1. Caring for patients with rabies in developing countries - the neglected importance of palliative care
- Author
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Hervé Bourhy, Yiksing Peng, Yoann Crabol, Sotheary In, Sowath Ly, Arnaud Tarantola, Philippe Buchy, Hubert Barennes, Bangalore Jayakrishnappa Mahendra, Institut Pasteur du Cambodge, Institut Pasteur du Cambodge-Réseau International des Instituts Pasteur ( RIIP ), Kodagu Institute of Medical Sciences, Dynamique des Lyssavirus et Adaptation à l'Hôte, Institut Pasteur [Paris], GlaxoSmithKline (GSK) Vaccine, Unité d'Épidémiologie et de Santé Publique [Phnom Penh], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre Collaborateur de l'OMS pour la Rage - Dynamique des lyssavirus et adaptation à l'hôte (CC-OMS), Unité de Virologie / Virology Unit [Phnom Penh], GlaxoSmithKline, Glaxo Smith Kline, and Institut Pasteur [Paris] (IP) more...
- Subjects
hidrofobia ,Palliative care ,[SDV]Life Sciences [q-bio] ,rabies ,Epileptic fits ,rage ,0302 clinical medicine ,tratamiento ,MESH : Anxiety ,MESH: Rural Population ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Health care ,030212 general & internal medicine ,MESH : Palliative Care ,MESH : Thirst ,MESH: Developing Countries ,MESH : Seizures ,palliative care ,treatment ,cvg.computer_videogame ,diazépam ,MESH: Seizures ,3. Good health ,[ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Infectious Diseases ,cuidados paliativos ,soins palliatifs ,midazolam ,Anxiety ,MESH: Palliative Care ,medicine.symptom ,medicine.medical_specialty ,030231 tropical medicine ,Developing country ,Hydrophobia ,[ SDV.MP.VIR ] Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,traitement ,03 medical and health sciences ,MESH: Rabies ,Intensive care ,medicine ,hydrophobie ,MESH : Developing Countries ,cvg ,Intensive care medicine ,hydrophobia ,MESH: Humans ,MESH: Anxiety ,[ SDV ] Life Sciences [q-bio] ,business.industry ,MESH : Humans ,Public Health, Environmental and Occupational Health ,developing countries ,pays en voie de développement ,MESH : Respiratory Insufficiency ,medicine.disease ,Surgery ,MESH: Drugs, Essential ,MESH : Rural Population ,MESH : Drugs, Essential ,países en vías de desarrollo ,MESH : Rabies ,MESH: Thirst ,Parasitology ,Rabies ,business ,Rabia ,MESH: Respiratory Insufficiency - Abstract
International audience; Although limited publications address clinical management of symptomatic patients with rabies in intensive care units, the overwhelming majority of human rabies cases occur in the rural setting of developing countries where healthcare workers are few, lack training and drugs. Based on our experience, we suggest how clinicians in resource-limited settings can make best use of essential drugs to provide assistance to patients with rabies and their families, at no risk to themselves. Comprehensive and compassionate patient management of furious rabies should aim to alleviate thirst, anxiety and epileptic fits using infusions, diazepam or midazolam and antipyretic drugs via intravenous or intrarectal routes. Although the patient is dying, respiratory failure must be avoided especially if the family, after being informed, wish to take the patient home alive for funereal rites to be observed. Healthcare staff should be trained and clinical guidelines should be updated to include palliative care for rabies in endemic countries. more...
- Published
- 2016
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