IN VIEW THE RECENT OUTBREAK OF DENGUE FEVER IN VARIOUS PARTS OF PAKISTAN,
MAILING DO AND DON’T OF DENGUE FEVER AS A SOCIAL RESPONSIBILITY AND FOR PUBLIC
Magnum Resource Centre
DO’S AND DON’TS
FOR DENGUE FEVER
DO’S AND DON’TS
- Cases of Dengue fever/Dengue
Haemorrhagic Fever (DF/DHF) should be observed every hour.
- Serial platelet and haematocrit
determinations drop in platelets and rise in haematocrits are essential
for early diagnosis of DHF.
- Timely intravenous therapy – isotonic
crystalloid solution can prevent shock and/or lessen its severity.
- If the patient’s condition becomes
worse despite giving 20ml/kg/hr for one hour, replace crystalloid solution
with colloid solution such as Dextran or plasma. As soon as improvement
occurs, replace with crystalloid.
- If improvement occurs, reduce the speed
from 20 ml to 10 ml, then to 6 ml, and finally to 3 ml/kg.
- If haematocrit falls, give blood
transfusion 10 ml/kg and then give crystalloid IV fluids at the rate
- In case of severe bleeding, give fresh
blood transfusion about 20 ml/kg for two hours. Then give crystalloid at
10 ml/kg/hr for a short time (30-60 minutes) and later reduce the speed.
case of shock, give oxygen.
correction of acidosis (sign: deep breathing), use sodium bicarbonate.
NOT TO DO
not give Aspirin or Brufen for treatment of fever.
giving intravenous therapy before there is evidence of haemorrhage and
giving blood transfusion unless indicated, reduction in haematocrit or
giving steroids. They do not show any benefit.
not use antibiotics.
not changes the speed of fluid rapidly, i.e., avoid rapidly increasing or
rapidly slowing the speed of fluids.
of nasogastric tube to determine concealed bleeding or to stop bleeding
(by cold lavage) is not recommended since it is hazardous.
SIGN OF RECOVERY
pulse, blood pressure and breathing rate
evidence of external or internal bleeding
confluent petechiae rash
CRITERIA FOR DISCHARGING PATIENTS:
of fever for at least 24 hours without the use of anti-fever therapy
of three days after recovery from shock
respiratory distress from pleural effusion and no ascites
count of more than 50,000/mm3
DO’S AND DON’TS FOR PATIENTS
- If you or any family member is
suffering from suspected dengue fever, it is important to carefully watch
yourself or relative for the next few days, since this disease can rapidly
become very serious and lead to a medical emergency.
- The complications associated with
Dengue Fever/Dengue Haemorrhagic Fever usually appear between the third
and fifth day of illness. You should therefore watch the patient for two
days even after fever disappears.
- Keep body temperature below 39oC. Give
the patient paracetamol (not more than four times in 24hours)
- Give large amounts of fluids (water,
soup, milk, juice) along with the patient’s normal diet.
- The patient should take complete rest.
- Immediately consult a doctor if any of
the following manifestations appear:
- Red spots or points on the skin;
- bleeding from the nose or gums;
- frequent vomiting;
- vomiting with blood;
- black stools;
- constant crying;
- abdominal pain;
- excessive thirst (dry mouth);
- pale, cold or clammy skin;
- difficulty in breathing.
- Do not wait in case the above symptoms
appear. Immediately consult a doctor. It is crucial to quickly get
treatment in case of these complications.
- Do not take Aspirin or Brufen or
· If your
platelets count is 50000 or below,
brush your teeth
cuts your nails
4. Don’t do
any act in which there is a chance of bleeding
SYED FAHIM AHMED