IMCI TECHNICAL UPDATES:

Preparedby:
RHEA G. MALLARI RN,MAN
COUGHING
Previous: Updated:
No assessment for wheezing Inclusion of wheezing during
assessment
If wheezing is present:
* Give a trial of rapid acting inhaled
bronchodilator for upto 3x with 15 to 20
minutes interval 0.5ml salbutamol diluted
in 2 ml sterile water per dose
* Bronchodilator for 5 days
Antibiotic treatment (pneumonia only)
Previous: Updated:
First line: Cotrimoxazole
2x a day for 5 days
Second line:Amoxicillin
3x a day for 5 days
First line: Amoxicillin
2x a day for 3 days
Second line: Cotrimoxazole
2x a day for 3 days
First line:Chloramphenicol
Second line: Benzylpenicillin and
Gentamicin
First line: Gentamicin plus
Benzyl penicillin
Second line: Chloramphenicol
DIARRHEA
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Use of antibiotics in the management of dysentery
Previous: Updated:
First line: Cotrimoxazole
2x a day for 5 days
Second line:Nalidixic acid
3x a day for 5 days
First line: Ciprofloxacin
2x a day for 3 days
Diarrheal diseases treatment
Previous: Updated:
Persistent diarrhea treatment
1.Give vit. A 1 dose only
2.Advise recommended feeding
3.Follow up 5 days
Persistent diarrhea treatment:
1.Give multivitamins and minerals with
zinc supplement for 14 days
2.Advise recommended feeding
3.Follow up 5 days
FEVER
Treatment of Malaria:
Previous: Updated:
First line: Sulfadoxine-Pyrimethamine
Chloroquine
Primaquine
Second line:Artemether-Lumefantrine
First line: Artemether-Lumefantrine

Second line:Sulfadoxine-Pyrimethamine
Chloroquine
Primaquine

EAR PROBLEM
2
Treatment of Chronic ear infections:
Previous: Updated:
Chronic ear infection treatment;
1.Dry the ear by wicking
2.Follow up 5 days
Chronic ear infection treatment;
1.Instill otic drops(quinolone)
2-3 drops 3x daily for 2 weeks
2.Dry the ear by wicking
3.Follow up 5 days
NUTRI TIONAL STATUS: Malnutrition And Anemia
Previous: Updated:
SEVERE MALNUTRI TION: PINK
Visible severe wasting
or
Edema on both feet
SEVERE MALNUTRI TION: PINK
Visible severe wasting
or
Edema on both feet
or
If age 6 mos. and above
with MUAC less than 115 mm
*MUAC(Mid Upper Arm Circumference)
MANAGEMENT OF SICK YOUNG INFANT
Previous: Updated:
Young infant age:
1wk old upto 2 months old
Young infant age:
At birth upto 2 months old
3
Any of the ff. 12 signs and
symptoms
Possible Serious Bacterial Infection
CUA-FFUNCES and
Low body temperature
Bulging of Fontannels
Any of the ff. 7 signs and symptoms
Very Severe Disease
Convulsions
Unable to feed or not feeding well
Abnormally sleepy or no movement at all
Fever and L ow body temperature
Fast breathing
Chest Indrawing ( severe)
Classifications:
Possible Serious Bacterial Infection (PINK)
Local Bacterial Infection
(YELLOW)
Classifications:
Very Severe Disease (PINK)
Local Bacterial Infection (YELLOW)
Severe Disease or Local Bacterial Infection unlikely
(GREEN)
Updated:
Inclusion of jaundice during assessment
ASSESSMENT CLASSIFICATION TREATMENT
Jaundice appearing less
than 24hours
Or
Yellow palms at any age
SEVERE JAUNDICE
(PINK)
Keep the infant warm
Treat to prevent low blood
sugar
Refer urgently to hospital
Jaundice appearing after 24
hours
JAUNDICE
(YELLOW)
Advise mother to give home
care
Breastfeed frequently:
as often, and for as
long as the infant
wants
day and night,
during sickness and
health
No jaundice NO JAUNDICE
(GREEN)
Advise mother to give home
care: Breastfeed frequently
IMNCI
INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS
Home visits for young infants: Schedule
All newborns:
3 visits :
within 24 hours of birth,
4
day 3 and
day 7
Newborns with low birth weight:
3 more visits :
day 14,
day 21 and
day 28.
Home visits for young infants:
Objectives:
Promote & support exclusive breastfeeding
Teach the mother how to keep the young infant warm
Teach the mother to recognize signs of illness for which to seek care
Give advise on cord ,skin and eye care and hand washing
Classify illness at visit and facilitate referral
Advise mother to go to the hospital if infant has any of the
following:
Jaundice of the soles
Convulsions
Difficulty of feeding
Movementonly when stimulated
Fast breathing
Fever
Low bodytemperature
Chest indrawing
Kangaroo mother care (KMC) is an effective way to care for a small baby
weighing
between1,000 and2,000 grams who has no major illness
1.Dress the infant in a warm shirt openat the front, with cap,nappy, andsocks
2. Place the infant in skin to skin contact
3. Place the infant in upright betweenthe mothers breasts, with headturned to one side.
4.The babyis then tied to the mothers chest with a cloth andcoveredwith the mothers clothes.
Research has shown that for preterm babies, KMC is at least as effective
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as incubator care.
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