Professional Documents
Culture Documents
Ref:
1. Management of child with serious infections and malnutrition, chp. 2who.int/child-
adolescent-health/publications/referral_care/chap2/chap2fr.htm
2. Mannual for Child survival management guidelines
Tender swelling behind the Pus draing from ear less than 2 wks Pus draining for 2 wks or
Earache
ear more
Red immomobile ear drum on
otoscopy
70.0
60.0
50.0
Percentage
40.0
30.0
20.0
10.0
0.0
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Year 2001
Nasal flaring
Grunting
Nasal flaring: with inspiration, the side of the
nostrils flares outwards
Lower chest wall in-drawing (lower chest wall
Crackles
Lower chest wall in-drawing: with inspiration,
the lower chest wall moves in
CASE STUDY
A five months old child was brought to the PHC center with
complaints of:
On examination:
Fever 102.4 0 F
Nasal flaring
Respiratory rate
Check that there are no signs of very
severe disease, such as:
Central cyanosis
Inability to breastfeed or drink
Vomits everything
Convulsions
Lethargy
Unconsciousness
Severe respiratory distress
hypothermia / hyperthermia
In addition, some or all of the other signs of
pneumonia may also be present:
Fast breathing:
age 2-12 months: =>50/minute
On examination:
Respiratory rate 56 / min
Temp 1000 F
Chest clear
Chest in-drawing - ve
Pneumonia (non-severe)
Diagnosis:
On examination, the child has cough or
difficult breathing and fast breathing:
Age 2-12 months: =>50/minute
Give the first dose at the clinic and teach the mother
Common features:
Cough
Nasal discharge
Mouth breathing
Fever
The following are absent:
Fast breathing
Lower chest wall in-drawing
Stridor when the child is calm
General danger signs.
Treatment
Treat the child as an outpatient.
Soothe the throat and relieve the cough with a
safe remedy, such as a warm, sweet drink.
Relieve high fever of =>39oC (=>102.2oF) with
paracetamol, if this is causing distress to the child.
Clear secretions from the child's nose before feeds
using a cloth soaked in water, which has been
twisted to form a pointed wick.
TAKE CARE:
Do not give any of the following:
An antibiotic (they are not effective and
be harmful)
Medicated nose drops
Clearing child’s blocked nose with cotton wick
or normal saline
Follow-up
Advise the mother to:
Feed the child
Watch for fast or difficult breathing and
return, if either develops