Physical examination for Dengue Hemorrhagic Fever (DHF)
1. General condition:
Grade 1: complaints of high fever, consciousness either.
Grade 2: The fever is still there, or has been dropped. Children looked tired, and lethargic.
Grade 3: Children's restless, anxious, very tired, moist clammy skin.
Grade 4: Children experiencing loss of consciousness, cold clammy skin.
2. Respiratory System:
Shortness of breath, bleeding through the nose / epistaxis, shallow breathing, tachypnea, asymmetrical chest movement, resonant percussion, auscultation sounds Ronchi and pleural effusion (crackles)
3. Cardiovascular System:
Grade I
Test tornikuet (+), thrombocytopenia, spontaneous bleeding and hemoconcentration
Grade II
Accompanied by spontaneous bleeding in the skin or other bleeding
Grade III
Circulatory failure may occur that is fast and weak pulse (tachycardia), narrow pulse pressure, hypotension, cyanosis around the mouth, nose, and fingers, as well as cool and moist skin
Grade IV
No palpable pulse, and blood pressure can not be measured
4.Sistem Neurology
In grade I and II, the awareness of compost mentis. In grade III and IV, restless, fussy, whiny, apathy, sopor coma. Grade I-IV can occur cramps, headache, and pain in various parts of the body, vision fotophobia, and pain behind the eyeball.
5. Urinary system
Decreased urine production, sometimes less than 30 cc per hour, especially in grade III, will reveal the pain while urinating. Red colored urine.
6. Digestive system (gastrointestinal)
Bleeding gums, dry mucous membranes, difficulty swallowing, epigastric tenderness, an enlarged spleen, enlarged liver / hepatomegaly accompanied with tender not accompanied by jaundice, abdominal stretch, decreased appetite, nausea, vomiting, pain on swallowing, may vomit blood / hematemesis, dysentery / melena.
7. Integumentary System
There was an increase in body temperature / fever, dry skin and rash makulo popular.
8. The degree of dehydration
Performed by examination of the degree of edema.
How to check:
- examiner pressed the leg area (lateral tibia musculus) with 2 fingers,
- release the pressure and note the time required to return to normal skin (in seconds)
- inform the results of examination of the patient and note on the status.
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