Knowing how to protect and care for your child when dengue strikes a household can make all the difference in their recovery. Navigating medicine safety, proper hydration, and emergency warning signs can feel overwhelming for worried parents. Dr Sheeja Sugunan, paediatric intensivist and associate professor at Government Medical College, Thiruvananthapuram, discusses critical dengue management strategies with Unnikrishnan S, providing clear, practical guidance every family needs. Edited excerpts:
Why are painkillers strictly unsafe during dengue, and how often can paracetamol be given?
Non-steroidal anti-inflammatory drugs like ibuprofen, mefenamic acid, and aspirin must be strictly avoided during dengue. They inhibit platelet function and irritate the stomach lining, drastically increasing the risk of severe internal bleeding. Paracetamol is the only safe option for managing fever and pain. It should be given at a weight-appropriate dose every four to six hours, capped at four doses per 24 hours to prevent liver toxicity.
What specific liquids should a child drink besides water, and how many wet diapers or urine breaks mean they are safely hydrated?
Plain water alone is insufficient; electrolyte-rich fluids are needed to maintain blood pressure and prevent plasma loss. Ideal choices include ORS solution, salted rice starch water (kanji), tender coconut water, salted lemonade, and milk for infants. Safe hydration is indicated by 4-6 wet diapers daily for infants, or 4-5 clear or pale-yellow urinations for older children. Going six hours without passing urine warrants immediate medical attention.
What emergency warning signs mean a parent must take their child straight to the hospital instead of waiting for a clinic visit?
Immediate emergency care is required if a child shows any visible bleeding, such as nosebleeds, bleeding gums, blood in vomit, or skin bruising. Cold, clammy extremities signal reduced blood flow and impending shock. Sudden lethargy, drowsiness, confusion, seizures, persistent vomiting, severe abdominal pain, or an absence of urine for over six hours also require urgent emergency evaluation.
