Hospitals lack dengue-fighting Dextran

Medical Supply Division says it has enough stocks, hospitals need to request
By Kumudini Hettiarachchi

With intermittent rains and fears of a dengue outbreak mounting, there was concern in health circles that many hospitals across the country had not stocked a few bottles of a crucial fluid essential in the treatment and management of critically-ill dengue patients.

From around December, there have been perturbing reports that several hospitals had to look around and scramble to get Dextran 40 which is administered intravenously, when a patient needed it, the Sunday Times understands.

The latest such incident had been in a hospital in the deep south in early March, it is learnt with similar occurrences in the central as well as north central areas between December and February.

It is a pity that hospitals don’t take the trouble to stock a few bottles of this life-saving fluid now that the country has introduced new management guidelines for dengue, a high-level source said, stressing that it is the duty of the Physicians and Paediatricians to be prepared for the possibility of a critically-ill dengue patient coming in.

This is an emergency and to be armed with the required fluid is their responsibility, another source explained. “It’s the only way to prevent deaths.” The ‘Guidelines on the Management of Dengue Fever and Dengue Haemorrhagic Fever’ are set out clearly by the Epidemiology Unit. Under the ‘Outbreak Response Plan for Hospitals’ the unit states: “There have been increasing number of dengue outbreaks in many parts of the country.

Therefore, having a hospital emergency response plan for dengue outbreaks is vital in early diagnosis and appropriate clinical management of cases to minimize complications and deaths.”

According to the Epid Unit list of “essential medicines” which should be available in hospitals providing inward care for patients with Dengue Haemorrhagic Fever is I.V. Fluids -- Crystalloids: 0.9% saline, Colloids – hyper-oncotic (plasma expanders): 10% Dextran 40 & 6% starch.

When contacted, the Director of the Medical Supplies Division, Dr. Kamal Jayasinghe said that there were adequate stocks of Dextran 40 at the MSD. Currently he has a stock of around 1,750. Explaining that it is usually rarely used, he however pointed out that there is no restriction on the issue of Dextran 40 from the MSD. He advised hospitals to request it, like they do their other medications.

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