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ED SSW SIGNIFICANT ROLE IN DF MANAGEMENT
Transcript of ED SSW SIGNIFICANT ROLE IN DF MANAGEMENT
Nazhatul Muna Ahmad Nasarudin*
Ismail Mohd Saiboon
Ahmad Khaldun Ismail
Shamsuriani Md Jamal
EMERGENCY DEPARTMENT SHORT STAY WARD HAS A SIGNIFICANT ROLE ON SAFETY AND WORKLOAD REDUCTION IN DENGUE FEVER MANAGEMENT
Department of Emergency Medicine
Universiti Kebangsaan Malaysia Medical Centre
Kuala Lumpur, Malaysia.
Q & A
ED UKMMC receives ~ 200 suspected Dengue cases/month
Short stay ward!
Unspecific Medical admission criteria
To evaluate the role of ED SSW on safety and workload reduction in DF management
Clinical and lab parameters
Method flow chart
Total = 147
Group 1(Discharged home) = 78 (53.1%)
Group 2 (Admited to Ward) = 69 (46.9%)
Majority presented at the right time of illness.
Better and rapid detection of warning signs.
ED SSW reduces the hospital management burden by 45.6% (patient-hour)
1 of key criteria to efficacy of SSW is reduction of unnecessary hospital admissions
Strong policy is vital.
Patients who need longer term admission should be admitted rapidly to definitive ward.
All ADULT patients with working diagnosis of DF
Admitted to ED SSW
Transfer out to other hospital
Lodger admission (transit)
Fever with 2 or more of the symptoms:
myalgia, arthralgia, rash
bleeding tendency or leucopenia
Dengue fever with or without warning sign
Severe dengue fever
1. American College of Emergency Physicians. 1998. Emergency Department Observation Units. Annals Emergency Medicine 17: 95-6.
2. Academy of Medicine Malaysia. 2010. Management of Dengue Infection in Adult (2nd edition). Clinical Practice Guidelines.
3. Ministry of Health (MOH), Malaysia. 2000. Annual Report
4. Suaya, J.A., Shepard, D.S. & Beatty, M.E. et al. 2007. Dengue: Burden of Disease and Costs of Illness. WHO Scientific Working Group, Report on Dengue.
5. Teves, M.A. wrong Treatment Most Common cause of Dengue Fatality. ABS-CBNnews.com. www.abs-cbnnews.com
6. Ibrahim, J., Mahmud, R. & Nissapatorn, V. et al. 2007. Retrospective Study of Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF) Among Patients in University Malaya Medical Center (UMMC), Kuala Lumpur. Southeast Asian journal of Tropical Medicine and Public Health 38: 224-30.
Majority discharged home well.
The presentation of patients according to day of admission.
A = Admission Day 2 to 3 of illness
B = Admission Day 4 to 6 of illnesss
C = Admission Day 7 onwards of illness