Indication for platelet transfusion

00000000Platelet concentrate is indicated only in cases with massive bleeding. Give 0.2 unit/kg/dose.

3. Convalescence phase

00000000In general, most DHF patients will recover rapidly without complication within 24 - 48 hours after shock. Indicators for recovery include:

• Improved general condition.
  
• Gain appetite.
  
• Stable vital signs: wide pulse pressure, slow and strong pulse.
  
• Hct stable and decrease to baseline value, 35% - 40%.
  
• Diuresis.
  
• Some (~ 30%) developed confluent petechial rash with characteristic, scattered small, whitish round areas on their lower extremities, may be itchy.
  
• Sinus bradycardia.
  

00000000IV fluid should be discontinued immediately if they enter convalescence phase. If the patient does not gain appetite and has distended abdomen with decreased or no bowel sound, check for hypodalemia which is commonly found in this phase (due to diuresis). Fruit or fruit juice or KCI solution orally are recommended to correct this electrolyte abnormality.

4. Indications for discharge

• At least 24 hours after defervescence without using antipyretic.
  
• Good appetite.
  
• Visible good general conditions.
  
• Diuresis.
  
• Stable Hct at baseline value 35% - 40%.
  
• At least 2 days after shock.
  
• No dyspnea or tachypnea.
  
• Platelet > 50,000 cell/cu/mm/
  
• No complications.