2023-10-15 04:41:00
The Department of Medical Services has created a brief guideline for diagnosing and treating patients with “dengue fever”, emphasizing groups at risk of severe symptoms. There are complications. Guidelines for diagnosing suspected patients, confirming the disease, characteristics of dengue shock Criteria for hospital admission for dengue patients with strange symptoms Caring for patients in all 3 phases: Precautions before sending them home
On Oct. 15, reporters reported that the Department of Medical Services together with a committee of experts both from the Department of Disease Control Department of Medical Sciences Maharajnini National Institute of Child Health and Faculty of Tropical Medicine Mahidol University has prepared “Guidelines for diagnosis and care for patients with dengue fever (abbreviated version) 2023” Clinical Practice Guideline Dengue Hemorrhagic Fever (DHF) 2023 published on the Department of Medical Services website on 11 Oct. To develop and improve guidelines for diagnosis and care for dengue fever patients. both children and adults to be current The said guidelines stated that Dengue fever is currently classified as one of the re-emerging infectious diseases. There are Aedes mosquitoes that carry disease. Dengue fever There are two important characteristics: the presence of plasma leaks; and have abnormal bleeding It is the cause of the severity of the disease. which often occur together But there are different levels of disease severity in each patient. The group of patients at high risk of severe dengue fever and complications includes children less than 1 year old, pregnant women, the elderly, and obese patients. People with chronic diseases such as diabetes, high blood pressure, heart disease, liver disease, blood disease, and kidney disease, etc., and those taking anticoagulant drugs. Antiplatelet drugs, etc.
The guidelines also specify the diagnosis of patients suspected of having dengue fever, namely patients with acute fever for 2-7 days and at least 2 of the following clinical characteristics and laboratory test results: 1. Pain. Headache 2. Eye socket pain 3. Muscle pain 4. Joint pain or bone pain 5.Red rash around the skin 6. Abnormal bleeding, including having a positive tourniquet test and having bleeding spots all over the body. There are blood spots on the skin. Have a nosebleed Vomiting fresh or black blood There is fresh blood or black in the stool. There is fresh blood in the urine. or dark brown and menstruation that comes out of the cycle or is abnormally large, etc. 7. White blood cell count ≤5,000 cells/mm3 with increased white blood cells of the type atypical lymphocytes. 8. Hematocrit value (hematocrit ) increased 5-10% 9. Platelet count ≤150,000 /mm3
As for the diagnosis of dengue hemorrhagic fever, it is stated that dengue hemorrhagic fever refers to patients who have acute and high fever for 2-7 days along with clinical symptoms and laboratory test results. The clinical symptoms are abnormal bleeding, enlarged liver, often tenderness, abdominal pain or vomiting, dengue shock. While the laboratory test results were evidence of plasma leakage. and have a platelet count less than or equal to 100,000 /mm3
For the diagnosis of dengue shock, patients are infected with the dengue virus or suspected of having dengue fever. Along with the following signs and symptoms, there is a failure of blood circulation. It will be found that the vitals are rapid and light, with cool, pale skin, especially cold hands and feet, and a pulse pressure value of ≤20 mmHg (found in only 100 25 per adult patient which has dengue shock) and has low blood pressure along with tissue hypoperfusion. It was found that there are symptoms of dizziness, fainting, dizziness, decreased urination, and restlessness. or decreased level of consciousness with a capillary refill time >2 seconds
As for the criteria for admitting patients with dengue virus infection or patients suspected of having dengue fever to the hospital, they are if only one symptom is found, such as not being able to eat or drink water, vomiting profusely, and abdominal pain. Fatigue, no energy, dizziness, fainting, excessive bleeding. Especially women who have more menstrual periods than usual or have irregular periods. and patients with dark brown, black, or coke-colored urine have dengue shock. Have a platelet count ≤100,000 /mm and begin to leak plasma. There is impaired functioning of the kidneys, heart, or nervous system, such as decreased urination, irregular heartbeat. The level of consciousness decreases, etc.
In addition, the guidelines also specify methods for diagnosing dengue patients with strange symptoms. Caring for patients with dengue fever in all 3 stages: fever, crisis, and recovery. Providing fluid replacement in dengue fever patients both with and without dengue shock Caring for patients with dengue fever who have complications Indications for giving Dextran 40 blood replacement Things to consider before sending the patient home Criteria for referring patients from Community hospital to Central hospital/general hospital or hospital with higher potential and care for dengue fever patients at home
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