories (on the internet, so you know it's true) of WWII refugees eating a large meal of normal foods as their first 'post starvation ' meal and dying shortly thereafter.

The stories are accurate. I read accounts of this back in the 70's BTI (Before The Internet). There is also a whisper in the back of my mind somewhere about one of my patients mentioning such as well, a European vet.

RR
 

zeker

Has No Life - Lives on TB
There is no physiological difference between "fasting" and "starving."
They are both terms for the body having no food.
If you try to start feeding again when a body has had no electrolytes the organs will shut down.
for reasons unknown to me, I have fasted 3 times over the last 8 yrs.

each time, was pain related.

blood clot in leg.. blood clot in lung.. and I cant remember the first 1. (broken shoulder? after a bad tumble on my atv)

I had no intention of fasting, I just realised, at the end of day 1, that I had not eaten.

just drank milk.

these fasts have been from 4-6 days,

I did lose weight during these times.

as much as 16 lbs.

I never felt tired or 'wanting' I just didnt have any desire for food.

it took 1 day of sampling tiny bits, to get back to reg consumption
 
Clear broths and Electrolyte solutions will help tremendously. There is a lot of info on long fasting and breaking the fast.

Edited to add, think of Alcoholic treatments. They give them what is called Banana bags. It is loaded with Electrolytes, B-Vitamins, Glucose. Given slowly IV. Same principle with eating, just go slow.
Believe that refers to the potassium in them.
 

mecoastie

Veteran Member

They were put on a rich diet and began to recover and put weight on but then they died suddenly.” –Laurie Pettit

Refeeding syndrome for many centuries was an unknown entity and remained somewhat of a myth until the liberation of the Nazi concentration camps in 1945; it is also possibly the least talked about cause of fatality in the Second World War.

Soviet soldiers upon the liberation of WWII camps were met by thousands of men, women and children who had been in a state of medical starvation for months on end. The well-meaning soldiers – met at the gates of the camps by POWs with their ribs and sternum protruding from their bodies and chests and obviously in need of medical care – took food such as biscuits and chocolate bars from their own government-issued ration supplies and gave them to the prisoners, not knowing that it would lead to their almost immediate death. It is estimated that 500 POWs from Auschwitz concentration camp and as many as 14,000 from the Belsen concentration camp – most famously known as the site where Anne Frank’s family died upon capture – died of refeeding syndrome.


There are reports from 1945 of prisoners dying immediately having taken their first bites of food, however when fleeing the concentration camps, the Nazi’s burned thousands of documents and medical records that they kept from previous experiments on the prisoners, therefore it is very difficult to confirm this to be true. The reports of people dying immediately may also be attributed to the many other ailments that the POWs would have been suffering from. What we do know now (from documented refeeding cases in the years post 1945 and advances in medical knowledge from cases of patients suffering from anorexia) is that death from refeeding, if it is done incorrectly, occurs within 36-48 hours of first taking in sustenance to the body. This is a result of the body going into shock from the re-introduction to calories.

As Soviet scouts, then troops, arrived at the Auschwitz complex, bewildered prisoners greeted them with tears and embraces. Anna Polshchikova, a Russian prisoner, later recalled the gruff confusion of the first soldiers. “‘And what are you doing here?’ they enquired in an unfriendly manner. We were baffled and did not know what to say. We looked wretched and pathetic, so they relented and asked again, in a kinder tone. ‘And what is over there?’ they said, pointing northwards. Also a concentration camp. ‘And beyond that?’ Also a camp. ‘And beyond the camp?’ Over there in, the forest, are the crematoria, and beyond the crematoria, we don’t know.”

The first Soviet troops to arrive moved on toward other targets, but the Red Army soon took over the camps, establishing field hospitals on site. Polish Red Cross workers — volunteer doctors, nurses and paramedics who just months earlier had participated in the Warsaw Uprising — assisted in the recovery too. “The situation was desperate,” recalled Józef Bellert, the physician who organised the group. “We could barely administer the most urgent medical aid.” As they got to work, they saw body parts strewn around ad hoc cremation pits used after the SS demolished Auschwitz-Birkenau’s crematoria; human remains and ashes were everywhere. Survivors suffered from malnutrition, bedsores, frostbite, gangrene, typhus, tuberculosis and other ailments. And though the SS had attempted to destroy all evidence of mass murder, they had left massive storerooms filled with shoes, dishes, suitcases, and human hair. “It was chaos,” says Jonathan Huener, a Holocaust historian at the University of Vermont.

Once established, the Red Cross staff and local volunteers responded as best they could to the survivors’ needs, navigating a cacophony of different languages. They diagnosed patients, gave them identification documents and clothing, and sent over 7,000 letters to help the patients locate family and friends around the world. “Some of the sick did not realise that they were now free people,” recalled Tadeusz Kusiński, a Red Cross orderly. At least 500 of the 4,500 patients died, many from refeeding syndrome or a lack of sanitary facilities.

Shocked at the skeletal condition of some of the prisoners they were liberating who had been subsisting on starvation diets for months or even years, Allied soldiers handed over every scrap of food they could lay their hands on. But then — many of these reports say — ‘the succour has an unexpected and horrifying effect: some of the prisoners fall instantly dead at the first bite, within minutes many others have followed.’

The most infamous of these stories comes from the Bergen-Belsen concentration camp in northern Germany, best known as the camp where Anne Frank died after her family’s arrest. Belsen did not have gas chambers and did not conduct mass executions as were carried out at Auschwitz and others, but by the end of the war it was suffering from a terrible epidemic of typhus and was as deadly as any camp. In December 1944, five months before the camp was liberated, Germany began mass transportation of prisoners from other camps into Belsen. This made the overcrowded, diseased, and starvation conditions far worse. From that point, the death rate of prisoners approximately tripled every month, reaching over 18,000 dying in March 1945 alone.

When the allied troops arrived, they found 60,000 survivors, most of who were near death from typhus, starvation, or both. From an article about Belsen in a BBC series on the liberation of the camps: ‘Some inmates had been starved for so long that they had lost the ability to digest the rations that well-meaning British soldiers offered them; within minutes of taking a biscuit, some inmates just passed away.’

During starvation our body makes a number of changes to its chemistry in response to starvation, changes which are intended to preserve its most important tissues for as long as possible. Electrolyte imbalances often result. Then when you start eating again, a whole wave of fluid and electrolyte shifts takes place. Insulin production increases, among other changes. The main feature of refeeding syndrome is hypophosphatemia, a dangerous shortage of phosphates in the serum, as well as shortages of other minerals. Phosphorus in particular is essential for all cellular processes, and hypophosphatemia can result in respiratory failure, cardiac failure, arrhythmia, seizures, coma, and death. Although the liberating soldiers at Belsen quickly learned that refeeding was doing its share of harm, the mechanisms weren’t known. But they couldn’t just not feed the people. And from what’s recorded historically and what’s known today, it does indeed appear that fatal refeeding syndrome was responsible for at least some substantial portion of those 14,000 post-liberation deaths.

We do see refeeding syndrome today. There’s no ethical way to deliberately put test subjects into such a dangerous physical state, but people already in that condition do come into hospitals, so we have study data on the syndrome. Mostly these are anorexia nervosa patients, but there are a variety of other types of patients with severe malnutrition. Among other lessons, these cases have given us an opportunity to study the actual time of onset of hypophosphatemia. The average time is 1.9 days after refeeding begins. This is generally in line with the best reports from Belsen and other camps, which stated that many prisoners died after just a few days.

More importantly, these modern cases have taught us how to refeed safely and avoid the syndrome altogether. According to data published in the British Medical Journal, which studied over ten thousand such cases, 100 per cent of patients went into hypophosphatemia when fed intravenously with a solution that did not include phosphorus supplementation; but when it did, the incidence was reduced to just 18 per cent. So clearly, phosphate supplementation is key in refeeding. The current recommended guidelines for refeeding malnourished patients is to start with multivitamin supplements, and then proceed with feeding at 10 kcal per kilogram of body weight per day, and slowly increase it over four to seven days. This allows the patient to adjust to the re-introduction of calories and has a much higher chance of survival. The phenomenon of refeeding syndrome is unusual but the unfortunate events of the liberation of concentration camps during the Second World War has allowed us to become more educated on the topic and in turn equipped us with the ability to save the lives of countless people in the future.
 
Last edited by a moderator:

mecoastie

Veteran Member
Below info is out of this pdf article.



Table 4. Suggested Guidelines to Prevent Complications from Refeeding
36
1. Anticipate those patients at risk (see Table 3).
2. Initiate nutrition support, including total calories and fluids, slowly
(~10 kcal/kg for severe cases; 15-20 kcal/kg for others).
¨
Consider all sources of calories and fluids in your calculations.
3. Check baseline electrolytes (especially phosphorus, potassium and magnesium)
before initiating nutrition support and replace any low levels promptly.
4. Monitor electrolytes every 8, 12 or 24 hours (depending on severity of refeeding risk).
¨
Replace electrolytes as needed.
o
If enteral replacement, consider scheduled dosing if levels continue to
be low, such as 1-2 packets neutra- or Kphos q 6, 8 or 12 hours until
phosphorus consistently remains > 2.0mg/dl (0.65mmol/L).
¨
Decrease blood draws as soon as electrolytes stabilize.
5. Routinely administer vitamins & minerals to malnourished patients, especially thiamine,
for 3 – 5 days.
6. Unless hemodynamically unstable, keep sodium-containing IV fluids to ~ 1 liter/day
initially in severely malnourished patients such as those with anorexia nervosa who
may have a component of cardiomyopathy.
7. Increase calories cautiously in a stepwise manner.
¨
By 200-300 calories every 2-3 days.
¨
Continue to monitor electrolytes as calories are increased.
8. Outline a plan for nutrition advancement (especially if patient is to be discharged before
goal calories reached) to prevent the patient from remaining on a refeeding calorie level
longer than necess
 

Voortrekker

Veteran Member
There used to a lot of public health info on convalescent menus that would be pertinant. Say 1940s. But the meat broth would be an issue for someone wedded to a vegetarian/vegan diet... then what?
Most "vegans" die out in the first phases of a disaster where hunger is an issue. If people must be on the move, the vegans expire because their bodies cannot handle the vigorous physical activities. True refugees are often involved in an athletic endeavor. Long marches, climbing, sprinting short distances, obstacle courses, etc.
 

ComCamGuy

Remote Paramedical pain in the ass
F-75 therapeutic milk, low in protein, sodium and calories (0.9 g of protein and 75 kcal per 100 ml) is used in the initial phase of treatment for patients suffering from complicated SAM. It is used to cover basic needs while complications are being treated. It is given in 8 daily meals

the trick is replicating and balancing everything without lab capability
 

ComCamGuy

Remote Paramedical pain in the ass
Part of the problem might be what is proper for them nutritionwise may be getting it into them. Nasogastric tube does wonders
 

Reasonable Rascal

Veteran Member
It is, but you aren't going to take in enough of that to gain weight. Not by a serous amount of gallons. Its kind of like people who won't allow insulin shots to control their blood sugar levels while they are on steroids (which can raise blood sugar levels semi-dramatically in some people, not a good thing when fighting infection) because they believe they will then have to take them the rest of their life, that they will actually give you diabetes. People will believe what they want, just like Democrats.

RR
 
Top