MANAGEMENT OF THE SICK CHILD AGED 2 MONTHS UP TO 5 YEARS

Child’s Name: ______Den_____________ Age: __13 months__ Weight: __11__ kg. Temperature: ___36.5___⁰C

ASK: What are the child’s problems? __6 days Diarrhea________________ Initial Visit? ___/____ Follow-up Visit?
_______

Assess (Circle all signs present)

CLASSIFY
CHECK FOR GENERAL DANGER SIGNS General Danger Sign
Present?
Not able to drink or breastfeed Abnormally sleepy or difficult to awaken
Vomits Everything
Convulsions YES _____ No __/__

DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES ____

NO __/__

For how long? _____ days - Count the breaths in one minute
__30__ breaths per minute. Fast
Breathing?
- Look for chest indrawing
- Look and listen for stridor
- Look and listen for wheeze
DOES THE CHILD HAVE DIARRHEA? YES __/__
NO _____
-For how long? __6__ days -Look at the child’s general condition. Is the
child:
Abnormally sleepy or difficult to awaken?
Restless & irritable?
-Look for sunken eyes.
SOME
- Offer the child fluid. Is the child:
DEHYDRATION
Not able to drink or drinking poorly?
Drinking eagerly & thirsty?
-Pinch the skin of the abdomen. Does it go
back:
Very slowly (longer than 2 seconds)?
Slowly?

DOES THE CHILD HAVE FEVER? (by history/feels hot/ temperature 37.5⁰C or above)
Yes___ NO ___

Decide MALARIA risk: - Look or feel for

stiff neck
Does the child live in a malaria area?
Has the child visited/traveled or stayed overnight - Look for runny nose
In a malaria area in the past 4 weeks?

If malaria risk, obtain a blood smear.

(+) (Pf) (Pv) (-) not done

-For how long has the child has fever? _____ days - Look for signs of
measles
-If more than 7 days, has the fever been present - Generalized rash
and
every day? - One of these: cough,
runny nose or red eyes
-Has the child had measles w/in the last 3 months?
If the child has measles now or -Look for mouth ulcers
Within 3 months: If yes, are they deep and
extensive?
- Look for pus draining
from the eye
- Look for clouding in the
cornea
Assess Dengue Hemorrhagic Fever:

- Had the child had any bleeding from the nose or - look for bleeding from nose or
gums.
Gums or in the vomitus or stools? - Look for skin petechiae
-Has the child had black vomitus or black tarry stool? - Feels for cold and clammy
extremities
-Has the child had persistent abdominal pain? - check capillary refill. ____
seconds
-Has the child had persistent vomiting? -Perform tourniquet test if a
child is 6
Months or older AND
has no other
Signs AND has fever
for more than
3 days.
TREAT

TREAT SOME DEHYDRATION WITH REFORMULATED ORS 800-960 ML OVER A 4 HOUR PERIOD.
GIVE ZINK (20 mg TAB) SUPPLEMENT, 1 TABLET DAILY FOR 14 DAYS

Return for follow-up in: 5 DAYS IF NOT IMPROVING

Advise mother when to return immediately:_________________________
Give any immunizations today:
Give vitamin A if needed today:
Give Mebendazole/Albendazole if needed

Feeding advise: GIVE EXTRA FLUIDS

Care for Development Advice:

_
 MANAGEMENT OF THE SICK CHILD AGED 2 MONTHS UP TO 5 YEARS

Child’s Name: ______JEZ_____________ Age: __10 months__ Weight: __9__ kg. Temperature: ___38.7___⁰C

ASK: What are the child’s problems? 4 DAYS COUGH, DIFFICULTY BREATHING & WEAK_ Initial Visit? ___/__ Follow-
up Visit? _____

Assess (Circle all signs present)

CLASSIFY
CHECK FOR GENERAL DANGER SIGNS General Danger Sign
Present?
Not able to drink or breastfeed Abnormally sleepy or difficult to awaken
Vomits Everything
Convulsions YES __/__ No ____

DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES __/__

NO ____

For how long? __4__ days - Count the breaths in one minute
__57__ breaths per minute. Fast SEVERE
Breathing? PNEUMONIA OR
- Look for chest indrawing VERY SEVERE
- Look and listen for stridor DISEASE
- Look and listen for wheeze

DOES THE CHILD HAVE DIARRHEA? YES ____ NO

__/__
-For how long? ____ days -Look at the child’s general condition. Is the child:
Abnormally sleepy or difficult to awaken?
Restless & irritable?
-Look for sunken eyes.
- Offer the child fluid. Is the child:
Not able to drink or drinking poorly?
Drinking eagerly & thirsty?
-Pinch the skin of the abdomen. Does it go
back:
Very slowly (longer than 2 seconds)?
Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/ temperature 37.5⁰C or above)
Yes_/_ NO ___

Decide MALARIA risk: - Look or feel for

stiff neck
Does the child live in a malaria area?
Has the child visited/traveled or stayed overnight - Look for runny nose FEVER:
In a malaria area in the past 4 weeks? NO MALARIA
If malaria risk, obtain a blood smear.
(+) (Pf) (Pv) (-) not done
-For how long has the child has fever? _____ days - Look for signs of
measles
-If more than 7 days, has the fever been present - Generalized rash
and
every day? - One of these: cough,
runny nose or red eyes
-Has the child had measles w/in the last 3 months?
If the child has measles now or -Look for mouth ulcers
Within 3 months: If yes, are they deep and
extensive?
- Look for pus draining
from the eye
- Look for clouding in the
cornea
Assess Dengue Hemorrhagic Fever:
- Had the child had any bleeding from the nose or - look for bleeding from nose or
gums.
Gums or in the vomitus or stools? - Look for skin petechiae
-Has the child had black vomitus or black tarry stool? - Feels for cold and clammy
extremities
-Has the child had persistent abdominal pain? - check capillary refill. ____
seconds
-Has the child had persistent vomiting? -Perform tourniquet test if a
child is 6
Months or older AND
has no other
Signs AND has fever
for more than
3 days.
TREAT

REFER URGENTLY TO HOSPITAL

GIVE AMOXICILLIN SYRUP 2.5 ML TWO TIMES DAILY FOR 3 DAYS (first dose given)
ORAL SALBUTAMOL SUSPENSION 2.5 ML 3 TIMES A DAY FOR 5 DAYS (first dose give)
START IV INFUSION OF 5 ML/KGG OF 10% DEXTROSE SOLUTION (D10) OVER A FEW MINUTES
OR GIVE 1 ML/KG OF 50% DEXTROSE SOLUTION (D50) BY SLOW PUSH.

GIVE PARACETAMOL SYRUP (120 mg/ 5 ml) of 5 ML (1tsp) EVERY 6 HOURS UNTIL FEVER IS
GONE
(1dose given)

Return for follow-up in: AFTER 2 DAYS __

Advise mother when to return immediately: __
Give any immunizations today:_______________________________
Give vitamin A if needed today: VITAMIN A CAPSULE 100,000 IU
Give Mebendazole/Albendazole if needed_______________________
Feeding advise: GIVE EXPRESSED BREASTMILK OR A BREASTMILK
SUBSTITUTE IF NEITHER OF THESE TWO IS AVAILABLE,
GIVE SUGAR OR WATER
GIVE 30-50 ML OF MILK OR SUGAR WATER BEFORE
DEPARTURE
________________________________________________________________________________
Care for Development Advice: