Facilitator - WHO Western Pacific Region - World Health Organization

Module
•
6: Patient assessment & evaluation
•For
•
most cases, a complete blood count (CBC) with haematocrit (HCT) is all that is necessary to
monitor the patient.
•The following components should be noted:
HCT
white blood cell (WBC) count
platelet count.
(Note: All may be within the normal range in the first one to two days of fever)
OO
OO
OO
SLIDE 23: Investigations (cont.)
•Facilitator
•
explains:
•All febrile patients should get a baseline CBC at the first visit:
OO
If resources are limited, a CBC should be done for febrile patients with poor oral intake and/
•
or poor urine output.
OO
•
A normal CBC in the febrile phase does not exclude dengue.
•The following patients should get a CBC on subsequent visits:
•
•all patients with warning signs (urgently);
•
•all patients with fever for more than three days; and
•all patients with circulatory disturbance/shock (these patients should have a full blood
•
count and a glucose check urgently).
•Patients should be referred for immediate medical consultation when the following conditions
•
are present:
•rising
•
HCT or high HCT;
•leucopenia and/or thrombocytopenia;
•presence of warning signs and shock.
SLIDE 24: Investigations (cont.)
•Facilitator
•
explains:
•Dengue diagnostic tests are generally not available in most outpatient settings. Laboratory
confirmation of dengue is not necessary for acute management but may be valuable because
some patients progress over a short period from mild to severe disease and sometimes to
•
death.
•Laboratory confirmation is recommended for patients with unusual manifestations and
•
suspected dengue deaths.
•Additional tests should be considered as indicated (and if available), including tests of liver
function, glucose, serum electrolytes, urea and creatinine, bicarbonate or lactate, cardiac
enzymes, ECG and urine-specific gravity.
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