Managing patients with dengue fever during an epidemic: the importance of a hydration tent and of a multidisciplinary approach

<p>Abstract</p> <p>Background</p> <p>Dengue fever is one of the most common tropical diseases worldwide. Early detection of the disease, followed by intravenous fluid therapy in patients with dengue hemorrhagic fever (DHF) or with warning signs of dengue has a major impact on the prognosis. The purpose of this study is to describe the care provided in a hydration tent, including early detection, treatment, and serial follow-up of patients with dengue fever.</p> <p>Findings</p> <p>The analysis included all patients treated in the hydration tent from April 8 to May 9, 2008. The tent was set up inside the premises of the 2^ndMilitary Firemen Group, located in Meier, a neighborhood in Rio de Janeiro, Brazil. The case form data were stored in a computerized database for subsequent assessment. Patients were referred to the tent from primary care units and from secondary city and state hospitals. The routine procedure consisted of an initial screening including vital signs (temperature, blood pressure, heart rate, and respiratory rate), tourniquet test and blood sampling for complete blood count. Over a 31-day period, 3,393 case recordings were seen at the hydration tent. The mean was 109 patients per day. A total of 2,102 initial visits and 1,291 return visits were conducted. Of the patients who returned to the hydration tent for reevaluation, 850 returned once, 230 returned twice, 114 returned three times, and 97 returned four times or more. Overall, 93 (5.3%) patients with DHF seen at the tent were transferred to a tertiary hospital. There were no deaths among these patients.</p> <p>Discussion</p> <p>As the epidemics were already widespread and there were no technical conditions for routine serology, all cases of suspected dengue fever were treated as such. Implementing hydration tents decrease the number of dengue fever hospitalizations.</p

Health professionals knowledge of medical billing standards in an Emergency Department

Objectives: To gain knowledge on the demographic and professional profile of workers at the Emergency Department and to assess their knowledge about the price of medicines, materials, procedures and other issues of medical care included in the Integrated Care Rate (ICR). Methods: This is a descriptive, exploratory and prospective study using a quantitative approach. The sample was composed of 123 subjects: 32 (26%) physicians, 30 (24.4%) registered nurses, and 61 (49.6%) Nursing technicians working at the Emergency Department during the study period. Rresults: A total of 102 subjects (85%) were aged less than 40 years. Most physicians (24) were male (75%) and registered nurses (28) were predominantly female (93%); among Nursing technicians (61) there was a balance: 50% of each sex. Many staff members (49, 40%) had been working for two years or less at the ED. Distribution of correct and wrong answers regarding the unit price of materials, medicines and procedures was similar, irrespective of profession. The correct answers by registered nurses corresponded to 82.2, 92.7 and 64.9%; by physicians, to 47.9, 78.5 and 46.2%; and by Nursing technicians, to 80.8, 92 and 58% regarding materials, medicines and procedures, respectively. Cconclusions: The activity follow-up enables an assessment and interpretation of present data to introduce corrective actions aiming at continuous improvement