IMCI UPDATED

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1. 2.

mortality & morbidity Healthy growth & development

To Improve: C-ase management skills; D-elivery system (health care) ; E-ncourage family & community practice

assess ` C- classify ` T- treat/ identify` A` C-

counsel ` F- follow up care

`C- cough/ Dif. Of breathing

`D- diarrhea `F- fever `E- ear pain

`Initial `Follow

up

Young infant to 2 mos 2. 2 mos up to 5 yrs1.

vomit ` A-abnormally sleepy ` C-convulsion ` U- unable to feed` VOMITING

LETH RGY UNCONSCIOUSNESS

**severe at least

1

D NGER SIGNSIN BILITY TO DRINK OR BRE ST EED

CON ULSIONS

URGENT REFERRA U ENTTREATMENT AT OUT-PX HEA TH FACILITY

HOME MANAGEMENT

` ` ` `

PNEUMONIA MA TOIDITIS ACUTE EAR INFECTION VERY SEVERE DISEASE

FIRST LINE ANTIBIOTICS: AMOXICILLIN SECOND LINE ANTIBIOTICS: COTRIMOZAXOLE

`CIPROFLOXACIN

CHOLERA:

TETRACYCLINE

`GENTAMICIN `BENZYL

PENICILLIN

38.5 C `EVERY 6 HOURS UNTIL GONE`PARACETAMOL

` FIRST

LINE ANTIMALARIAL:

ARTEMETHERLUMEFANTRINE` SECOND

ANTIMALARIAL:

` CHLOROQUINE,

PRIMAQUINE, SULFADOXINE AND PYRIMETHAMINE

` `

May have pneumonia Streptococcus pneumoniae/ H. influenza

ASSESS: a. How long is the cough/ DOB; wof:>30days b. Fast breathing c. Chest indrawing lying flat d. Stridor when calm

If child is: 12 mos 5yo

Fast breathing 40bpm & >

2 mos up to 12 mos

50bpm & >

Any general danger sign VACU or Chest indrawing or Stridor in calm child

severe pneumonia or very severe disease

First dose antibiotics Vit A HOSP!! Tx child to x hypoglycemia 3days anitibiotics Soothe throat F.up = 2days bronchodilator Soothe throat F.Up in 5 days Refer if (+) >30days cough bronchodilator

Fast breathing

pneumonia

No signs of pneumonia or very severe disease

no pneumonia: cough or cold

` ` ` `

Ingestion of contaminated food/ water 3&> watery stool /day Tx: ORESOL infant = AM Home made:1Lt water, 1 tsp salt, 8tsp sugar

ASSESSMENT: a. Irritable b. Sunken eyes c. Skin pinched d. thirst

diarrhea: DEHYDRATION ` >14days diarrhea: DIARRHEA ` Blood in the stool: DYSENTERY` 7 days, refer for assessment

Fever (by history or feels hot or temperature 37.5C or above)

malaria

NO runny nose and NO measles and NO other causes of fever

Fever: unlikely malaria

1.

Able to swallow=Breastfeed

2. (-)breastfeed + swallow= GIVE expressed breastmilk sugar water; 30-50ml milk/ sugar water before departure ` SUGAR WATER: 4 tsp sugar in 200ml cup 3. (-) swallow: 50 ml milk/sugar water NGT ` Difficult to awaken: START IV **

Any Very danger sign severe Stiff neck febrile disease

Antibiotics Prevent low blood sugar Paracetamol URGENT to HOSP Paracetamol Ff up 2 days If + fever >7 days, refer for assessment

(-) sign of Fever: no very severe malaria malaria

Now or w/in last 3 mos: ` Mouth ulcer? Deep/extensive ` Pus/drainage eye ` Clouding of cornea`

Generalized rashes ` Cough ` Runny nose ` Red eyes`

yAny danger sign or yClouding of cornea or yDeep or extensive mouth ulcers

severe complicated measles

Vit A 1st dose antibiotics If + pus & clouding; tetracycline URGENT TO HOSP

Pus draining from the eye or Mouth ulcers

measles with eye or mouth complications

yMeasles now or within the last three months

measles

Vit A If + pus in eyes; tetracycline If + mouth ulcer; gential violet Ff up 2 days Give vit A

both eyes 4x/day ` wipe pus ` Apply eye ointment both eyes 3x/day ` Squirt amount in lower lid ` Tx until redness is gone` Clean

` 2x/day ` Wash

hands ` Wash childs mouth; using soft cloth around fingers wet with salt water ` +cotton buds; paint mouth w/ 0.25% Gentian Violet ` Wash hands again ` Cont 48 hrs after ulcer has been cured

` ASSESS: ` Bleeding?nose,gums, ` Black

vomit; stool

vomitus ` Black stool ` + abdominal pain ` + persistent vomiting ` Tourniquet test, petichiae; cold clammy extremities; slow capillary refill

Bleeding from nose, Severe: (+) vomit=PLAN B gums, DHF (+) bleeding= plan C (+) black stool; Tx prevent low blood Vomit; + tourniquet sugar Petichiae URGENT TO HOSP Abdo pain; cold X aspirin clammy skin (-) sign of severe DHF Fever: Ff up 2 days DHF X give aspirin unlikely

` a. b. c. d.

ASSESS: Look for severe wasting + edema (feet) Palmar pallor? Severe/ some Determine weight for age

IF AGE UP TO 6 MOS & VISIBLE SEVERE WASTING, (+) EDEMA BOTH IF AGE 6 MOS AND ABOVE: MUAC IS