Patient care

Please refer to the full prescribing information and/or patient information supplied by the relevant marketing authorization holder for your country, as well as local policies and treatment guidelines as they may vary from country to country.

Measures to be taken for all patients with diagnosed or suspected severe malaria. Meticulous nursing care can be life-saving, especially for unconscious patients.

Assessment

  • Rapid clinical assessment
  • Treatment and management
  • If coma: exclude meningitis by lumbar puncture
  • Carry out regular laboratory evaluation/monitoring

Bedside management

  • Treat with IV artesunate or alternative
  • Avoid over- or under-hydration
  • Avoid drugs that increase the risk for gastrointestinal bleeding
  • Manage complicating or associated infections
  • Treat seizures
  • Manage those unable to retain oral fluids
  • If black or red urine: prepare for transfusion if necessary 
    • Manage raised temperature above 39º
    • When in coma: 
      • Maintain a clear airway
      • Turn the patient every 2h
      •  

    Monitoring

    • Monitor breathing
    • Monitor vital signs every 4 hours
    • Instill more sophisticated monitoring if complications develop
    • Record and observe urine output
    • Monitor for retinal whitening, vascular changes or haemorrhages
    • Monitoring for hypoglycaemia
    • Monitor the therapeutic response
    • Look for other causes of coma