Dengue Management DON’Ts do X DON’T use corticosteroids. They are not indicated and can increase the risk of GI bleeding, hyperglycemia, and immunosuppression. X DON’T give platelet transfusions for a low platelet count. Platelet transfusions do not decrease the risk of severe bleeding and may instead lead to fluid overload and prolonged hospitalization. X DON’T give half normal (0.45%) saline. Half normal saline should not be given, even as a maintenance fluid, because it leaks into third spaces and may lead to worsening of ascites and pleural effusions. X DON’T assume that IV fluids are necessary. First check if the patient can take fluids orally. Use only the minimum amount of IV fluid to keep the patient well-perfused. Decrease IV fluid rate as hemodynamic status improves or urine output increases. ✓ DO tell outpatients when to return. Teach them about warning signs and their timing, and the critical period that follows defervescence. ✓ DO recognize