INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI)
Steps in the IMCI Case Management Process:1.Assess and Classify2.Identify Treatment3.Treat4.Counsel the Mother 5.Follow-Up
A. Assess and Classify Sick Children 2 months up to 5 Years
1. Determine which age group the child belongs:1 week up to 2 months2 months up to 5 years2. Record the child’s data :
Name, Age in months, Weight in kg., temperature, etc.
Ask the mother what the child’s problems are.4. Determine if this is an initial or follow – up visit:
Initial visit – 1
visit for this episode of an illness or problemFollow-up visit- the child has been seen a few days ago for the same illness-if the child’s condition improved, still the same or is getting better 4.
Check for general danger signs:
a.not able to drink or breastfeed
too weak to drink and is not able to suck or swallow when offered a drink or Breast-feed
if not sure: ask mother to offer child a drink of clean water or breast milk
A child may have difficulty sucking when his nose is blocked. If the nose is blocked, clean it. b.vomits everything
a child is not able to hold anything down at all
if in doubt, offer the child water c.convulsions (during this illness)
arms and legs stiffen because muscles are contracting
the child may lose consciousness or not be able to respond to spoken directions or handling, even if eyes are open
“fits” or “spasms” or “jerky movements” Note: Shiver is not convulsion. There is no loss of consciousness.d.abnormally sleepy or difficult to awaken
drowsy and does not show interest in what is happening around him
stare blankly and appear no to notice what is going on around him
does not respond when touched, shaken or spoken toNote: 1. If the child is asleep and has cough or difficult breathing, count the number of breaths first before you try to wake the child.2. If there is any general danger sign, complete the assessment and any pre-referral treatment immediately so referral is not delayed. 5.
Assess and classify cough or difficult breathing
2 Common Causes of Pneumonia
2 Causes of Death
1.hypoxia – too little oxygen2.sepsis – generalized infection
Health workers can identify almost all causes of pneumonia by checking for 2clinical signs: 1.
– body’s response to stiff lungs and hypoxia2.
Assess cough or difficult breathing:
Does the child have cough or difficult breathing? “fast” or “noisy” or “interrupted”?