Assess and classify DIARRHEA

A child with diarrhea is assessed for: How long the child has had diarrhea? Look for the childs general condition: 1. Abnormally sleepy or difficulty awaken 2. Restless and imitable Look for sunken eyes Offer the child fluid.

- Not able to drink? or drink poorly? - Eager to drink or thirsty Pinch the skin of the abdomen, Does it go back? - Very Slowly (longer than 2 seconds) - slowly Blood in the stool to determine if the child has dysentery

Two of the following signs?

SEVERE Abnormally sleepy or DEHYDRATION difficult to awaken Sunken eyes Not able to drink or drinking poorly Skin pinch goes back very slowly

If child has no other severe classification: o Give fluid for severe dehydration ( Plan C ) OR If child has another severe classification : o Refer URGENTLY to hospital with mother giving frequent sips of ORS on the way o Advise the mother to continue breastfeeding If child is 2 years or older and there is cholera in your area, give antibiotic for cholera Give fluid and food for some dehydration ( Plan B ) If child also has a severe classification : o Refer URGENTLY to hospital with mother giving frequent sips of ORS on the way o Advise mother when to return immediately

Two of the following signs :

Restless, irritable Sunken eyes Drinks eagerly, thirsty Skin pinch goes back slowly

SOME DEHYDRATION

Follow up in 5 days if not improving

Not enough signs to classify as some or severe dehydration

NO DEHYDRATION

Home Care Give fluid and food to treat diarrhea at home ( Plan A ) Advise mother when to return immediately Follow up in 5 days if not improving Treat dehydration before referral unless the child has another severe classification Give Vitamin a Refer to hospital Advise the mother on feeding a child who has persistent diarrhea Give Vitamin A Follow up in 5 days Treat for 5 days with an oral antibiotic recommended for Shigella in your area Follow up in 2 days Give also referral treatment

Dehydration present SEVERE PERSISTENT DIARRHEA

No dehydration PERSISTENT DIARRHEA

Blood in the stool DYSENTERY