Ryan A.

Vocalan BSN IV- abdellah

Integrated Management of Childhood Illness 6. Give follow-up

(IMCI) DISEASES ASSOCIATED IN IMCI

Objectives: • COUGH
1. Significantly reduce global morbidity and • DIARRHEA
mortality in children.
• FEVER
2. Contribute to the healthy growth of children.
o Malaria
Components:
o Measles
1. Improving the case management and
counseling skills of health care providers. o Dengue hemorrhagic fever
2. Strengthening the health system for effective • EAR PROBLEM
management of childhood illness.
• MALNUTRITION & ANEMIA
3. Improving the family and community practices
related to child health and nutrition. CLASSIFICATION
STEPS: Sick Young Infant
1. Assess  1 week-2 months
2. Classify the illness to help you in the (1 month- 29 days)
treatment
Sick child
a. Pink- urgent referral
 2 months-5 years
b. Yellow- you’re the one to treat.
DANGER SIGNS
c. Green- maybe advise or home treatment Ask for:
3. Identify the treatment
• Convulsion unconscious
4. Treat or refer the child

5. Counsel the mother

• Unable to feed cannot swallow

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Ryan A. Vocalan BSN IV- abdellah

• Vomiting does the child vomits AGE or WEIGHT ADULT SYRUP

everything? CAPSULE (125 mg/5 ml)
( 250 mg )
2 mos up to 6 mos ½ 5ml
• Abnormally sleepy/ difficult to awaken (3-5 kg)
- No reaction even if you’re clapping, 6 mos up to 12 1 10 ml
mos
tapping, or shaking the infant.
(6-9 kg)
12 mos up to 3 yrs 1½ 15 ml
If yes (CUVA) (10-14 kg)
 Make sure the child with any general danger 3 yrs up to 5 yrs 2 -
sign is referred after the first dose of an (15-19 kg)
appropriate antibiotic and other urgent
treatment

 EXCEPTION: rehydration of the child according

to plan C may resolve the danger signs so that THEN ASK ABOUT THE MAIN SYMPTOMS:
referral is no longer needed. Does the child have cough of difficulty
breathing?

IF YES, ASK:

APPROPRIATE ORAL ANTIBIOTIC • For how long?

 For pneumonia, mastoiditis/acute ear infection, LOOK, LISTEN:

or very severe disease
• Count the breaths in one min.
st
1 line: AMOXICILLIN
• Look for chest indrawing. CHILD
AMOXICILLIN
• Look and listen for stridor. MUST
 Give two times daily for 3 days
(pneumonia) • Look and listen for wheeze. BE CALM
 Give three times daily for 5
days (acute ear IF WHEEZING AND EITHER FAST BREATHING
infection/mastoiditis) OR CHEST INDRAWING: give a trial of rapid
acting inhaled bronchodilator for up to 3 times 15-

Submitted to : Mam Ulanday

Ryan A. Vocalan BSN IV- abdellah

20 min. apart. Count the breaths and look for chest • If chest indrawing and wheeze, go directly to
indrawing again, and then classify. treat wheezing.

• Treat the child to prevent low blood sugar.

IF THE CHILD IS: FAST • Refer URGENT to hospital
BREATHING

• 2 months up to 12 months old 50 BPM

or more GIVE VITAMIN A

• 12 months up to 5 years old 40 BPM  Give one dose in the health center
or more
SUPPLEMENTS

 Give one dose In the health center if:

PINK o Child is 6 mos of age or older, AND

o Child has not received a dose of

SIGNS vitamin A in the past 6 mos.

• Any general danger sign, or

AGE VITAMIN A CAPSULE
• Chest indrawing, or
100,000 IU 200,000 IU
• Stridor in calm child
6 months up to 12 months 1 ½
CLASSIFY AS:
12 months up to 5 years - 1
• SEVERE PNEUMONIA OR VERY SEVERE DISEASE

TREATMENT
TREAT THE CHILD TO PREVENT LOW BLOOD
• Give first dose of antibiotic.
SUGAR
• Give vitamin A
 If the child is able to breastfeed:

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Ryan A. Vocalan BSN IV- abdellah

o Ask the mother to breastfeed the TREATMENT

child.
• Give an appropriate antibiotic for 3 days
 If the child is not able to breastfeed but is
able to swallow: • If wheezing (even if it disappeared after
rapidly acting bronchodilator) give an
o Give expressed milk or a breast inhaled bronchodilator for 5 days
milk substitute. ( salbutamol is the drug of choice)

o If neither of these is available, give
sugar water.
o Give 30-50 ml of milk or sugar
water before departure.
To make sugar water: dissolve
4 level teaspoons of sugar (20
grams) in a 200ml cup of clean
water.
 If the child is not able to swallow:
• Soothe the throat and relieve the cough
with a safe remedy (T-tamarind, L- luya, C-
calamansi)
• If coughing for more than 3 weeks or if
having recurrent wheezing, refer for
assessment for TB or asthma
• Advise the mother when to return
immediately
• Follow-up in 2 days

o Give 50 ml of milk or sugar water GREEN

by NGT.
SIGNS

• No signs of pneumonia or very severe

YELLOW disease

SIGNS: CLASSIFY AS

• FAST BREATHING • NO PNEUMONIA: cough or cold

CLASSIFY AS: TREATMENT

• PNEUMONIA

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Ryan A. Vocalan BSN IV- abdellah

• If wheezing (even if it disappeared after

rapidly acting bronchodilator) give an
inhaled bronchodilator for 5 days

• Soothe the throat and relieve the cough

with a safe remedy

• If coughing for more than 30 days, refer

for assessment.

• Advise mother when to return immediately

• Follow up in 5 days if not improving; if not

treated for wheeze, follow up in 2 days.

Submitted to : Mam Ulanday