Caring for patients with rabies in developing countries – the neglected importance of palliative care. Issue 4 (17th February 2016)

• Record Type: Journal Article
• Authors: Tarantola, Arnaud; Crabol, Yoann; Mahendra, Bangalore Jayakrishnappa; In, Sotheary; Barennes, Hubert; Bourhy, Hervé; Peng, Yiksing; Ly, Sowath; Buchy, Philippe
• Is Part Of: Tropical medicine & international health. Volume 21:Issue 4(2016)
• Page Start: 564
• Page End: 567
• Publication Date: 2016-02-17
• Subjects: rabies -- treatment -- palliative care -- diazepam -- midazolam -- hydrophobia -- developing countries; rage -- traitement -- soins palliatifs -- diazépam -- midazolam -- hydrophobie -- pays en voie de développement; Rabia -- tratamiento -- cuidados paliativos -- diazepam -- midazolam -- hidrofobia -- países en vías de desarrollo; Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12670
• Languages: English
• ISSNs: 1360-2276

Abstract

Summary: 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.