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This form is to be completed by the attending physician for the request of parenteral therapy for severe malaria, including necessary patient and treatment details.
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How to fill out PARENTERAL THERAPY FOR SEVERE MALARIA - FORM A

01
Gather all necessary patient information, including name, age, weight, and medical history.
02
Assess the severity of malaria symptoms and confirm the diagnosis.
03
Select the appropriate parenteral antimalarial medication, typically artesunate or quinine.
04
Calculate the correct dosage based on the patient's weight and clinical guidelines.
05
Prepare the medication according to the manufacturer's instructions.
06
Administer the medication intravenously or intramuscularly, as per guidelines.
07
Monitor the patient for any adverse reactions during and after administration.
08
Document the treatment details in the patient's medical record.
09
Schedule regular follow-ups to assess the patient's recovery and response to treatment.

Who needs PARENTERAL THERAPY FOR SEVERE MALARIA - FORM A?

01
Patients diagnosed with severe malaria, characterized by severe symptoms such as altered mental status, severe anemia, respiratory distress, or multi-organ failure.
02
Individuals who cannot take oral antimalarial medications due to vomiting or inability to swallow.
03
Patients who are at high risk of complications from malaria, including pregnant women and young children.
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Give parenteral antimalarials for a minimum of 24hrs once started (irrespective of the patient's ability to tolerate oral medication earlier), and, thereafter, complete treatment by giving a complete course of: – an ACT – artesunate + or – quinine + or .
Artesunate injection is used to treat severe malaria. This medicine is also used together with other medicines (eg, 8-aminoquinoline medicine) to treat severe malaria caused by Plasmodium ovale or Plasmodium vivax. Artesunate belongs to a group of medicines known as antimalarials.
Each dose of IV artesunate is 2.4 mg/kg. A dose of IV artesunate should be given at 0, 12, and 24 hours. Note that the weight-based dosing applies to both adults and children. Previously, weight-based dosing was differentiated between children <20kg and those ≥20kg.
Parenteral artesunate: The recommended treatment for severe malaria. Dosing: Artesunate 2.4 mg/kg body weight (bw) administered intravenously (IV) or intramuscularly (IM) at the time of admission (time=0), then at 12h and 24 h, then once a day until the patient is able to take oral medication.
Patients with severe malaria, regardless of infecting species, should be treated with intravenous (IV) artesunate.
Dosage and duration One dose on admission (H0) then 12 hours after admission (H12) then 24 hours after admission (H24) then, once daily. Administer parenterally at least 24 hours (3 doses), then, if the patient can tolerate the oral route, change to a complete 3-day course of an artemisinin-based combination.
Dosage and duration One dose on admission (H0) then 12 hours after admission (H12) then 24 hours after admission (H24) then, once daily. Administer for at least 24 hours (minimum 3 doses), then, if the patient can tolerate the oral route, change to a full 3-day course of an artemisinin-based combination (ACT).

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PARENTERAL THERAPY FOR SEVERE MALARIA - FORM A is a standardized document used to report and track the administration of intravenous therapies in patients diagnosed with severe malaria.
Healthcare providers administering parenteral therapy for severe malaria, such as physicians and nurses in clinical settings, are required to file PARENTERAL THERAPY FOR SEVERE MALARIA - FORM A.
To fill out the form, include patient demographics, treatment details, dosage information, administration times, and healthcare provider signatures as required by the specific guidelines provided with the form.
The purpose of the form is to ensure proper documentation of treatment provided to patients with severe malaria, facilitate monitoring and evaluation of treatment outcomes, and comply with health regulations.
Information that must be reported includes patient name, age, diagnosis, treatment regimen, dates of therapy, healthcare provider details, and any adverse reactions or complications encountered during treatment.
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