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    IMCI Review

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    sue_cide
    This document provides guidelines for the Integrated Management of Childhood Illnesses (IMCI). It outlines the process for assessing and classifying sick children ages 2 months to 5 years. This includes checking for general danger signs, determining main symptoms, and assessing nutritional status. It then provides treatment plans labeled A through C depending on the illness classification. The classifications include pneumonia, diarrhea, fever, ear infections, and malnutrition. Treatment involves antibiotics, oral rehydration solution, vitamin A, and referral if danger signs are present. The overall process is focused on identifying children who need urgent referral versus those who can be managed at home.

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    IMCI Review

    Uploaded by

    sue_cide
    339 views39 pages
    This document provides guidelines for the Integrated Management of Childhood Illnesses (IMCI). It outlines the process for assessing and classifying sick children ages 2 months to 5 years. This includes checking for general danger signs, determining main symptoms, and assessing nutritional status. It then provides treatment plans labeled A through C depending on the illness classification. The classifications include pneumonia, diarrhea, fever, ear infections, and malnutrition. Treatment involves antibiotics, oral rehydration solution, vitamin A, and referral if danger signs are present. The overall process is focused on identifying children who need urgent referral versus those who can be managed at home.

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    This document provides guidelines for the Integrated Management of Childhood Illnesses (IMCI). It outlines the process for assessing and classifying sick children ages 2 months to 5 years. This includes checking for general danger signs, determining main symptoms, and assessing nutritional status. It then provides treatment plans labeled A through C depending on the illness classification. The classifications include pneumonia, diarrhea, fever, ear infections, and malnutrition. Treatment involves antibiotics, oral rehydration solution, vitamin A, and referral if danger signs are present. The overall process is focused on identifying children who need urgent referral versus those who can be managed at home.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    339 views39 pages

    IMCI Review

    Uploaded by

    sue_cide
    This document provides guidelines for the Integrated Management of Childhood Illnesses (IMCI). It outlines the process for assessing and classifying sick children ages 2 months to 5 years. This includes checking for general danger signs, determining main symptoms, and assessing nutritional status. It then provides treatment plans labeled A through C depending on the illness classification. The classifications include pneumonia, diarrhea, fever, ear infections, and malnutrition. Treatment involves antibiotics, oral rehydration solution, vitamin A, and referral if danger signs are present. The overall process is focused on identifying children who need urgent referral versus those who can be managed at home.

    Copyright:

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    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 39

    Community Health Nursing Board Review

    Integrated Management for Childhood Illnesses (IMCI)


    Prepared by: Kit S. Lagliba, RN

    Kit Lagliba, RN
    At the start of a sick child (2 months to 5 years) consultation

    Determine if this is an initial or followup visit for this problem. Ask the mother what the childs problems are.

    IMCI Case Management


    Focused Assessment Danger signs Main Symptoms Nutritional status Immunization status Other problems Classification

    Need to Refer
    Specific treatment

    Home management
    Treatment Identify treatment Treat

    Counsel & Follow-up Counsel caretakers Follow-up

    Check for general danger signs


    Ask: Not able to drink or breastfeed, Vomits everything, Convulsions, or Look: Abnormally sleepy or difficult to awaken
    Need to Refer (except in severe dehydration)

    Ask about the main symptoms

    Cough or difficulty in breathing Diarrhea Fever Ear problem

    Cough or difficulty in breathing


    Ask: For how long? Look: Count RR Chest indrawing Stridor

    The child must be calm.

    Any general danger sign or Chest indrawing or Stridor

    SEVERE PNEUMONIA OR VERY SEVERE DISEASE

    1st dose of antibiotic Vitamin A Breastfeeding/sugar water URGENT REFERRAL

    Fast breathing 2 12 months old: 50/minute 1 year or older: 40/minute

    PNEUMONIA

    Antibiotic for 5 days Relieve cough with safe remedy Advise mother on danger signs Follow up in 2 days

    No signs of pneumonia or a very severe disease

    NO PNEUMONIA: COUGH OR COLD

    If cough 30 days refer to hospital for assessment Relieve cough with safe remedy Advise mother on danger signs Follow up in 5 days if no improvement

    Diarrhea: Classify For dehydration

    Persistent diarrhea Blood in the stool

    Classify for dehydration


    2 or more of the following:
    Abnormally sleepy/difficult to wake Sunken eyes Not able to feed/drinking poorly Skin pinch goes back very slowly

    SEVERE DEHYDRATION

    Plan C

    Plan C: To treat dehydration quickly


    IV fluid: LRS 100 ml/kg body weight (in 6 hrs for infants; 3 hrs for children)

    NO
    IV treatment within 30 minutes

    NO
    Oresol/NGT

    Plan C: To treat dehydration quickly


    Oresol/NGT

    NO
    Oresol p.o.

    NO
    URGENT REFERRAL

    Classify for dehydration

    2 of the following:
    Restless, irritable Sunken eyes Skin pinch goes back slowly

    SOME DEHYDRATION

    Plan B

    Plan B: Treat some dehydration with ORS

    Determine the amount (in ml) of Oresol to be given in 4 hours = weight of the child (in kg) X 75, or if weight is unknown, use this chart.
    Age < 4 mos 4-12 mos

    Amount

    200-400

    400-700

    Plan B: Treat some dehydration with ORS

    Determine the amount (in ml) of Oresol to be given in 4 hours = weight of the child (in kg) X 75, or if weight is unknown, use this chart.
    Age 12 mos-2 yrs 2-5 yrs

    Amount

    700-900

    900-1400

    Plan B: Treat some dehydration with ORS

    Show the mother how to give Oresol to the child: frequent sips from a cup If the child vomits, wait for 10 minutes. Then continue, but more slowly. Continue breastfeeding if the child wants to breastfeed. If the child develops puffy eyelids, stop ORS.

    Plan B: Treat some dehydration with ORS

    After 4 hours: Reassess the child & classify for dehydration. Select appropriate plan. Begin feeding the child in the health center.

    Classify for dehydration

    Not enough signs to classify as SEVERE DEHYDRATION or SOME DEHYDRATION

    NO DEHYDRATION

    Plan A

    Plan A: Treat diarrhea at home

    Give extra fluid.


    Up to 2 yrs 50 100 ml after each LBM

    2 -4 yrs

    100 200 ml after each LBM

    Continue feeding. Know when to return.

    Persistent diarrhea: 14 days or more

    + Dehydration=severe persistent diarrhea

    Treat dehydration Give Vitamin A Refer to hospital

    Persistent diarrhea: 14 days or more

    No dehydration=persistent diarrhea

    Advise regarding feeding Give Vitamin A Follow up in 5 days

    Blood in the stool = dysentery

    Oral antibiotic for shigella for 5 days Follow up in 2 days

    Fever: (history/temperature 37.5C or above)

    Malaria risk?

    Measles now or w/in last 3 mos Dengue risk?

    Fever: Ask about malaria risk


    Residing in endemic area? OR: Travel & overnight w/in past stay in endemic area, or 6 mos Blood transfusion

    Malaria risk +

    Blood smear Ask: Duration of fever? Present everyday? Look: Stiff neck Runny nose Other signs of measles

    Malaria risk + any general danger sign or stiff neck

    Very severe febrile disease/malaria

    Quinine (under med. supervision) 1st dose of antibiotic, Paracetamol Urgent referral

    Malaria risk +, blood smear + No runny nose, no measles

    Malaria

    Oral antimalarial Paracetamol Follow up in 2 days > 7 days fever hospital for assessment

    No malaria risk Any general danger sign or stiff neck

    Very severe febrile disease

    1st dose of antibiotic, Paracetamol Urgent referral

    Measles now or w/in last 3 mos Clouding of cornea or Deep or extensive mouth ulcers

    Severe complicated measles

    1st dose of antibiotic, Vitamin A Urgent referral

    Measles now or w/in last 3 mos Pus draining from the eye or Mouth ulcers

    Measles with eye or Mouth complications

    Vitamin A Tetracycline eye ointment Gentian violet Follow up in 2 days

    Measles now or w/in last 3 mos No other signs

    Measles

    Vitamin A

    If there is Dengue risk


    Bleeding gums, nose, in vomitus or stools Black vomitus or stools Persistent abdominal pain Persistent vomiting Skin petechiae Slow capillary refill No signs, but fever > 3 days Tourniquet test

    Any of the danger signs or + tourniquet test

    Severe Dengue hemorrhagic fever

    If skin petechiae, persistent abdominal pain or vomiting, or + tourniquet test only signs, give ORS Any other signs of bleeding Plan C Urgent referral Do not give aspirin

    Ear problem: tender swelling behind ear

    Mastoiditis

    1st dose of antibiotic Paracetamol for pain Urgent referral

    Ear discharge < 14 days or Ear pain

    Acute ear infection

    Antibiotic for 5 days Paracetamol for pain Wicking Follow up in 5 days

    Ear discharge for 14 days or more

    Chronic ear infection

    Wicking Follow up in 5 days

    Visible severe wasting or Edema on both feet or Severe palmar pallor

    Severe malnutrition or severe anemia

    Vitamin A Urgent referral

    Some palmar pallor or Very low weight for age

    Anemia or very low weight for age

    Assess for feeding problem Pallor: iron & Albendazole Wt for age very low: Vitamin A

    Kit Lagliba, RN

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