Dengue shock: signs and urgent action

In severe dengue, fluid may move out of blood vessels into surrounding tissues. The circulating volume can then fall, reducing blood flow to vital organs. A person may become weak, restless, dizzy or unusually sleepy. The hands and feet may feel cold and the skin may look pale or clammy. Dengue Fever can include fever, headache, joint pain and muscle aches before more serious signs develop. Shock is not diagnosed from a single symptom; healthcare professionals assess circulation, breathing, mental alertness, urine output and blood results.

Call emergency services or go to an emergency department immediately if shock is suspected. Keep the person lying down, help them stay warm, and do not leave them alone. If they are awake and able to swallow, small sips may be reasonable, but do not force drinks if they are drowsy or vomiting. Do not give aspirin or ibuprofen unless a clinician specifically says to use them. Tell responders when the fever started, whether there has been vomiting or bleeding, and any previous dengue infection.

Treat fainting, severe weakness, confusion, trouble breathing, cold or clammy skin, a very fast or weak pulse, little urine, persistent vomiting, severe abdominal pain, black stools or vomiting blood as emergencies. Shock can develop around the time fever improves, so apparent relief from fever is not a reason to delay care. Easy bruising or other bleeding also needs urgent assessment.

Ask what monitoring is needed, which changes should trigger immediate return, how fluids will be managed, whether blood tests need repeating, and which medicines or activities should be avoided during recovery.