IMCI 1.

Know the general danger signs c convulsion - malaria u unable to feed/drink BF - diarrhea v vomits everything - diarrhea a abnormally sleepy or difficult to awaken one general danger sign is classified as severe Know the color coding pink -severe classification -urgent referral -needs immediate attention -give first dose/one dosse of antibiotic -treat to prevent low blood sugar -0-2mo. keep the infant warm -monitoring and follow-up -plan c yellow -give an antibiotic -give an appropriate antibiotic -give oral drugs -treat local infection -dry the ear by wicking -soothe the throat with safe remedy (calamansi) -follow-up within 2 or 5 days -instruct or advise mother when to return immediately -plan b green -follow-up within 2 or 5 days -home management -home treatment -give home care -no urgent measures needed -feeding and fluids -praise the mother for feeding the child -plan a 3. Know the assessment process 2mo-5yo -cough/difficulty of breathing - pneumonia -diarrhea a. Within 5 days b. More than 14 days - Persistent Diarrhea - give multivitamins and minerals for 14 days c. Blood in stool - ciprofloxacin -fever a. Malaria b. Measles c. DHF -Ear problem a. Mastoiditis b. More than 14 days - chronic c. Less than 14 days - acute -malnutrition -anemia -immunization -vitamin A -deworming - done twice a year a. First line - abendazole b. Second line - mebendazole 0-2mo -very severe disease -jaundice -diarrhea -feeding problem

2.

COUGH/DOB - PNEUMONIA  g GDS  c chest indrawing - severe pneumonia  s stridor - for wheezing - give trial of rapid acting inhaled bronchodilator o give 3x dose for 15-20min apart o if -W + -S = asthma o if -W + +S = severe pneumonia  fast breathing – pneumonia - yellow o 2mo-12mo = 50bpm o less than 2mo. = 60bpm o more than 12mo. = 40bpm  no s and sx - no pneumonia; no, not, unlikely - green Diarrhea  within 5 days a. GDS (1) + s/sx (1) = severe dehydration b. No GDS + s/sx (2) = some dehydration c. No GDS + s/sx (1/no) = no dehydration  more than 14 days + s/sx = severe persistent diarrhea a. s sunken eye b. i irritable c. r restless d. s slow skin turgor  more than 14 days w/o s/sx = persistent diarrhea  blood in the stool - dysenterY - yellow - ciprofloxacin Malaria 

 Measles    

with malaria risk (BT) a. G GDS (convulsion) b. S Stiff neck - very severe febrile disease/very severe malaria c. (+) blood smear - malaria d. (-) blood smear - fever: malaria unlikely e. 1st line - artemether lumefanthrine f. 2nd line - chloroquine, primaquine, quinine, sulfadoxine no malaria risk (Hx of malaria) a. G GDS b. S Stiff neck - VSFD no s/sx of malaria - fever: no malaria

  DHF  

E extensive mouth ulcer C clouding of cornea G GDS (optional) s/sx (1) - severe complicated measles a. P pus draining in the eyes - tetracycline ointment b. M mouth ulcer - paint with 1/2 strength gentian violet measles with eye/mouth complications measles now/within 3months - measles (green)

with s/sx - severe DHF - pink - plan C if bleeding only; avoid aspirin, dolan (ibuprofen) no s/sx - fever DHF unlikely - green

Ear Problem  T Tender swelling behind the ear - mastoiditis (pink)  G GDS (optional)  more than 14 days - chronic - instill otic solution (quinolones) for 14 days - yellow  less than 14 days - acute - yellow  1st line - (amoxicillin) mastoiditis, pnemonia, acute ear problem, VSD  2nd line - cotrimoxazole - hepatotoxic  no s/sx of ear problem - no ear problem - green Malnutrition  v visible severe muscle wasting  e edema on both feet  m mid upper arm circumference - tape measure - 115mm or below (started 6mo-5yo) (CBQ)  only 1 s/sx = severe malnutrition (pink)  very low weight for age (yellow)

w weighing of newborn .8 assessment (at least 1) a. calamansi juice (give only if child more than is 6mo.5) hypothermia e. Consistency .no jaundice  pneumonia + dysentery = cipro only Diarrhea  within 5 days . Properly timed cord clamping and cutting -1-3 min after cord pulsations stops -prevents: a anemia b brain hemorrhage 4. N not feeling well Local bacterial infection .increase CHO UFC .  Anemia      not very low weight for age (green) follow up 30 days 2. oral thrush  No feeding problem .CHO  s/sx: (kwashiorkor) m moon face e edema on both extremities s stunted growth a apathy  s/sx (marasmus) w wasted muscles o old man face w wrinkled skin  skin: desquamation . F fast breathing d.no s/sx Early skin to skin contact of NB and mother -prevents: H hypothermia I infection H hypoglycemia 3.  hypoglycemia . 1-3 min 4.anemia no s/sx of anemia . 2009  legal basis .avoid Vit C since unabsorbed instead give metronidazole (anti-protozoan) 3. a administration of prelacteal . PGH  protocol for new life according to ENC  4 new steps in NBC 1. D draining Pus b.pink Feeding Problem  Feeding Problem/low weight for age . MOS/NMA . amoebiasis (mucoid like stool) .3 assessment a.severe jaundice  more 24 hours with jaundice no yellow palm/sole . S skin pustules Very severe disease/Local bacterial infection unlikely .HBMR (Home Based Mothers Record) UFC   GMC .tamarind. variety of foods . T temperature (37. 10-15 MODERATE DHN. bath.glucose water 3.erythromycin 4. not well attached. Intervention/Management b breastfeeding . vitamin A  Alternative Treatment IMCI  cough .severe persistent diarrhea pink  blood in the stool . Withing 30 sec 2. no movement at all f.Growth Monitoring Chart.yellow o s/sx: not sucking effectively.AO 2009-0025  goal/aim: reduce child mortality  3 Hospital 1.Under Five Care Program  mother (pregnant) .prevent infection) and can only be done after 16 hours -done 30 sec Elements of Diarrhea 1. assess MALNUTRITION ORT . Within 90 min  Non time bound 1.rice watery stool (cholera) . Re red umbilicus c. Non separation of mother and newborn to initiate BF colustrum . ginger (before). e eye prophylaxis . 1glass + 2tsp sugar + 1 pinch salt o oresol commercial: 1sachet + 1lit of h20 . more than 15 SEVERE DHN 2. i immunization BCG and Hepa B 3. BF less 8 for 24 hours.0-2yo  main problem: CHON .5) hyperthermia. receive other food/fluids. (35.routinely performed 1.move only if stimulated. nor remove vernix caseosa .5-10 unformed stool w/in 24 hours is called MILD DHN. assess height and weight.give tetracycline. v vitamin K administration 2.glucose water  oral thrush . Frequency .first immunization  3 Categories of Unang Yakap  Time Bound .most effective and affordable treatment for less than 6mo a am h home made oresol 1L H20 + 8tsp sugar + 1tsp salt. dysentery.2500grams  Unnecessary . r routine suctioning 4. Immediate and thorough drying of the skin -stimulates breathing -prevents hypothermia (do not wash. After thorough drying 3. r routine separation kwashiorkor vs marasmus  cause: poverty  treatment: food  onset: toddler .No s/sx  less 4mo = 200-450ml  4-12mo = 450-800ml  12mo-2yo = 800-960ml  2-5yo = 960-1600ml UNANG YAKAP  launched December 7.severe anemia some palmar pallor . C convulsions b.dysentery . S severe chest indrawing c.optional 1. f foot printing 2.Oral Rehydration Therapy  Jaundice  less 24 hours with jaundice with yellow palm/sole .MOS/NMA + s/sx (sunken eyes or skin pinch goes back slow) = severe DHN  2 of the following = some DHN  no s/sx of DHN = no DHN  more than 14 days + s/sx or no s/sx .wash mouth with clean soft cloth with salt and water 0-2 months  Very severe disease . severe palmar pallor . Quirino Memorial Medical Center 2. calamansi. Fabella Memorial MC 3.wrinkle  treatment: increase CHON.no anemia follow up is 14 days meds (Iron supplementation for 14 days.jaundice  no s/sx of jaundice .

assess 10. Rich 2. Healthy lifestyle . Health promotion 2. IMCI . People empowerment 4.DOH  vision l leader a advocate (staunched) m models in promoting health mission q quality health care e excellence and equitable s sustainable for all Filipinos  Environmental Sanitation Code of Philippines -PD 856 1. Active community participation 8. affordability. 6 No No No Words 1. Nurse focused 10 Magic Words 1. Dependency. Community integration 9. Self reliance 3.hole with cover r reed odorless earth closet .referrals. Politics .requires small amount of water a aqua privies p pour flush Level 2 s septic tank w water sealed f flush type Level 3 s septic tank with vault w water carriage type s sewage system Approved water supply facilities Pollution   2. Funding 5.  Approved toilet facilities Level 1 p pit latrines . 3. networking and linkages 4. Money 3. Health education 6. Availability. accessibility 7. Partnership with people 5. Discourage 6.

¯n  ½f°$¾ °–– °f°   ¯ f¾ ¾  $¯n¯½nf°¾  ¯ f¾ ¾°$°¯°¾ ¯ f¾ ¾%– °%     ¾$¾  ¾      ½°  ½f° .n °–€n° f  %½°f%  ¾$¾%% ¾   n¯½nf ¯ f¾ ¾ f  9½¾ f°°–°   ¾  fnn° °¯ °  .

f°°  ¾  ¾   ¯¾n f¾°–   ¯f° €   ¯ ¯  ½½  f¯ nn¯€  °n   f½  ¯ f¾   ¯¯  %¾f ¯ %%. €  °– °  f  f¾½°  f°% ½€ °%  °¾$¾ €  °  – °  f9  ¯  @@ ° ¾ °– °   f ¯f¾ ¾%½°%  %½°f%  ¯ f° f¾ n°n °¾n¾°%°° ¾%€  f¾     ¾¾f° f¾ fn     ¾ °   %f¯n°% ¯f¾ ¾  ½° ¯°f  fn  f ½  ¯  I  ° °  n¯f   ½fn  °¾$¾€ f½  ¯ ° f½  ¯ – °  .

%  °¾$¾ ¾   ¯f°°%½°%    –€f– % % . .

  °  –€f– %– °% €½ f¾  ° ¯f  ¾   ½f¯f½f ¾   f° ¯f  ¾¯ ½f¯f½f f° ¯f  °¾$¾€f° ¯f °f° ¯f  €½¾ f¾  ¯ ¾%°¾½½ ¯ °f°€ f¾ f¯°   °f @ f¯ °.

  n– f¯f° nff¯f°¾ –°– % € % nff¯f°¾©n %–  °€n ¯ f°¾¯   ½–n ¯f –n¾ f   f¾ f¾¯n f°¾€n¾ff° f    ¯°¾   I ¾    ¾ f¾  f¾¾ ¾¾¯ °%f f¾% f  .

°.$-. ¯f. ¯ °€¾¯f °¯ ¯ °ff €  -°€ °–   nf fn f°€ n° f¾¾ ¾¾¯ ° f   f°°–9¾    ¯ n¾ n  ¾°½¾ ¾  I ¾    ¾ f¾ $nf fn f°€ n°°  °¾$¾  f° n    ¾¾  ¾  ©f° n     ½f¯$¾   ¾    ©f° n   ¯ ¾©f° n ° ½f¯$¾  ©f° n   °¾$¾€©f° n  °©f° n   ½° ¯°f+ ¾ °  n½°  f f  ° f¾ . nf.$-.n°¾°¾  ¾   n ¾° f°– n  €f¾  f°–  @ ¯½ f % %½  ¯f % %½ ¯f  .+¾$¾%¾° °  ¾ ¾°½°n– ¾ fn¾% ¾   -  € €°– ¾¯ -  °¾$¾€- °-  ¯ f° f¾+¾$¾°¾$¾ ¾   ½ ¾¾ ° f f  ½°   ° ¾  ¾ °  ½°   °–9  ¯   °–9  ¯$ –€f–    4 ¾$¾ °¾n°– €€ n  ° ffn  n    € $€ ¾   ¾¾€¾ f¾  -€ °–½  ¯ -¾$¾   ¾¾¯  ¯   ¯  ¯  ¯   ¯     ¯  D--9  f°n  n ¯     –f f¾¾    –f$f¯  n n ¯f  ¾½f   .

¯f. °    f f.

   9  ½n€° € fnn °–-.

  ° ¾ ½¾°- .

   ¯¯ f f° – °–€ ¾° ¾¯f ¾  f°– ½  °¾ ½ ¯f %  ° f¾  f  °  ¯   ° nf¾ ¾f  ½  ° °€ n°% f°  nf° °  °  f€ ¾ ° ¾ n   .

f – ¾€D°f°–ff½  @¯  °  ° ½ €¯    J°–¾ n   € – °–    ¯°   J°¯°  -°¯  °    f¯°f ¯°¾f°   ¯¯°f° .

f°  ½f      ½½f¾  ¯n°    –°–€°  ° –f¯¾  D°° n ¾¾f ½°f   €€½°°–   ff ¯°¾f°€½ fn f –n¾ f    ° ¾n°°–   ° ¾ ½ff°  f¾¾¯ff¾¯¾  nf¾ ½    f¯ ° €   °¾        ¯f°½  ¯ .

- .

  ¾$¾ %f¾% ¯¯°€fn   ¯f°   ¯ ¾ ¾¾° – ff½f  ¾$¾%¯ff¾¯¾% f¾ ¯¾n ¾  ¯f°€fn  ° ¾°  ¾°  ¾f¯f° °    f¯ ° °n f¾ .

f €€ ¾ °n f¾ ..

  D.

 D°  .

f 9–f¯  ¯ %½ –°f°%  .%¯  f¾ . ¾ n %  D.

  .

°°–. .

¯ f°I-   .@.f f¾¾ ¾¾ –f°  – f¾¾ ¾¾ . .-D@@-  @ f  f°@ f½   ¯ °¾€f f     °n    °€¯  ¾ $°  ¾ ¾ nf  . .

°¾¾ °n  n  f  ¾ %n f%  –   fnn°  ¾ °   f¯ f¾¾ %¯n    ¾%  f  I .

f°f– ¯ °   f¾€ °– ¯¾ €€ n f° f€€ f   f¯ °€ ¾¾ f°¯ ff¯ ¯ ¯f  ¾  +¾½¾–f+¾½¾f  –f¾¾+¾½¾–f+½°n¾f  ¾n¯¯ nf ¾fn +€    f¾°¾°n°fn€- f° ¯  ½  °¾  ½ ¯f °€ n° ½–n ¯f   9½ ¯ n nf¯½°–f° n°–  ¯°f€ n ½¾f°¾¾½¾ ½  °¾  ff° ¯f  f° ¯f–    -°¾ ½ff°€¯ f° °  °°f   n¾¯ €¾¯¯°f°  . ¾°n  °f ¾ °¾ f – ¯ ° f %f° ½f°%   °  °°$.

  ¾°  f  ff nf %¾f°n % ¯¯ ¾°½¯°– f ¯¾¾° f fnf   n  °n f°  f   ¾¾¾f°f  €f½°¾   °°¯ °ff°f°.

f–nJ ¾    f½¯°    € f°n    9 ½  ¯½ ¯ °   9f° ¾½½ ½     f nf°   ff  f€€ f  fnn ¾¾    n n¯¯°½fn½f°   .°    9n¾  € f¾ ° °–f° °f– ¾   ° °–    ½ ° °n ¾nf–    -¾ €n¾   . €9½½° ¾ 9    ½½  €fn ¾     ½½f° ¾  n     ¾¾ fn¾    ¾¾¯ff¯°€f  fff½ ¾ ½½€¾     ¾¾ ½nf° f ¾ f  €€¾½      ¾¾ ½nf°f f nff– ½  ¾¾ f– ¾¾ ¯   ½½ f ¾½½€fn ¾   9°  ---J ¾   n   .

¯¯°° –f°   .

 f¾¾ ¾¾    f€ ¾  .

Sign up to vote on this title
UsefulNot useful