RLE\POWERPOINT

[TRANS] LESSON 4: IMCI SUMMARY

DIARRHEA 2 or More 2 or More
OUTLINE • Pinched goes • Pinched
I IMCI Case Management Process back very goes
A Assess slowly (>2 back
B Classify secs) slowly
C Treat • Unable to • Drinking
D Follow up
drink or eagerly/
breastfeed thirsty
IMCI CASE MANAGEMENT PROCESS • Sunken Eyes • Sunken
• The following steps can be observed when caring for children • Abnormally eyes
less than 5 years old who visits RHU or out-patient department sleepy or • Irritable
of a hospital for consultation. lethargic or
• You should always ACT (Assess, Classify and Treat). restless
• They are similar with the phase of nursing process
Diarrhea
Table No.1 IMCI vs Nursing Process Diarrhea greater greater than
IMCI CASE MANAGEMENT PROCESS NURSING PROCESS than 14 days with 14 days
Assess Assess signs of without signs
Classify Diagnose dehydration of
Treat Plan dehydration
• Identify the treatment
• Treat the child Implement
• Counsel the mother Evaluate • Blood in
• Follow-up care the stool

ASSESS FEVER Malaria Malaria

• Interview: ASK Stiff Neck (+) blood
o What’s the child’s problem? smear
o Initial or follow-up visit?
• Observe: LOOK, LISTEN AND FEEL Measles Measles
o DANGER SIGNS (VUCA) • Clouding of • Pus
Vomiting the cornea drainage in
Unable to drink or breastfeed • Extensive the eyes
Convulsions Mouth Ulcers • Mouth
Abnormally sleepy or lethargic Ulcers
o MAIN SYMPTOMS (CDFE) Dengue
Cough Hemorrhagic Fever
Diarrhea
Fever (4Ps)
Ear problem • Persistent
o OTHER PROBLEMS vomiting
Malnutrition • Persistent
Anemia abdominal
Immunization Status pain
Deworming Status • Positive
Feeding Problem tourniquets
• Petechiae
CLASSIFY
• Based on the group of signs and symptoms (2Cs)
• Color Coding Triage (PINK, YELLOW, GREEN) • Cold clammy
• To facilitate our classification, ASSESS for the following extremities
STRATEGIC WORDS • Capillary refill
• Note: one sign in pink row and one sign in yellow row is >3 secs
classified as SEVERE (PINK)
(S&S of Bleeding)
Table No.2 Classification: A Summary • Epistaxis
DANGER PINK YELLOW GREEN • Bleeding gum
SIGNS (SEVERE) (MODERATE; (MILD; • Hematemesis
DHN: SOME) DHN:NO) • Melena
COUGH • Stridor Fast No or
• Chest Breathing Inadequate
indrawing • 2-11 Signs and EAR Tender swelling • Pus
mos: 50 symptoms PROBLEM drainage on
bpm or the ear less
more than 14 days
• 12-59
mos 40 • or
bpm or greater
more than 14
days

ALCALA. IBARRA. MARIANO. ONG. PECUNDO. PERALTA. RICO. 1

 [TRANS] LESSON 4: IMCI SUMMARY
MALNUTRI • Severe Muscle Very low TREATMENT FOR DEHYDRATION
-TION Wasting weight for
• Edema on age • PLAN A (HOME MANAGEMENT)
both feet RULE OF HOME MANAGEMENT
• If 6 mos and o Continue feeding the child
above MUAC o Give extra fluid
<115 cm <2 y/o: 50-100 ml ORS/LBM
ANEMIA Severe Palmar Some Palmar >2 y/o: 100-200 ml ORS/LBM
Pallor Pallor o Zinc supplement for 14 days
o Advise mother when to return
• PLAN B (OUT-PATIENT)
TREAT o Solution: ORS (Oral Rehydration Salts)
• Based on classification o Amount: 75 ml/kg in 4 hours
If <6 mos : give 100-200 ml of clean water to
Table No.3 General Treatment Plan prevent hypernatremia
URGENT/REFERAL OUT-PATIENT HOME If the child vomits, wait 10 minutes before
MANAGEMENT giving again fluids
• 1st dose of • 1st dose of • DHN: Plan A • PLAN C (SEVERE)
appropriate appropriate • Vitamin A o Solution: LRS (Lactated Ringer Solution) or PNSS
(infection) (infection) (measles) (Plain Normal Saline Solution)
• Treat low • DHN: Plan B • Advise the o Amount: 100ml/kg
blood sugar • Vitamin A mother when
• DHN: Plan C • Advise the to return
30 ml/kg 70 ml/kg
• Vitamin A mother when immediately
<1 /0 1 hour 5 hours
• Counsel the to return • Follow up
>1 y/o 30 minutes 2.5 hours
mother immediately
• Follow up
VITAMIN A
• Supplementation: THE 6-6-6 RULE
SPECIFIC TREATMENTS o Starts at 6 months, end at 6 years old and at least 6
• PRE-REFERRAL ANTIBIOTCS months of minimum interval
o 1st line: Gentamicin (7.5 mg/kg) • Treatment: 2day, 2morrow, 2weeks After Rule
o 2nd line: Benzyl Penicillin (50,000 units/kg) o Same dosage as below
o Sever Malaria: Quinine
AGE DOSE INTERVAL
Table No.4 Oral Antibiotics 6 mos – 11 mos 100,000 IU
DISEASE 1ST LINE 2ND LINE 12 mos – 6 y/o 200,000 IU Every 6 mos

PNEUMONIA Amoxicillin bid x 3 days Co-trimoxazole bid ADVISE THE MOTHER WHEN TO RETURN
x 3 days • If the child is not able to drink or breastfeed
ACUTE EAR Amoxicillin bid x 5 days Co-trimoxazole bid • If child becomes sicker
INFECTION x 5 days • If child develops fever

CHOLERA Tetracycline qid x 3 days Erythromycin qid x FOLLOW UP

3 days
*(given 2 y/o Table No.5 Follow-Up Plan
and above) DISEASE FOLLOW UP AFTER
if there is MALNUTRITION 30 days
cholera in ANEMIA 14 days
the area PENS 2 days – conditions other
DYSENTERY Ciprofloxacin bid x 3 • Persistent Diarrhea than mentioned above
days • Ear Infection
• No Pneumonia
MALARIA Artemeter-Lumefantrine Chloroquine, • Some/No Dehydration
Primaquine,
Sulfadoxine, and
Pyrimethamine
REFERENCES
OTIC ANTIBIOTICS
Notes from the discussion by Prof. Albert Jerom Y. Jopida RN
• Chronic Ear infection: Quinolone Drops
Manila Doctors Colleges of Nursing PowerPoint Presentation
TREAT LOW BLOOD SUGAR
• Continue breastfeeding
• Give expressed milk
• Sugar Water – Oresol (200ml clean water + 4 tsp of sugar)

ALCALA. IBARRA. MARIANO. ONG. PECUNDO. PERALTA. RICO. 2