Tag Archives: Bleeding in children

Precautions we need to take in Dengue Season; Danger signs to watch out for?

During rainy season ,please take plenty of Fluids ,fruits and watch for danger signs like Decrease oral intake, decrease urine output and bleeding from any site (including skin rashes).

In case of any danger signs contact your doctor as soon as possible and get yourself checked.
Do not Take Pain killers or Aspirin for fever. Take Simple paracetamol formulation like Crocin for fever.

 

Read on to know in detail regarding Dengue fever.

 

Dengue Fever

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Dengue Fever as we all know spread from bite of an infected Mosquito. It has 4 serotypes. It can cause very severe life threatening illness; however most cases are milder in nature.

Huge number of cases has been reported worldwide (50-100 million cases every year worldwide).

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Dengue virus is transmitted by Aedea Mosquito. It bites during day time only. Outbreaks can occur at anytime, however rainy season with high humidity increases changes of transmission.

Symptoms:

Occurs after 4-10 days of mosquito bite and symptoms can last from 2 to 7 days usually.

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High grade Fever associated with atleast 2 of the below mentioned features should raise suspicion of Dengue Fever:

  • Headaches
  • Body ache.  esp pain behind eyes
  • Joint Pain, bone pain, Muscular pains
  • Nausea, vomiting
  • Rashes (usually extensive red colored all over body)
  • Itching

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Most crucial Phase of Dengue illness occurs once fever subsides; i.e. at deffervescence of Fever as most of the complications arises at this time. At this time platelet counts start decreasing along with rise in Hematocrit values. 3rdspace losing occurs, so it is very important to prevent dehydration and let your child have PLENTY OF FLUIDS.

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Severe Cases (also called dengue hemorrhagic fever):

Special attention needs to be given to these warning signs as it could lead to severe dengue:

  • Severe abdominal pain
  • Persistent vomiting
  • Bleeding from any site eg gums, blood in vomiting etc
  • Rapid breathing
  • Fatigue/ restlessness
  • Altered sensorium

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Treatment:

  • At present no vaccine is available.
  • No specific medication for dengue fever.
  • Mainstay of treatment is supportive
  • Patients should seek medical advice, rest and drink plenty of fluids.
  •  Paracetamol (Crocin) is the drug of choice for Fever. Other medications like aspirin or ibuprofen should be avoided as it increases the risk of bleeding.
  • Vital Monitoring along with blood test to have a look at Hematocrit along with platelet count.
  • Platelet transfusion in some cases

Infection with one strain will provide life-time protection only against that particular strain. However, it is still possible to become infected by other strains and develop into severe dengue. Usually re-infection cases are severe.

With proper medical care and early recognition, case-fatality rates are below 1%.

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What should be done by Patients and Relatives?

  • If you suspect you have dengue you first need to avoid panic and consult a doctor soon.
  • Drink plenty of fluids, watch for urine output & watch for bleeding from any site.
  • For diagnosis, your doctor will
    • Evaluate your signs and symptoms
    • Test your blood for evidence of a dengue virus using NS1 Antigen or serology test (IgG& IgM).

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How Dengue is spread:

  • Bite from infected mosquito (Aedes aegypti)
  • Day time biting by this mosquito (esp early morning & evening)
  • Does not spread by contact

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Mosquitoes  breading Ground:

  • Clear water in nearby areas esp water filled containers etc.
  • Rest Indoors in dark areas like closet, under beds, behind curtain etc.

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Preventive measures:

  • Source reduction: eliminate mosquitoe’s egg laying sites.  Examples of the following habitats are listed:
  • Indoor, Ant traps, Flower vases and saucers
  • Water storage tank (domestic drinking water, bathroom, etc…)
  • Plastic containers, Bottles, Outdoor, Discarded bottles and tins
  • Discarded tyres, Artificial containers, Tree holes, potholes, construction sites, Drums for collecting rainwater
  • Shells, husks, pods from trees, Leaf axils of various plants
  • Community participation is the key to dengue prevention. As every household aims to reduce vector density, the transmission rate will decrease or maybe even stop.
  • Protecting yourself from mosquito bites: It can be done by using
    • Long-sleeved clothing and mosquito repellents are the most viable options.
    • Window and door screens, air conditioning reduces the risk of mosquitoes coming into contact with the household members.
    • Mosquito nets (and/or insecticide-treated nets) will also provide additional protection to people sleeping during the day, or protect against other mosquitoes which can bite at night (such as malaria).
    • Household insecticides aerosols, mosquito coils or other insecticide vaporizers maybe also reduce biting activity.

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Feel free to contact your doctor for detail or contact us at MAYA CLINIC.

Regards

Dr Rahul Varma

dengue fever danger signs in dengue fever precautions in dengue maya clinic dr rahul varma
nose bleed (mayaclinic.in)

How to manage child with nose bleed (Epistaxis) ?

 

Epistaxis (Nosebleed): What to do?

nose bleed (mayaclinic.in)

 

One of the most frightening sites for a parent is to see their child bleed from nose. But you can rest assure that in most cases it is not serious. Most of them can be treated at home.

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It occurs due to bleeding from small vessels of nose. It happens as a result of break in the tissue lining of nose (mostly in front part or “anterior” of nose).

 Epistaxis Management        images

Cause:

  • Irritation and lack of moisture in the nasal membrane
  • Dry air or warm air can lead to crusting of membrane inside nose and it may cause itching which can lead to scratching or nose picking. It in turn leads to bleeding.
  • Allergic conditions and cold
  • Repeated nose blowing
  • Excessive use of antihistamines and Decongestant medicines can also lead to it.
  • Serious causes: Head Injury
  • Bleeding disorders

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In some cases bleeding can occur from posterior part of nose which can be dangerous. It leads to flow of blood down the back of throat.

Frequent or long time bleeding if occurs; you should consult doctor.

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What can be done at home?

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  • Do not Panic and remain Calm
  • Make your child sit in your lap and tilt his or her head slightly forward.
  • Gently pinch nose with clean cloth.
  • Keep applying pressure on nose for about 10 minutes. If we stop too soon bleeding may start again
  • If child is leaning back, it may cause blood to flow down the throat which may in turn cause gagging, coughing or vomiting.
  • Discourage child to blow nose, picking, rubbing.
  • Ice pack on forehead might help.

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When to call doctor?

  • Frequent nose bleed
  • Long time duration of bleeding or difficult to control bleeding
  • Foreign body in nose
  • Bleeding from any other site as well
  • Associated symptoms like fever, rashes etc
  • Easy bruising tendency
  • Medication: recently added or long term

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Urgent Attention needed if:

  • Bleeding is heavy
  • Associated with weakness or dizziness
  • Head injury or history of fall
  • Bleeding continues after two attempts of applying pressure for 10 minutes each

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Prevention:

  • Avoid nose picking (Keep finger nails trimmed most of the time)
  • Use saline nasal spray frequently during illness
  • Vaporizer or steam helps
  • Protective gears while playing or driving to prevent injury

 

Even after taking all the precautions, sometimes child starts bleeding without any obvious reason. So do not panic as most of them are harmless and can be stopped easily.

Discuss with your doctor (Child specialist/ ENT specialist) or contact us at Maya Clinic.

 

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”