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Guidelines for the management of Dengue fever

Guidelines for the management of Dengue fever

Simple Dengue Fever:

  • Over ninety-five percent people suffer from simple dengue fever, which is not as threatening as severe dengue fever.

  • In simple dengue fever there is no capillary leakage, the person requires only oral fluids, 100 ml per hour, and is advised to visit a local doctor

  • Additionally, the patient is recommended to drink 500 ml water at the time of diagnosis. Only those patients with dengue fever who have vomiting should consume intravenous fluids

Severe Dengue Fever:

  • Those suffering from severe dengue develop capillary leakage and intravascular dehydration. Also, they suffer from a rapid fall in the platelet count along with rapid rise in their hematocrit levels They will have rapid fall in platelets along with rapid rise in hematocrit levels

  • Persistent vomiting, nausea, extreme exhaustion and lethargy are some of the symptoms of dengue. Along with these symptoms, a victim might suffer unrelieved abdominal pain and mental irritability and confusion.

  • These people require close daily observation.

Dengue patients are kept under close observation and are recommended to consume 1500 ml fluids (20 ml per kg) immediately
And in case, when they cannot consume liquids orally, then intravenous fluids are a must

Formula of 20 to identify high-risk cases of Dengue fever:

  • If there is a rise in pulse by 20

  • Fall in upper blood pressure by 20

  • Rise in hematocrit by 20 percent

  • Rapid fall in platelets to less than 20,000

  • Petechiae (red spot) count of more than 20 in one inch after tourniquet test

  • If the difference between upper and lower blood pressure is less than 20, then such cases should be given 20 ml of fluid per kg immediately and then shifted to nearest medical center for medical assistance

What you need to do in case symptoms are prevalent?

  • The follow-up tests are required to witness the rise in hematocrit and significant fall in the level of platelets.

  • The tests are required to be screened simultaneously.

  • Platelets transfusions are not required unless there is active bleeding and platelet count is less than 10,000

  • Keep a tab on hematocrit levels are crucial as their count decides the adequate requirement of fluids required by the body

It is important to remember the following:

  • Capillary leakage only occurs when the fever is on the verge of subsiding.

  • In the initial 48 hours, including 24 hours after fever is over, are crucial, and the patient requires plenty of fluids as a sub-treatment

  • Signs of itching or rash usually occur post the capillary leakage period is over

When is urgent admission required?

  • If the patient is unable to consume or tolerate the consumption of liquids

  • Pregnant women Underlying comorbid conditions

  • Infants or elderly people

  • Patients suffering from uncontrolled diabetes

A release by Indian oil corporation


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