Professional Documents
Culture Documents
For WHOM?
Community Children: One week to 2 months Age 2 months to 5 years
Main Concerns: Cough or Difficult Breathing (ARI) Diarrhea Malaria Measles Ear Infections Malnutrition Breastfeeding Preventive Activities: Vaccinations & Vitamin A Algorithm: Check for Danger Signs
Referral Facility
(pink)
Home Management
(green)
Out-patient Management: Children 2 months to 5 years History-taking General Danger Signs Main Symptoms Nutritional Status Immunization Status Other Problems
History-taking
Main Symptoms
Nutritional Status Immunization Status Other Problems
Main Symptoms
Assess for:
Respiratory rate Lower chest wall in-drawing Stridor
Fast Breathing
(green)
Interventions: Give the 1st dose of an appropriate antibiotic Give Vitamin A Treat the child to prevent the lowering of his or her blood sugar level Refer the child URGENTLY to a hospital Give an appropriate antibiotic for 5 days Soothe the throat and relieve the cough with a safe remedy Advice the mother regarding when to return to the health center Follow-up in 2 days If the coughing persists for more than 30 days, refer to a hospital for assessment Soothe the throat and relieve the cough with a safe remedy Advise the mother regarding when to return to the health center Follow-up in 5 days if no improvement is observed If the coughing persists for more than 30 days, refer to a hospital for assessment Soothe the throat and relieve the cough with a safe remedy Advise the mother regarding when to return to the health center Follow-up in 5 days if no improvement is observed
Main Symptoms
- Cough or difficult breathing
- Diarrhea
- Fever - Ear problems Nutritional Status Immunization Status Other Problems
Assess for
General condition Sunken eyes Reaction when offered a drink Elasticity of the skin
Classification of Dehydration
(pink) (pink)
2 of these signs: - Lethargic or unconscious - Sunken eyes - Not able to drink or drinking poorly - Skin pinch go back very slowly
(yellow) (yellow)
Severe Dehydration
2 of these signs: - Restless, irritable - Sunken eyes - Skin pinch go back slowly
(green) (green)
Some Dehydration
NO Dehydration
Interventions: If the child has no other severe classification: Give fluid for severe dehydration OR If the child has another severe classification: Refer the child URGENTLY to a hospital, with the mother giving the child frequent sips of ORS on the way. Advise the mother to continue breastfeeding the child. If the child is 2 yrs old or older, and there is cholera in your area: Give the child an antibiotic for cholera Give fluid and food Advice the mother regarding when to return to the health center immediately. Follow-up in 5 days if no improvement is observed Give fluid and food Advice the mother regarding when to return to the health center immediately. Follow-up in 5 days if no improvement is observed
Main Symptoms
- Cough or difficult breathing - Diarrhea
- Fever
- Ear problems Nutritional Status Immunization Status Other Problems
Assess for:
Stiff neck Risk of malaria Runny nose Duration of fever Risk of measles
Classification of Fever
(pink) (pink)
fever @ 37.5 and above in high malaria risk area no runny nose, no measles and no other causes of fever in low malaria risk areas
(yellow)
Malaria
(yellow)
(yellow)
pus draining from eye or mouth ulcers In low malaria risk area -Runny nose present or -Measles present or -other causes of fever present
(green)
(green)
(green)
Uncomplicated Fever
(green)
Measles
Main Symptoms
- Cough or difficult breathing - Diarrhea - Fever
- Ear problems
Nutritional Status Immunization Status Other Problems
Assess for:
Tender swelling behind the ear Ear pain Ear discharge or pus
(yellow)
Ear discharge in less than 14 days Or ear pain Ear discharge for more then 14 days
(green)
(green)
NO ear pain and NO ear discharge seen draining from the ears
History-taking General Danger Signs Main Symptoms - Cough or difficult breathing - Diarrhea - Fever - Ear problems
Nutritional Status
Immunization Status Other Problems
History-taking General Danger Signs Main Symptoms - Cough or difficult breathing - Diarrhea - Fever - Ear problems Nutritional Status
Immunization Status
Other Problems
Out-patient Management: Children 1 week to 2 months Check for possible bacterial infection Assess for presence of diarrhea Check for feeding problems or low birth weight Check for immunization status Check for other problems Classification of Bacterial Infections Convulsions Fast breathing Severe chest in-drawing Nasal flaring Grunting Bulging fontanelle Pus drainage from ear Umbilical redness extending to skin Fever or hypothermia Many or severe skin pustules Lethargy or unconsciousness Less than the normal movement
Classification of Feeding Problems or Low Weight Not able to feed No attachment at all No sucking at all Not well attached to breast Not sucking effectively Fed fewer than 8 times in 24 hours Receiving other food or drinks Low weight for age Thrush Possible Bacterial Infection
Not low weight for age and no other signs of inadequate feeding
NO FEEDING PROBLEMS
For all children before referral: Give breast milk or sugar water Convulsions Severe pneumonia/ Mastoiditis Severe Complicated Measles Severe malnutrition Malaria Diazepam (10mg/2ml) 0.1 ml/kg Cotrimoxazole or amoxicillin
Vitamin A
First line anti-malarial Chloroquine and Primaquine Second-line anti-malarial Sulfadoxine and Pyrimethamine