IMCI Flashcards
Classification of fast breathing in a child 2 months upto 12 months
> = 50 BPM
Patient comes in with difficulty of breathing, you ask for? look, listen feel for?
- Duration of symptoms
- Breaths per minute
- Chest indrawing
- Listen for stridor
Classification of fast breathing in child 12 months upto 5 years of age
> = 40 BPM
To classify a child with severe pneumonia or very severe disease you will look for the following signs:
- Any general danger signs
- Chest indrawing
- Stridor in a calm child
What is the treatment to be given in a child with severe pneumonia
- Give first dose of antibiotics
- Refer urgently to hospitals
The clinical sign of pneumonia
Fast breathing
Treatment to be given in a child with pneumonia
- Give appropriate oral antibiotic for the first 5 days
- Soothe throat and relieve cough with a safe remedy
- Advise mother when to return immediately
- Follow up within 2 days
If you are not entertaining pneumonia what is your basis?
No signs of pneumonia or severe disease
Treatment classified in patient with no pneumonia, only cough and cold
- If coughing is more than 30 days refer for assesment
- Soothe the throat and relieve cough with a safe remedy
- Advise mother when to return immediately
- Follow up in 5 days if not improving
How many days does it need to refer a cough for assessment?
30 days
What are the signs that you have to look out for the determination of severe dehydration in a child?
- Lethargic or unconscious
- Sunken eyes
- Not able to drink or drinks poorly
- Skin pinch goes back very slowly
Treatment to be given in patients who suffers severe dehydration but has no other severe classification:
Give fluid for severe dehydration
If the child has another severe classification that goes with severe dehydration what will be given:
- Refer URGENTLY to hospital with mother giving frequent sips of ORS
- Advise the mother to breast feed
If the severe dehydration si due to cholera, what will be your management:
Antibiotic to cholera
Some dehydration signs are the following:
- Restless, Irritable
- Sunken eyes
- Drinks eagerly, thirsty
- skin pinch goes back slowly
Treatment plan for patient classified as some dehydration:
Give some fluid and food
Patient is classified as some dehydration + associated severe classification, what is your treatment:
- Refer urgently to hospital with mother giving frequent sips of ORS on the way
- Advise mother to continue to breastfeed
- Advise mother when to return immediately
- Follow up in 5 days if not improving
Patient was classified as not having diarrhea, what is your treatment plan:
- Give fluid and food to treat diarrhea AT HOME
- Advise mother when to return immediately
- Follow up in 5 days of not yet improving
For children with persistent diarrhea what is your sign to consider?
The presence and absence of DEHYDRATION
Treatment given in patients with severe persistent diarrhea?
- Treat dehydration before referral unless the child have another severe classification
- Referral to hospitals
Treatment given to patients with persistent diarrhea:
- Advise the mother on FEEDING a child who has persistent diarrhea
- Follow up in 5 days
Signs with presence of blood in the stool indicates __
Dysentery
Treatment in patients with dyesentery
- Treat for 5 days with an oral antibiotics recommended for shigella in the area
- Follow up in 2 days
Patient is classified as with very severe febrile disease what are the signs associated with it?
- Any general danger signs
- STIFF NECK
Treatment to be given in a very severe febrile disease
- Give first dose of an appropriate ANTIBIOTIC
- Treat child to PREVENT LOW BLOOD GLUCOSE
- Give one dose of PARACETAMOL in clinic FOR HIGH FEVER (38.5 or above)
- Refer urgently to hospital
Treatment to be given in patients with unlikely fever due to malaria:
- Give one dose of PARACETAMOL for high fever
- Advise mother when to return immediately
- Follow up in 2 days if fever persists
- If fever is persistent every day for more than 7 days refer for assessment
The signs of a severe complicated measles case:
- Any general danger signs
- Clouding of the cornea
- Deep or Extensive mouth ulcers
Treatment to be given in a severe complicated measles case:
- Give VITAMIN A
- Give first dose of appropriate antibiotic
- If clouding of cornea or pus draining from the eye, APPLY TETRACYCLINE eye ointment
- Refer urgently to hospital
What are the signs of a measles complication:
- Pus draining from the eye
- Mouth ulcers
Treatment for complication of measles
- Give vitamin A
- If pus is draining from the eye give Tetracycline eye ointment
- For mouth ulcers treat with GENTIAN VIOLET
- Follow up in 2 days
If measles is now or within the last 3 months what will you give to patient:
Give VITAMIN A
Signs to determine the presence of Mastoiditis in patient:
Tender swelling behind the ear
Treatment for mastoiditis:
- Give first dose of antibiotic
- Give first dose paracetamol
- Refer urgently to hospital
The sign in patient with acute ear infection:
- Pus is seen draining from the ear and discharge is reported for LESS THAN 14 days
- Ear pain
Treatment in patients with acute ear infection:
- Give oral antibiotic for 5 days
- Give paracetamol for pain
- Dry the ear by wicking
- Follow up to 5 days
Signs in patient with a chronic ear infection:
Pus is seen draining from ear and discharge is reported for 14 days or MORE
Treatment for chronic ear infection:
- Dry the ear by wicking
- Follow up in 5 days
Signs of a patient with severe malnutrition or anemia:
- Visible severe wasting
- Severe palmar pallor
- Edema on both feet
Treatment given to patients with severe malnutrition or anemia
- VITAMIN A
- Refer to hospital
Signs of patient suffering from anemia or very low weight:
- Some palmar pallor
- Very low weight for age
Treatment to be given in patients with anemia or very low weight:
- ASSESS FEEDING according to the FOOD BOX on the COUNSEL THE MOTHER chart
- Give iron
- Give antimalarial in high risk
- Give mebendazole in children 2 yo and older if not had a dose in previous 6 months
- Advise mother when to return immediately
In patients with anemia and low weight give the dates of return follow up:
Feeding problem
Pallor
Very low weight for age
5 days
14 days
30 days
What age group will you assess the feeding and counsel, if the patient has no anemia and not very low weight:
LESS THAN 2 yo
Treatment of a possible serious bacterial infection
- Give first dose of IM antibiotics
- Treat to prevent low blood glucose
- Advise mother to keep the infant warm on the way to hospital
- Refer urgently to hospital
Treatment for local bacterial infection:
- Give appropriate oral antibiotics
- Teach mother to treat local infections at home
- Advise mother to give home car for the young infant
- Follow up in 2 days
Signs of a local bacterial infection:
Red umbilicus
Draining pus
Skin pustule
