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    Dengue Case

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    Ho Yong Wai
    This document contains a dengue case summary including: - Details of a patient's presentation with fever, nausea, vomiting, abdominal pain, headache, and arthralgia/myalgia. - Their vital signs, physical exam findings, lab results, and impression of dengue fever in a certain phase with warning signs are noted. - The plan involves strict input/output monitoring, encouraging oral intake, watching for warning signs, and following up with additional testing.

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    © All Rights Reserved
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    Dengue Case

    Uploaded by

    Ho Yong Wai
    166 views4 pages
    This document contains a dengue case summary including: - Details of a patient's presentation with fever, nausea, vomiting, abdominal pain, headache, and arthralgia/myalgia. - Their vital signs, physical exam findings, lab results, and impression of dengue fever in a certain phase with warning signs are noted. - The plan involves strict input/output monitoring, encouraging oral intake, watching for warning signs, and following up with additional testing.

    Original Title

    Dengue Clerking.docx

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    This document contains a dengue case summary including: - Details of a patient's presentation with fever, nausea, vomiting, abdominal pain, headache, and arthralgia/myalgia. - Their vital signs, physical exam findings, lab results, and impression of dengue fever in a certain phase with warning signs are noted. - The plan involves strict input/output monitoring, encouraging oral intake, watching for warning signs, and following up with additional testing.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    166 views4 pages

    Dengue Case

    Uploaded by

    Ho Yong Wai
    This document contains a dengue case summary including: - Details of a patient's presentation with fever, nausea, vomiting, abdominal pain, headache, and arthralgia/myalgia. - Their vital signs, physical exam findings, lab results, and impression of dengue fever in a certain phase with warning signs are noted. - The plan involves strict input/output monitoring, encouraging oral intake, watching for warning signs, and following up with additional testing.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    Dengue Case

    Date & Time < Admission Clerking >

    Age / Race / Sex

    - U/l, NKMI, NKDFA

    - Smoker? Non-smoker?

    NS1 – positive, combokit panel -

    p/w

    - fever (day of onset)

    ------- documented temperature at home/ED? PCM taken? h/o visiting GP / private clinic / a/w
    chills & rigors?

    - Nausea / vomiting / diarrhea

    * How many episodes in a day, watery or bloody?

    - Abdominal pain

    - Headache

    - Retro-orbital pain

    - Arthralgia / myalgia

    - Rash

    - Bleeding tendencies (epistaxis, gum bleeding, menorrhagia, haematuria)

    - Reduced oral intake

    - Last PU @ ___ am/pm, frequency, volume (oliguria?) – Concentrated?

    - H/o jungle trekking / swimming in waterfall

    - H/o contact with rodents

    - H/o sick contact at home / family members

    - H/o taking outside food

    - Recent fogging in neighbourhood / dengue-prone area

    Other components of history taking:

     Past Medical / Surgical History


     Drug / Allergy History
     Family History
     Social History / Epidemiological History

    At ED

    - FBC stat, VBG stat

    - Repeated FBC after bolus, VBG

    - Vital signs

    In ward

    O/E

    - Alert, conscious (mental state, GCS score), dehydrated? Pulse volume? Capillary refill time <
    2s? , warm peripheries, not tachypnoiec

    Input - , output- , balance, urine output:

    Vital signs: BP (pulse pressure), Pulse, Temperature, RR, SpO2

    Lungs: Clear

    CVS: DRNM

    Abdomen: Soft, non-tender, no hepatomegaly, no shifting dullness

    Impression: DF, Day __ of illness, in febrile/critical/recovery phase with warning signs (………..)

    Ix

    FBC (HCT), VBG

    Plan

    1. Strict I/O
    2. Watch out for warning signs
    3. Encourage orally

    < AM / PM / On-call review>

    Age / Race / Sex

    Diagnosis: DF, Day __ of illness, in febrile/critical/recovery phase with warning signs (………..)

    Currently/ Progress,

     No fever
     No abdominal pain
     No vomiting , no loose stools (diarrhea)
     No bleeding tendencies
     Tolerating orally well

    O/E: alert, full GCS, not tachypnoiec, CRT < 2s, warm peripheries, good pulse volume

    Lungs: Clear

    CVS: DRNM

    Abd: Soft, non-tender , no ascites

    Vital signs:

    Input, output, balance, urine output

    Ix: FBC trend

    Plan

    - Strict I/O charting

    - Encourage orally

    - Watch out for warning signs

    Transaminitis: AST / ALT daily

    Dengue PCR, dengue IgM

    Reminder:

    1. Update DENGUE CHART every 4 – 6 hours


    2. Send PCR form & dengue IgM (day___)
    3. Send notification form as soon as possible
    4. Dengue QID (6 am , 12 pm , 6 pm , 12 am)

    ACUTE CUBICLE

    Normal Compensated Shock Decompensated Shock


     Clear consciousness  Clear consciousness  Altered mental status
     Capillary refill time  Prolonged capillary  Prolonged capillary
    <2s refill time refill time
     Warm and pink  Cool peripheries  Cold, clammy
    peripheries  Weak and thread peripheries
    peripheral pulses  Feeble (weak) and
     Tachycardia absent peripheral
     Normal systolic pulses
    pressure with raised  Severe tachycardia ,
    diastolic pressure bradycardia in late
     Postural hypotension shock
     Narrowing pulse  Hypotension/
    pressure unrecordable BP
     Tachypnea  Narrowed pulse
    pressure
     Reduced urine  Metabolic acidosis
    output (Kussmaul’s
     Increased thirst breathing)
     Oliguria / anuria

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