Pocket Guideline for Dengue Case Management July 2019
22
Pocket Guideline for Dengue Case Management July 2019
Transcript of Pocket Guideline for Dengue Case Management July 2019
Pocket Guidelinefor
Dengue Case ManagementJuly 2019
, DGHS, MoH&FW
Deng
ue ca
se cl
assif
icatio
n by
seve
rity
Den
gue
war
ning
sig
nsSe
vere
den
gue
with
war
ning
sig
nsW
ithou
t1.
Seve
re p
lasm
a le
aka
ge2.
Seve
re h
aem
orra
ge3.
Seve
re o
rgan
impa
irm
ent
03
Den
gue
vir
al In
fect
ion
Sym
pto
ma
tic
Mild
den
gue
DF
with
hig
h r
isk
co-m
orb
id c
onditi
ons
Und
iffer
entia
ted
DF
A. Fe
ver
with
out
com
plic
atio
n lik
ebl
eedi
ng.
Hyp
oten
sion
and
orga
n in
volv
emen
t
B.
With
out e
vide
nce
of c
apill
ary
leak
age
C.
DF
with
warn
ing s
igns
and s
ym
pto
ms/
DH
F G
r I &
II w
ithm
inor
ble
edin
g
Moder
ate
den
gue
Sever
eden
gueA
sym
pto
ma
tic
Infa
nts
Old
Age
Dia
bet
esH
yper
tens
ion
Preg
nanc
yC
AD
Hem
oglo
bin
opath
ies
Imm
unoc
ompro
miz
edpatie
ntPa
tient
on
ster
oids,
ant
icoa
gul
ant
s or
imm
unsu
pper
essa
nts.
DF
with
sig
nifi
cant
Ha
emor
rha
ge
(i) D
HF
with
sig
nifi
cant
haem
orra
hage
with
or
with
out sh
ock
(ii) D
HF
III &
IV**
DSS
)Se
vere
org
an in
volv
emen
t(E
xpan
ded
deng
ueSy
ndro
me)
Seve
re M
eta
bol
icA
cid
osis
A.
B. C.
D.
A.D
F w
ith W
arn
ing
sig
ns a
nd s
ymp
tom
sRe
curr
ent vo
miti
ngA
bd
omin
al P
ain
/te
nder
ness
Gen
era
l wea
knes
s/le
tha
rgin
ess/
res
tless
Mild
ple
ura
l eff
usio
n/a
scite
sH
epa
tom
ega
lyIn
crea
sed
Hct
>2
0%
B.D
HF
I & II
with
Min
orb
leed
s
Hom
e M
ana
gem
ent
Clo
se M
onito
ring*
and p
oss
ibly
Hosp
italiz
atio
nTe
rtia
ry lev
el c
are
04
05
06
Nat
ural
cou
rse
of D
HF
Shoc
kDa
y 1
23
45
67
89
Feve
r
Hem
atoc
rit
Pleu
ral e
ffus
ion
Ascit
es
Plas
ma
leak
age
Stop
leak
age
Reab
sorp
tion
IV fl
uid:
NSS
. DAR
. DLR
Collo
id: 1
0%De
xtra
n-40
M+
5% D
efici
t(=
4,6
00 m
l in
adul
t)
W B C
WBC
Plat
elet
cour
t20
0,00
06,
000-
9,00
0
Hct
Albu
min
Chol
este
rol
35
5.00
0
100,
000
3.5
gm% 10
0 gm
%
50,0
00
45(ri
sing
20%
)38
Flui
d ov
eloa
d
07
08
Mon
itori
ng C
hart
for D
engu
e Pat
ient
sIn
stru
ctio
ns -
Do
CBC
daily
/bd
and
PCV
6 h
rly. M
onito
r oth
er p
aram
eter
s 3-4
hrly
and
when
leak
ing
dete
cted
mon
itori
ng ev
ery h
our.
Case
OPD
IPD
Refe
r
Shoc
k
Shoc
k
Wal
k in
Non
Sho
ck
Non
Sho
ck
Indi
catio
ns to
call
for i
mm
edia
te ad
vice
1. P
ulse
rate
> 1
20/m
in w
ith fe
ver o
r > 1
00/m
in w
ithou
t fev
er.
2. P
ulse
Pre
ssur
e 25-
20 m
mhg
or l
ess (
in su
pine
pos
ition
)3.
Pos
tura
l dro
p of
SBP
>20m
mH
g.4.
Sign
i�ca
nt b
leedi
ng (H
aem
etem
esis,
Mal
ena,
Blee
ding
PV
etc.)
5. U
OP
<0.5
ml /
Kg/h
r6.
CRF
T >2
sec
Dat
e
CBC
Day
of A
dmiss
ion
Nam
eW
ard
Atte
ndin
g Ph
ysic
ian
Age
HN
AN
Pulse
:F
= Fu
ll M
= M
oder
ate
W=
Wea
k N
= N
ot P
alpa
ble
BW =
IBW
=
Mai
nten
ance
�ui
d =
M +
5%
De�
cit
=
kgs.
Hei
ght =
cms
Dat
e of F
ever
TT Live
rBl
eedi
ngEp
istax
isAb
dom
en
Day
of I
llnes
skg
s.H
ct =
Plt
=PM
N =
WBC
=Ly
m =
Tim
eBP
Tem
pPR
PRPP
RRH
CT (%)
Clin
ical
/La
b/Tr
eatm
ent
Nur
sing
Care
/Si
gns
Bloo
d/ra
te &
Am
ount
IVA
mou
ntTo
tal
Uri
ne/
Stoo
lVo
mit
/Ble
edTo
tal
OU
TPU
TIN
TAK
E Ora
l
09
10
11
12
13
14
15
0416
17
18
19
Notes
20
