Saturday, August 27, 2016

Dengue fever

25/8/2016 thurday

Discussion with dr sabeera, paeds consultant iphkl.

Question:

Dengue fever patient, day 4 of illness, suddenly c/o abdominal pain in ward.

What will you do?

1. Think of shock first. Shock decreases blood supply to other organs and only supply vital organs such as heart and brain.

This leads to messentric ischemia. Leads to abdominal pain.

Check the vital signs. If suggestive of symptoms of shock, start iv bolus normal saline or ringer lactate 20ml/kg. Rate of infusion depends on bp. If hypotensive run over 15-30 minutes.

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You can repeat iv bolus of crystalloid up to 3 times. Then can change to colloid.

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Rashes in dengue : maculopapular rash, itchy, more over lover lomb, persists up to 3 days, appears as islands of white in the sea of red. Usually occurs during recovery phase.

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Dont forget to take gxm for blood transfusion if condition does not improve after iv bolus.

Common site of bleeding is in the stomach.

Watch out for brown colour vomiting.

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