Is hospital ready for epidemic?

SINGAPORE - I recently visited the accident and emergency (A&E) department at Tan Tock Seng Hospital after having a high fever for three days.

During the visit, I told the medical staff that a general practitioner suspected I had dengue fever.

The doctors did a blood test and allowed me to go home after prescribing medication for fever, nausea and stomach cramps.

I had to return to the A&E department the next night because I was still feeling unwell.

While a nurse attended to me promptly, and I was wheeled in for treatment after I notified the staff that I was in a bad condition following the first visit, I encountered several issues that made me wonder if the hospital is ready for the dengue epidemic:

  • I was given a wrist tag indicating that I had no drug allergy even though this was not the case.
  • The doctor did not update the system on the medication he had given me, and I was nearly given a second dose within five minutes of the first one.
  • The nurse turned on the drip for me only when my husband reminded her to do so.

Even after a second blood test, the doctor still did not know what was wrong with me, so he sent me for X-rays.

I was admitted to the hospital and informed that I had dengue only at the end of the next day.

Khoh Chin Hwei (Ms)

Hospital's reply: Doctors have to check for other conditions

Our emergency department has treated about 86,000 patients since the start of the year.

To date, despite the current dengue epidemic, only 2.5 per cent of the total cases seen at the department have been for dengue. The majority of the patients needed treatment for known or ill-defined conditions other than dengue.

Hence, it is prudent for our emergency department doctors to consider all possible causes, including dengue, so as not to miss out on any other serious and treatable conditions.

Ms Khoh Chin Hwei visited our emergency department on April 20 for fever, vomiting and abdominal pain.

She was diagnosed with viral fever as her symptoms were consistent with many common infections. In addition, her platelet count was normal.

She was discharged with medication and advised to return if her symptoms worsened.

She returned the next day for persistent vomiting with streaks of blood and abdominal pain. Her fever had subsided by then.

Blood tests and chest X-rays were ordered concurrently to check for a possible oesophagus tear from her severe vomiting.

Ms Khoh was then admitted for further investigations and closer monitoring. She tested positive for dengue during her hospitalisation, and we treated her accordingly.

She recovered well and was discharged after three days. She was followed up at our Infectious Disease Clinic.

Once again, we apologise to Ms Khoh for not communicating better on her treatment plan and for the service lapses cited.

We will do our best to better care for and meet the expectations of our patients. We thank Ms Khoh for her feedback and wish her well.

Thomas Lew (Associate Professor) Chairman, Medical Board Tan Tock Seng Hospital

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