denguefever登革熱-資料下載頁
2025-04-13 22:49本頁面
【正文】 Discharge criterian afebrile for 24 h appetiten clinical improvement 3 days post shockn Stable Hct Platelets ?50,000/mm3n Eupnea: No respiratory distress from pleural effusions/ascitesprevention Three operations must be conductedn isolation of patients.n emergency mosquito control simultaneouslyn Personal protectionvaccine n no vaccine currently available n research is underway for the development of a vaccine. n vaccine will not available for 5 to 10 years. as167。 it must provide immunity to all 4 serotypes167。 Lack of dengue animal modelPersonal protectionn remain in wellscreened or pletely enclosed, airconditioned areas。 n wear lightcolored clothing with fulllength pant legs and sleeves。 n use insect repellent on exposed skin.n Use ting when sleeping Common Misconceptions about DHFvDengue + bleeding = DHFv Need 4 WHO criteria, capillary permeabilityvDHF kills only by hemorrhagev Patient dies as a result of shockvPoor management turns dengue into DHFv Poorly managed dengue can be more severe, but DHF is a distinct condition, which even welltreated patients may developvPositive tourniquet test = DHFv Tourniquet test is a nonspecific indicator of capillary fragilityRehydrating Patients Over 40 kgn Volume required: twice the remended maintenance volume n Formula for calculating maintenance volume: 1500 + 20 x (weight in kg 20)n For examplen 55 kg patient: maintenance volume : 1500 + 20 x (5520) = 2200 mln For this patient, the rehydration volume would be 2 x 2200, or 4400 mlDengue virus infectionAsymptomatic symptomaticUndifferentiated fever (viral syndrome) dengue hemorrhagic fever (plasma leakage)dengue fever syndromeno shock DSSWithout hemorrhagewith unusual hemorrhageDF DHFFever tournigeut test(+) Increased vascular permeabilityheptomegalythrombocytopeniaDengue infectionOther haemorrhagic manifestationsLeakage of plasmaRising haematocritHypoproteinaemiaSerous effusioncoapulopathyhypovolaemiashockDIC Severe bleedingdeathAntiinflamatory agentsMonitor vital sings q2hProvide oral hydrationSame as above +type and cross matchDetermine PT AND PTTSame as above+ iv isotonic fluids,monitor q30mins,follow urine outputSame as above+Iv colloids or plasmaProvide critical care support Criteria for DHF1+spontaneaous bleeding1+Sings of shock:hypotention1+undetectalbe pulse and blood pressureGrade 1Grade 2Grade 3Grade
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