23 IMCI Chart Booklet Timor Leste

8/6/2019 23 IMCI Chart Booklet Timor Leste

1/34


2/34


3/34


4/34


5/34


6/34

6

Does the child have an ear problem?

Tender swelling behind theear

MASTOIDITIS

Give first dose of anappropriate antibiotic

Give first dose ofparacetamol for pain

Refer URGENTLY to

hospital

Pus is seen draining fromthe ear and discharge isreported for less than 14days, or

Ear pain

ACUTE EAR INFECTION

Give an antibiotic for5 days.

Give paracetamol forpain.

Dry the ear by wicking Follow-up in 5 days.

Pus is seen draining fromthe ear and discharge isreported for 14 days or

more

CHRONIC EARINFECTION

Give ear dropsantibiotic for 2 weeks

Give Dry the ear by

wicking. Follow up in 5 days

No ear pain and No pusseen draining from the ear. NO EAR

INFECTIONNo additional treatment

IF YES, ASK:

Is there ear pain?

Is there ear discharge ?

if yes, for how long?

ClassifyEARPROBLEM

LOOK AND FEEL:

Look for pus drainingform the ear

Feel for tender swelling

behind the ear


7/34

7

THEN CHECK FOR MALNUTRITION AND ANAEMIA

LOOK AND FEEL:

Look for visible severe

wasting.

Look for palmar pallor. Is it:- Severe palmar pallor?- Some palmar pallor?

Look for oedema of both feet.

Determine weight for age

ClassifyNUTRITIONALSTATUS

Visible severe wasting or

Severe Palmar pallor or

Oedema of both feet

Some palmar pallor or

Very low weight for age

Not very low weight for ageand no other signs ofmalnutrition

SEVEREMALNUTRITION

AND/OR SEVERE

ANAEMIA

ANAEMIAAND/OR

VERY LOWWEIGHT

NO ANAEMIAAND

VERY LOWWEIGHT

Give vitamin A for < 6 months, if visible severewasting or oedema on both feet.

Refer URGENTLY to Hospital

Assess the childs feeding and counsel the mother- On feeding according to the FOOD box on the

COUNSEL THE MOTHER chart.- If feeding problem, follow-up in 5 days

If Anemia- Give iron- Give vit A for > 6 months old and if none was given in

the last one month.- Give Albendazole (only if child is 2 - 5 years and has not

had a dose in the previous 6 months).- Follow-up after 4 weeks

Advice mother when to return immediately. If very low weight for age, refer to a supplementary

feeding program and follow-up in 4 weeks

If child is less than 2 years old, assess the childsfeeding according to the FOOD box on theCOUNSEL THE MOTHER CHART

If feeding problem, follow up in 5 days Advise mother when to return immediately

THEN CHECK THE CHILDS IMMUNIZATION STATUS CHECK VITAMIN A STATUS CHECK ANTIHELMINTHIC STATUS

ASSESS OTHER PROBLEMS

MAKE SURE CHILD WITH ANY GENERAL DANGER SIGN IS REFERREDafter first dose of an appropriate antibiotic and other urgent treatments.Exception: Rehydration of the severely daily dehydration child according to plan C may resolve danger signs so that referral is no longer needed.

* AGE VACCINEAt birth BCG OPV-0

IMMUNIZATION 6 weeks Hep B-1 OPV-1 DPT-1SCHEDULE: 10 weeks Hep B-2 OPV-2 DPT-2

14 weeks Hep B-3 OPV-3 DPT-39 months Measles

VITAMIN A SCHEDULE

First dose 100 000IU for 6 months up to1 year. Next dose 200.000 IU every 6months (age 1 year to 5 years), Februaryand August. If a child has not received adose in last 6 months, give a dose.

*ANTIHEMINTHIC COVEREDAll children 1 to 5 years should receiveworm medicine albendazole single doseevery 6 months


8/34


9/34

9

TEACH THE MOTHER TO GIVE ORAL DRUGS AT HOME:

Follow the instructions below for every oral drug to be given at home.Also follow the instructions listed with each drugs dosage table

Dysentry: Give antibiotic recommended for shigella for 5 days

FIRST LINE ANTIBIOTIC: CIPROFLOXACIN

SECOND LINE ANTIBIOTIC: NALIDIXID ACID

CIPROFLOXACIN NALIDIXID ACID

AGE Tablet 500 mgor Give 4 times a day

Give 2 times a dayfor 3 days

WEIGHT for 5 daysWEIGHT

100 mg 250 mg 2 to 4 months

3 - < 6 kg (4 -


10/34

10


Give an Oral Antimalarial

FIRST LINE ANTIMALARIAL: Artemether-Lumefantrine(Coartem) or ChloroquineSECOND - LINE ANTIMALARIAL: Quinine + Clindamycin

FOR COARTEM (malaria falciparum & mix infections)

Explain to the mother that she should watch her childcarefully for 1 hour after giving a dose of coartem. If thechild vomits within 1 hour, she should repeat the dose andreturn to the clinic for additional tablets.

Tell the mother that, the child must eat coartem tablet assoon as it is taken out from the blisters. If the tablet isexposed to air the medicine becomes ineffective.

Explain to the mother that for small children, paracetamol

and coartem can be crushed, diluted in water and then puteither directly into the mouth using a syringe or given with aspoon.

ARTEMETHER LUMEFANTRINE (Coartem)

Age groupWeightgroup

Blistercolor

(Day 1) (Day 2) (Day 3)

1 tb, 1 tb, 1 tb ,4 monthsto 5y

5 to 14kg

Yellow1 tb 1 tb 1 tb

FOR CHLOROQUINE (malaria vivax):

Explain to the mother that she should watch her child carefully for30 minutes after giving a dose of chloroquine. If the child vomitswithin 30 minutes, she should repeat the dose and return to theclinic for additional tablets.

Explain than itching is a possible side effect of the drug, but is not

dangerous.

CHLOROQUINEGive daily for 3 days

PRIMAQUIINE

TABLET(150 mg base)

TABLET(300 mg)

AGE or WEIGHT

Day 1 Day 2 Day 3 3 times daily for 7 days

2 4 months(


11/34

11


Follow the instructions below for every oral drug to be given at home.Also follow the instructions listed with each drugs dosage table

Give Paracetamol for High Fever (38.5 C) orEar Pain

PARACETAMOLAGE

orWEIGHT

TABLET 500mg

TABLET100mg

Syrup(120mg/5ml)

2months to 6 months(4


12/34

12

TEACH THE MOTHER TO TREAT LOCAL INFECTION AT HOME

Explain to the mother what the treatment is and why it should be given. Describe the treatment steps listed in the appropriate box. Watch the mother as she does the first treatment in the clinic

(Except remedy for cough or core throat). Tell her how often to do the treatment at home If needed for treatment at home, give mother the tube of

Tetracycline/ chlorampenicol ointment or a small bottle of gentian violet Check the mothers understanding before she leaves the clinic

Clear the ear by dry wicking and give eardrops Dry the ear at least 3 times daily Roll clean absorbent cloth or soft, strong tissue paper into a wick Place the wick in the childs ear Remove the wick when wet Replace the wick with a clean one and repeat these steps until the ear is

dry Lie the child down turn the head on the side and drop the ear drop Give ciprofloxacin ear drop once a day for 2 weeks.

Treat mouth Ulcers with Gentian Violet

Treat the mouth ulcers twice daily Wash hands Wash the childs mouth with clean soft wrapped around

the finger and wet with salt water Paint the mouth with gentian violet. 0.5% in child mouth Wash hands again

Soothe the Throat, Relieve the Cough witha Safe Remedy

Safe remedies to recommend:-Exclusively Breast milk to breastfed infant up to 6 months.- Sweet soy sauce or honey mixed with lime water

Harmful remedies to discourage

- All commercial cough syrups that contain codeine- Decongestant food for oral or spray/ nose drops

Treat Eye Infection with Tetracycline orChloramphenicol Eye Ointment

Clean both eyes 3 times daily

Wash hands

Ask child to close the eyes

Use clean cloth and water to gently wipe away pus

Then apply Tetracycline/ Chloramphenicol ointment in both eyes 3 times daily

Ask the child to look up Squirt a small amount of ointment on the inside of the lower lid

Wash hands again

Treat until redness is gone

Do not use other eye ointments or drops, or put anything else in the eye


13/34

13

GIVE THESE TREATMENTS IN CLINIC ONLY

Explain to the mother why the drug is given

Determine the dose appropriate for the childs weight (or age)

Use a sterile needle and sterile syringe. Measure the dose accurately

Give the drug as a intramuscular injection

If child cannot be referred, follow the instructions provided

Give An Intramuscular AntibioticFOR CHILDREN BEING REFERRED URGENTLY WHOCANNOT TAKE AN ORAL ANTIBIOTIC:

Give first dose of intramuscular chlorampenicol and refer child urgentlyto hospital

IF REFERRAL IS NOT POSSIBLE:

Repeat the chlorampenicol injection every 12 hours for 5 days

Then change to an appropriate antibiotic to complete 10 daystreatment.

AGE or WEIGHTCHLORAMPHENICOL

Dose: 40 mg per kgAdd 5.0 ml sterile water to vial

containing1000 mg = 5.6 ml at 180 mg/ml

2 months up to 4 months (4 - < 6 kg) 1.0 ml = 180 mg



12 months up to 3 years (10 - < 14 kg) 2.5 ml = 450 mg

3 years up to 5 years (14 19 kg) 3.5 ml = 630 mg

Give intramuscular antimalarial drugsFOR UNCOMPLICATED MALARIA FALCIPARUM IN YOUNG INFANT

Give IM Arteminisin derivatives first dose (preferably when available) andcontinue with the oral artesunate until day 7.

Administration of Artemisinin derivatives or Quinine for malaria falciparumfor 2-4months infant.

Artemisinin *Quinine

**First dose IMArtesunate (60mg) or

Artemether (40mg)

# OralArtesunate

(50mg)

Oral Quinine(300mg)

Agegroup

Weightgroup

Artesunate1.2 mg/kg

Artemether1.6 mg/kg

2mg/kg/day on day2 to day 7

10mg/kg TIDfor 4days

15-20mg/kgTID forthe next4 days

2 -


14/34

14

Give Quinine for Severe MalariaFOR CHILDREN BEING REFERRED WITH VERY SEVEREFEBRILE DISEASE: Check which quinine formulation is available in your clinic Give first dose of intramuscular quinine and refer immediately

IF REFERRAL IS NOT POSSIBLE AND THERE IS NO DOCTOR Give first dose of intramuscular quinine The child should remain lying down for one hour Repeat the quinine injection every 8 hours until the child is able to take

an oral antimalarial. Do not continue quinine injections for more than 1 week

Intramuscular QuinineAge or Weight

150 mg/ml* (in 2 mlampoules)

300 mg/ml* (in 2 mlampoules)

2 months up to 4months (4 < 6 kg)

0.4 ml 0.2 ml

4 months up to 12months (6 < 10kg)

0.6 ml 0.3 ml

12 months up to 2

years (10 < 12 kg) 0.8 ml 0.4 ml2 years up to 3 years

(12 < 14 kg)1.0 ml 0.5 ml

3 years up to 5 years(14 < 19 kg)

1.2 ml 0.6ml

* Quinine salt solution

Give Artesunate Suppository for Severe MalariaFOR CHILDREN BEING REFERRED WITH VERY SEVEREFEBRILE DISEASE/ MALARIA:

Give single dose Artesunate suppository and refer immediately tohospital.

AgeWeight

group (kg)Artesunatedose (mg)

Regimen (single dose)

0 12months

5 8.9 50 One 50 mg suppository

13 42months

9 19 100 One 100 mg suppository

43 60months

20 29 200Two 100 mgsuppositories

In case Artesunate is not available, give Quinine for children with severemalaria.


15/34


16/34

16

GIVE TREATMENT IN CLINIC ONLY

Explain to the mother why the drug is given Determine the dose appropriate for the childs weight (or age)

Oral Salbutamol

Give oral salbutamol three times daily for 5 days

when inhaled salbutamol is not available.

Dosage and administration of oral Salbutamol

Treat the child to prevent low blood sugar

If the child is able to breastfeed:

Ask the mother to breastfeed the child

If the child is not able to breastfeed but able toswallow:

Give expressed breast milk or breast milk substitute. Ifneither of these is available, give sugar water. Give 30 50 ml of milk or sugar water before departure.

To make sugar water: dissolve 4 level tea spoons ofsugar (20 grams) in a 200-ml cup of clean water

If the child is not able to swallow:

Give 50 ml of milk or sugar water using a nasogastrictube (exception for dengue fever)*

If nasogastric not available, refer urgently

* Insertion of a nasogastric tube in a dengue fever patient cancause bleeding of the gastro intestinal system.

Age orWeight

Syrup 2mg/ml

2 4 months(4 - < 6kg)

1 ml

4 12 months(6 - < 10kg)

2 ml

12 months 3 years(10 - < 14kg)

2.5 ml

3 - 5 years(14 19kg)

5 ml


17/34


18/34


19/34


20/34


21/34


22/34

22

COUNSEL THE MOTHER

GIVE FOLLOW-UP CARE

Care for the child who returns for follow-up using all the boxes that match the childs previous classifications. If the child has any new problem, assess, classify and treat the new problem as on the ASSESS AND CLASSIFY chart.

VERY LOW WEIGHT

After 4 weeks:

Weigh the child and determine if the child is still very low weight for age.

Reassess feeding. => See questions at the top of the COUNSELING THEMOTHER chart.

Treatment:

If the child isno longer very low weight for age, praise themother and encourage her to continue.

If the child is still very low weight for age, counsel the mother

about any feeding problem found. Continue to see the childmonthly until the child is feeding well and gaining weightregularly or is no longer very low weight for age.

Exception:

If you do not think that feeding will improve, or if the child has lost weight,

refer the child.

IF ANY MORE FOLLOW-UP VISITS ARE

NEEDED BASED ON THE INITIAL VISIT OR

THIS VISIT,ADVISE THE MOTHER OF THE

NEXT FOLLOW-UP VISIT

ALSO, ADVISE THE MOTHER

WHEN TO RETURN IMMDIATELY.(SEE COUNSELING THE MOTHER CHART)


23/34

23

FOOD

Assess the Childs Feeding

Ask questions about the childs usual feeding and feeding during this illness. Compare the mothers answers to

the Feeding Recommendations for the childs age in the box below.

ASK Do you breastfeed your child?

o How many times during the day?o Do you also breastfeed during the night?

Does the child take any other food or fluids?

o What food or fluids?o How many times per day?

oWhat do you use to feed the child?

o If very low weight for age: How large are servings? Does the child receive his own serving?o Who feeds the child and how?

During this illness, has the childs feeding changed? If yes, how?


24/34

24

Feeding recommendation During Sickness and Health *

Breastfeed as often as the childwants, day and night, at least 8

times in 24 hours.

Do not give other foods orfluids.

6 months up to 12 months

begin with Breastfeed

as often as the child wants,day and night, at least 8

times in 24 hours.

Give other

foods 2 times per day after

breastfeeding, each time 2tablespoons.

Breastfeedbefore give other food(add food).

Add Foods as:

- Mashed rice-porridgeadded with egg yolk /chicken / fish / soy bean /tofu / beef / carrot /

spinach / green beans / oil.

6 months up to 12 months

after baby tolerating

quantities in column to the

left then gradually increase

as below

Breastfeed asOften as the child wants.

Give rice porridge

and egg yolk / chicken / fish /soy bean / tofu / beef / carrot /spinach / green beans / oil.

Give daily

foods in 3 times a day, giveadequate serving of:-6 months = 6 table spoons

-7 months = 7 table spoons-8 months = 8 table spoons-9 months = 8 table spoons-10 months = 10 table spoons

-11 months = 11 table spoons

Give additional foodsin 2 times a day:

-Green bean porridge, banana,biscuit, steamed cassava.

Breastfeed as

often as the child wants.

Give steamed ricewith egg yolk / chicken / fish /soy bean / tofu / beef / carrot /

spinach / green bean /oil

Give add foods 2times a day:-green beans porridge, banana,

biscuit, steamed cassava.

Give family foods at 3 mealseach day as: consisting of rice,

meat, side dishes, vegetablesand fruits.

Give add foods 2

times a day:

-Green bean porridge-Biscuit

-Steamed cassava.


25/34


26/34

26

8. Always wash your hands with soap and water before preparing food and after going to the toilet, and wash childrens hands before they

begin eating.WHY? This will help prevent children from getting diarrhea and many other illnesses.

9. When starting to give foods to the young baby, make the food soft and thick and not runny or watery. You can add a little oil, to

increase the energy in the food.

WHY?If the food is watery, the baby will not put on weight and grow well.

10. Give babies from six months and young children a variety of food to eat, like ripe banana, papaya, pumpkin, mango, rice porridge,

mashed potato, chicken, fish, meat, eggs, corn, beans, and dark green leafy vegetables,

WHY? Young children need to eat a variety of foods so they will grow well.

11.Dont forget to add a little iodised salt to the young childs food.

Why? Iodine is important for the mental and physical development of children and also important for pregnant women.

12.Feed the young child many times during the day.

WHY? A young child is growing rapidly and has a small stomach. So that he can grow and develop he needs to eat often many meals and snacks

throughout the day.

13. Continue to breast-feed when a child is sick, and, if the child is over six months encourage him/her to eat and drink and give him/her

extra food when he is well again.

WHY? If the child does not eat he will lose weight, become weak and is more likely to get sick again.


27/34

27

Important; Dont forget to take your baby or young child to the health clinic every month for growth monitoring, vaccinations,

vitamin A, and de-worming tablets, and other health assistance!

The table below provides some guidelines on types of foods, frequency and quantity for different age

groups of children.

Age

group

How to prepare the food How many times in the

day

How many spoons

or cups

each time

6

months

Rice porridge mixed with soft

pumpkin, potato, ripe banana or

pawpaw, tofu, and later, egg

yolk.

2 times and breastfeed

often

6 9 small

spoons

7-8

months

Rice porridge mixed with soft

pumpkin, potato, ripe banana or

pawpaw, egg yolk, meat, fish,

with bones removed, tempura,

tofu, green leafy vegetables.

Fruits

3 times, and breastfeed

often

Increase slowly

the quantity of

food up to about

two thirds of a

cup

9-11

months

All kinds of food, soft, cut into

small pieces and which baby can

hold and feed himself.

Fruits

3 times, and aslo snacks

between meals, and

breastmilk as much as the

child wants

About a cup of

food

12-24months

All kinds of foods eaten by therest of the family, cut small

and made soft as necessary

Fruits

3 times, and aslo snacksbetween meals, and

breastmilk as much the

child wants

A full cup or moreafter each meal


28/34

28

*Counsel the Mother about Feeding Problems

If the child is not being fed as described in the above recommendations, counsel the mother accordingly. In addition:

If the mother reports difficulty with breastfeeding, assess breastfeeding. (see YOUNG INFANT Chart.)

As needed, show the mother correct positioning and attachment for breastfeeding.

If the child is less than 6 months old and is taking other milk or foods:- Build mothers confidence that she can produce all the breast milk that the child needs.

- Suggest giving more frequent, longer breastfeeds, day and night, and gradually reducing other milk or foodsIf other milk needs to be continued, counsel the mother to:

- Breastfeed as much as possible, including night.- Make sure that other milk is locally appropriate breast milk substitute.- Make sure other milk is correctly and hygienically prepared and given in adequate amounts.- Prepare only an amount of milk which the child can consume within one hour. If there is some left-over milk, discard.

If the mother is using a bottle to feed the child:- Recommend substitutinga cup for bottle.- Show the mother how to feed the child with cup.

If the child is not being fed actively, counsel the mother to:

- Sit with the child and encourage eating.- Give the child an adequate serving in a separate plate or bowl.- observe what the child likes, and consider these in the preparation the child foods.

If the child is not feeding well during illness, counsel the mother to: - Breastfeed more frequently and for longer if possible.- Use soft, varied, appetizing, favorite foods to encourage the child to eat as much as possible, and offer frequent small feedings.- Clear a blocked nose if it interferes with feeding.- Expect that appetite will improve, as child gets better.

Follow-up any feeding problem in 5 days.


29/34

29

Teach Correct Positioning and Attachment for Breastfeeding Show the mother how to hold her baby correctly

- With the babys head and body straight- Facing her breast, with babys nose opposite her nipple- With baby body close to her body- Supporting babys whole body, not only neck and shoulders.

Show her how to help the baby to attach properly. Ensure the mother holds the baby correctly with the babys noseopposite her nipple. Do the following steps:

- touch her babys lips with her nipple- then wait until her babys mouth open wide- after mouth opens wide, attach the baby mouth onto her breast immediately such that her nipple inside babys

mouth, aiming the babys lower lip well below the nipple.

Observe good signs of attachment and sucking effectively. If not, try once again.


30/34

30

FLUID

WHEN TO RETURN

Advise the mother to Increase Fluid During IllnessFOR ANY SICK CHILD:

Breastfeed more frequently and for longer at each feed. Increase fluid. For example, give soup, rice water, yogurt drinks or clean water.FOR CHILD WITH DIARRHOEA:

Giving extra fluid can be lifesaving. Give fluid according to Plan A or Plan B on TREAT THE CHILD chart.

Advise the Mother When to ReturnFOLLOW-UP VISIT:

Advise the mother to come for follow-up at the earliest time listed for the childs problems.

If the child has: Follow-up in:

MAYBE DENGUE FEVER, until fever has resolved 2

days or another caused of the fever has been found.

daily

FEVER-MAYBE NOT DENGUE FEVER, if fever persistsMEASLES WITH EYE OR MOUTH COMPLICATIONSPNEUMONIADYSENTRY

2 days

MALARIA if fever persists 3 days

PERSISTENT DIARRHOEA

ACUTE EAR INFECTION

CHRONIC EAR INFECTIONFEEDING PROBLEM

ANY OTHER ILLNESS, if not improving

5 days

ANAEMIA 4 weeks/1 month

VERY LOW WEIGHT FOR AGE 4 weeks/1 month

NEXT WELL CHILD VISIT:

Advise the mother when to return for the next immunization and vitamin A supplementation according to the respective schedules.

RETURN IMMEDIATELY:

Advise mother to return immediately if the child has any of these signs:

Any sick child

Not able to drink

Becomes sicker Develops a fever

Child with cough: notpneumonia

Difficult breathing Fast breathing

If child has diarrhoea Any bleeding Cold and clammy extremities

Pit of the stomach pain and restless Vomit repeatedly

If child has DHF or fevermaybe not Dengue Fever

Any bleeding signs Cold and clammy extremities Pit of the stomach pain and restless

Vomiting weak or drowsy Refusing to eat Restless and altered behaviour

Cold and clummy skin No urine for 4 6 hours


31/34

31

Counsel the Mother about Her Own Health

If the mother is sick, provide any care for her, refer her for help

If she has a breast problem (such as engorgement, sore nipples, and breast infection), provide care for her or refer for help

Advise her to eat well to keep up her own strength and health.

Check the mothers immunization status and give her tetanus toxoid (TT) if needed.

Make sure she access to:

- Family planning

- Counseling on STD and AIDS prevention

MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS


32/34

NAME:____________________ Age:______ weight: ______kg Temperature __________ C

ASK: What are the childs problems?_____________ Initial visit?________ Follow-up visit_______

ASSESS (Circle all signs present) CLASSIFY TREATMENT

CHECK FOR GENERAL DANGER SIGNS Not able to drink or breastfeed Lethargic or unconscious Vomiting everything

Convulsion

Common danger signs

Yes___ No___

Remember to use

danger sign when

selecting classifications

Remember to refer

every child who hasgeneral danger signs

DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING?

Yes__ No__

For how long?___ Days Count the breaths in oneminute._______Breaths per

minute. Fast breathing?

Look for the chest indrawing.

Look and listen for stridor or wheezing

DOES THE CHILD HAVE DIARRHOEA? Yes______ No______

For how long?___ Days Look at the child general condition. Is the Is there blood in the stool? child:

Lethargic or unconscious?Restless and irritable?

Look for sunken eyes.

Offer the child fluid. Is the child:Not able to drink or drinking poorly?Drinking eagerly, thirsty?

Pinch the skin of the abdomen. Does it go

back:Very slowly (longer than 2 seconds)?

Slowly?

Blood smear taken?

Yes___ No___

DOES THE CHILD HAVE FEVER? Yes_____ No______(by history/feels hot/temperature 37.5C or above)

IF YES:

For how long has the child had fever? ____Days

If more than 7 days, has fever been present every day?

Has child had measles within the last 3 months?

Look or feel for stiff neck.

Look for signs of MEASLES:- Generalized rash and

- One of these: cough, runny nose, or red eyes.

If the child has measles now or within the last 3 months:

Look for mouth ulcers or thrush.

If yes, are they deep and extensive? Look for pus draining from the eye.

Look for the clouding of the cornea

Classify DENGUE FEVER if FEVER present from 2 to less than 7 days

Any severe bleeding from nose or gums

ASSESS (Circle all sign present) CLASSIFYTREATMENT


33/34

DOES THE CHILD HAVE AN EAR PROBLEM? Yes___ No___

Is there ear pain? Look for pus draining from the eye.

Is there ear discharges? Feel for tender swelling behind the earIf yes, for how long?___ days

THENCHECK FOR MALNUTRITION AND ANAEMIA?

Look for visible severe wasting.

Look for palmar pallor

- Severe palmar pallor?

- Some palmar pallor

Look for oedema of both feet.

Determine weight for age.

Very Low_____Not Very Low_____

CHECK THE CHILDS IMMUNIZATION STATUS

(Circle immunization needed today)

_____ _______ ______ ______

BCG Hep B1 Hep B2 Hep B3

_____ _____ _____ ______

DPT1 DPT2 DPT3 Campak

_____ _____ _____ _____Polio0 Polio1 Polio2 Polio3

Immunization to

be given to day:

CHECK THE CHILDS VITAMIN A SUPPLEMENT STATUS

Vitamin A Needed?Yes___ No___

Vitamin A to be

given today:Yes__ No__

CHECK THE CHILDREN AGED 1 - 5 YEAR ALBENDAZOLE

SUPPLEMENT STATUS?

ALBENDAZOLE Needed

Yes___ No___

Whether giveAlbendazole or to

day:Yes__ No__

ASSESS THE PROBLEM OR SIGNS

ASSESS CHILDS FEEDING if the child has ANAEMIA or VERY LOW

WEIGHT or CHILDS AGE< 2 YEARS

Do you breastfeed your child? Yes___ No___If yes, how many times in 24 hours? _______ Times.

Is the child breastfeed at night? Yes___ No___

Does the child receive other food or drink: Yes___ No___

If yes, what food and drink?________________________________________________________________

How many times per day? times What do you use to feed the child?

Feeding

problems:

Feeding

problems:


34/34

34

CORRECT TIME FOR

IMMUNIZATIONS

3 6 monthsRaise the head straightlyat face downward position

9 12 monthsWalk with holding

12 18 monthsDrinks alone andnot spill out

18 14 monthsScribble with pencilr l l int

2 3 yearsStand with one legwithout holding

2 3 yearsUndress on theirown

3 4 yearsRecognize and mentionat least one color

4 5 yearsWash and dry handswithout any help

Childs Growth andDevelopment ChartA healthy child will gain weight as they grow older

PERIOD FOR EXCLUSIVE BREASTFEEDING

Write childs age into this column

Write the subsequent months into the subsequent column

23 IMCI Chart Booklet Timor Leste

Documents

Transcript of 23 IMCI Chart Booklet Timor Leste