Utilização de sinais de alarme para Dengue Grave em crianças por profissionais do Sistema Único de Saúde

摘要: Introduction: Dengue is a disease with broad clinical spectrum. T he early recognition and treatment of severe cases the main strategy to reduce lethality. The revised dengue case classification proposed by World Health Organization (WHO), as well management guideline adopted Brazilian Minis try (MS), emphasizes the early identification warning signs predictors outcomes. In Brazil, since 2008, the incidence pediatric has been increased. The diagnosis cases among children difficult since they are usually oligosymptomatic, rapid progression shock syndrome without hemorrhagic manifestations . Objective: To identify signs in recognized health personnel National Health System (SUS) using t he version an instrument WHO. Methods : Translation back translation of WHO followed expert panel consensus and a pretest first prototype version. survey was conducted 2011 b y applying final questionnaire physicians (MD), nurses (N) nurse assistants (NA) two primary care units , one secondary tertiary care facilities SUS (n=488). Data collection included socio - demog raphic characteristics, clinical experience, use ranking warning defined MS. chi - square Kruskal - Wallis tests (p<0.05) were used assess whether there differences according to level occupations. R esults: Only item instrument, related signs, rephrased ease understanding. Of total, 474 (97%) participants filled out questionnaire; 40% MD, 2 3% N e 37% NA; 75% them from facilities. Mucosal bleeding abdominal pain were most commonly refer patients higher level care. Ninety percent all participants reported most frequently cited major bleeding, hemoconcentration/thrombocytopenia ; less abdominal tenderness hepatomegaly. three most - cited at secondary There sta tistical significant occupations, particularly for fluid effusion , mucosal bleeding, lethargy respiratory distress (p<0.01). Despite wide range scores assigned each sign hemoconcentration concurre nt thrombocytopenia more often ranked important sign. Physicians emphasized "hypotension/collapse" "lethargy/restlessness" while stressed importance "nose gum bleeding". Discussion: D engue widely practice. Bleeding and hemoconcentration/thrombocytopenia highly valued, but directly severity received attention. These results suggest need revision in clinical management trainings personnel working children. Clinical should be emphasized, considering different roles health professional.