According to international guidelines, unless the platelet count is below 10,000/or there is spontaneous active bleeding, no platelet transfusion is required. The cause of death in dengue is capillary leakage, which causes blood deficiency in the intravascular compartment, leading to multiorgan failure. At the first instance of plasma leakage from intravascular compartment to extravascular compartment, 20 ml per kg body weight per hour of fluid replacement should be administered to the patient till the difference between upper and lower blood pressure is more than 40 mmHg or the patient passes adequate urine. Giving unnecessary platelet transfusion to the patient can harm the individual.Family doctors should remember the ‘Formula of 20’ to understand the severity of dengue.

1. Rise in pulse by 20

2. Fall in upper blood pressure by 20 mmHg

3. Pulse pressure lower than 20

4. Hematocrit increase by 20%

5. Platelet count less than 20,000

6. More than 20 petechiae in the tourniquet test