This is an automatically translated article.
The article is professionally consulted by Master, Doctor Nguyen Thi An - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital.Hand, foot and mouth disease is an infectious disease that spreads from person to person, caused by an intestinal virus and easily spreads into an epidemic. The most common pathogens are Coxsackie virus A16 and Enterovirus 71 (EV71).
1. Manifestations of hand, foot and mouth disease level 3
The main manifestation of the disease is lesions on the skin and mucous membranes, especially the mucous membranes of the palms, mouth, soles of the feet, knees, buttocks. If not detected in time, the disease can cause many dangerous complications to the nervous, respiratory, especially can lead to death.Accurately identifying the manifestations of hand, foot and mouth disease according to each level will help the treatment process be more effective.
Hand, foot and mouth disease grade 3 has the following manifestations:
Rapid pulse > 170 beats/min (when the child is lying still, no fever). In some cases, the pulse may be slow (very severe signs). Sweating, generalized or localized chills. HA increases. Rapid breathing, abnormal breathing: Apnea, abdominal breathing, shallow breathing, chest indrawing, wheezing, laryngeal stridor. Consciousness disorder (Glasgow < 10 points). Increase muscle tone.
Bệnh chân tay miệng cấp độ 3
2. Treatment of hand, foot and mouth level 3
Grade 3 is a severe degree of hand, foot and mouth disease, requiring inpatient treatment in the hospital.Breathing oxygen through the nose 3-6 liters / min. Endotracheal intubation helps with early breathing when oxygen therapy fails. Phenobarbital 10 – 20 mg/kg IV infusion. Repeat after 8-12 hours as needed. Prevention of cerebral edema: head position 30°, fluid restriction (total fluid is 1/2-3/4 of normal need), mechanical ventilation to increase ventilation to keep PaCO2 from 25-35 mmHg and maintain PaO2 from 90-100 mmHg. Immunoglobulin (Gammaglobulin): 1g/kg/day by slow intravenous infusion over 6-8 hours, used for 2 consecutive days Dobutamine is indicated when cardiovascular failure > 170 times/minute, starting dose of 5μg/kg/minute IV infusion pulse, gradually increasing 1-2.5 μg/kg/min every 15 minutes until clinical improvement; The maximum dose is 20 μg/kg/min. Milrinone IV infusion 0.4 μg/kg/min is used only when BP is high, for 24-72 hours. Adjust water, electrolyte, acid-base disorders, treat hypoglycemia. Active antipyretic. Treatment of convulsions if present: Midazolam 0.15 mg/kg/time or Diazepam 0.2-0.3 mg/kg slow intravenous infusion, repeat after 10 minutes if convulsions persist (maximum 3 times). Monitor pulse, temperature, blood pressure, breathing rate, consciousness, rales, SpO2, every 1-2 hours. If possible, invasive arterial blood pressure monitoring should be performed.
Trẻ mắc chân tay miệng cấp độ 3 cần được điều trị nội trú tại bệnh viện
3. Effective prevention of hand, foot and mouth disease
Currently, Vietnam as well as the world does not have an effective vaccine to prevent hand, foot and mouth disease. The disease is spread by ways such as contact with nasopharyngeal secretions, fluid from the patient's blisters, and feces, so the best way to prevent the disease is to practice clean personal hygiene, conduct medical care. timely care for sick children.Typical hand, foot and mouth precautions:
Wash hands with soap before preparing food and eating; before feeding young children and after changing diapers and clothes for sick children. Cooked food, boiled water Clean dirty objects with soap and water Avoid close contact with sick people If the child is sick, keep the child at home, do not go to class, go to crowded places until healthy children. Cover mouth and nose when coughing and sneezing. Dispose of used diapers and tissues in the trash and dispose of them properly. If your child has a fever, take them to a health facility. Clean the house. If not treated promptly, the child can have severe neurological and cardiovascular complications. Therefore, please take your child to medical facilities for examination and treatment if the child has the above-mentioned signs of hand, foot and mouth.
Master. Doctor. Nguyen Thi An, former Head of Pediatrics Department, Quang Ninh General Hospital, is a person who is very passionate about health care for children and successfully treats many difficult cases. Currently, he is a Pediatrician - Neonatologist - Neonatology Department of Vinmec Ha Long International General Hospital.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
