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Name :

Sex

R/N

Weight :

kg

Height :

cm

Age :
I/C

DENGUE CARE CHART


DEPARTMENT
HOSPITAL

Ward:

ALERT SENIOR IF IN RED


CATEGORIES (SEE KEY BESIDE)

Date
180

180

160

160

160

140

140

140

120

120

120

Systolic BP

100

100

100

Diastolic BP

80

80

80

60

60

60

40

40

40

IgM

Pos / Neg

IgG

Pos / Neg

NS1 Pos / Neg

mmHg

Pulse Rate

bpm

N U R S E

if 50 please INFORM DR

50

50

40

40

40

30

30

30

20

20

20

10

10

10

Pulse Pressure X
if <20 please INFORM DR

Respiratory Rate
if >24 please INFORM DR .
if >24 DR to do ABG

SpO2

I N

50

CRT

Temperature of extremities
Bleeding

T O

Abdominal pain
Vomiting

D O C T O R

Hct

(Male >45% Female >40%)

Hb
Plt
WCC
ALT
HCO3 (Actual)

Key : CRT: I (immediate); <2s; 2s

F I L L

Pulse volume

Pulse volume: N(normal); W(weak); A(absent)


Temperature of extremities: W (warm); C (cold)

T O

F I L L

I N

Non-invasive BP

Abdominal pain: + / Vomiting: No or Yes (number of times/day)

180

Bleeding: P(provoked); S(Spontaneous) + M(mucosal; C(cutaneous)

Time
Immunology Date
Taken:
_______________
(please circle):

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