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TREAT THE CHILD.pptx

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The document provides treatment guidelines for children at first-level health facilities. It recommends first-line oral and intramuscular drugs that are effective, easy to administer, and inexpensive. Second-line drugs should only be used if first-line drugs are unavailable or not effective. It provides specific treatment guidelines for conditions like pneumonia, fever, pain, and vitamin deficiencies.

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z TREAT THE CHILD
z  The oral drugs, intramuscular drugs and other treatments presented in the IMCI charts are recommended for first-level health facilities.  First-line drugs were chosen because they are effective, easy to give and inexpensive.  second-line drug is only given if a first-line drug is not available, or if the child's illness does not respond to the first-line drug.
z ORAL ANTIBIOTICS  Give the first-line oral antibiotic if it is available. It has been chosen because it is effective, easy to give and inexpensive.
ï‚· Recommended first-line and second-line antibiotics may need to be changed based on resistance data. You should give the second-line antibiotic only if: o the first-line antibiotic is not available, o the child's illness does not respond to the first-line antibiotic, or the first line antibiotic is cotrimoxazole and an HIV exposed or infected child is already on cotrimoxazole prophylaxis
z  Some children have more than one illness that requires antibiotic treatment, so single antibiotic is given to treat several illness.  Sometimes more than one antibiotic must be given to treat the illnesses. Eg, An antibiotic to treat pneumonia may not be effective against dysentery, so a child may need to be given two antibiotics.
z RAPID ACTING BRONCHODILATOR  A bronchodilator is a drug that helps some children with a wheeze to breathe easier by relaxing the muscles in the bronchi walls so that the bronchi open up. Bronchodilators act rapidly when given by injection or inhaled as a vapour. This is why they are called "rapid acting". Salbutamol is the most common and effective bronchodilator.
z Give inhaled salbutamol for trial before classifying cough or difficulty breathing  All children presenting with a wheeze and either fast breathing or chest in drawing should get a trial with a rapid acting bronchodilator, given up to three times 15-20 minutes apart, before their cough or difficulty breathing is classified. If chest in drawing or fast breathing disappears, then antibiotic treatment is not needed.
z Give inhaled salbutamol for home treatment  Children with wheezing should continue getting 2 puffs of inhaled bronchodilator three times daily for 5 days. In settings where an inhaler is not available, oral salbutamol may be the second choice.
z PARACETAMOL FOR HIGH FEVER (>38.5°C) OR PAIN  Paracetamol lowers fever and reduces pain.  If a child has a high fever, regardless of the classification, give one dose of paracetamol in clinic.  If the child has ear pain, give the mother enough paracetamol for 1 day, that is, 4 doses. Tell her to give one dose every 6 hours or until the ear pain is gone.
z VITAMIN A  One dose of vitamin A is given to all children every 6 months to prevent serious illness any time after 6 months of age.  One extra dose of vitamin A is given to treat children with measles or PERSISTENT DIARRHOEA if they have not received a dose of vitamin A within the past month.  Vitamin A helps resist the measles virus infection in the eye as well as in the layer of cells that line the lung, gut, mouth and throat. It may also help the immune system to prevent other infections. Corneal clouding, a sign of vitamin A deficiency, can progress to blindness if vitamin A is not given.
z Cont. IRON  A child with some palmar pallor may have anaemia. A child with anaemia needs iron. Give syrup to the child under 12 months of age. If the child is aged 12 months or older, give iron tablets. Give the mother enough iron for 14 days. Tell her to give her child one dose daily for the next 14 days. Ask her to return for more iron in 14 days. Also tell her that the iron may make the child's stools black. MEBENDAZOLE  If hookworm or whipworm is a problem in your area, give mebendazole as a single dose in the clinic to each child that is 1 year old or older and has not had a dose in the previous 6 months.  Hookworm or whipworm infections contribute to anaemia because of iron loss through intestinal bleeding. These infections also contribute to malnutrition.  Give 500 mg mebendazole as a single dose in the clinic. Give either one 500 mg tablet or five 100 mg tablets.
z ARV PROPHYLAXIS FOR HIV EXPOSED BREASTFEEDING CHILD  A young infant classified as HIV EXPOSED should be given cotrimoxazole and nevirapine, based on the weight of the baby. Nevirapine is given from birth or from the time HIV exposure is recognised.

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TREAT THE CHILD.pptx

  • 2. z  The oral drugs, intramuscular drugs and other treatments presented in the IMCI charts are recommended for first-level health facilities.  First-line drugs were chosen because they are effective, easy to give and inexpensive.  second-line drug is only given if a first-line drug is not available, or if the child's illness does not respond to the first-line drug.
  • 3. z ORAL ANTIBIOTICS  Give the first-line oral antibiotic if it is available. It has been chosen because it is effective, easy to give and inexpensive.
  • 4. ï‚· Recommended first-line and second-line antibiotics may need to be changed based on resistance data. You should give the second-line antibiotic only if: o the first-line antibiotic is not available, o the child's illness does not respond to the first-line antibiotic, or the first line antibiotic is cotrimoxazole and an HIV exposed or infected child is already on cotrimoxazole prophylaxis
  • 5. z  Some children have more than one illness that requires antibiotic treatment, so single antibiotic is given to treat several illness.  Sometimes more than one antibiotic must be given to treat the illnesses. Eg, An antibiotic to treat pneumonia may not be effective against dysentery, so a child may need to be given two antibiotics.
  • 6. z RAPID ACTING BRONCHODILATOR  A bronchodilator is a drug that helps some children with a wheeze to breathe easier by relaxing the muscles in the bronchi walls so that the bronchi open up. Bronchodilators act rapidly when given by injection or inhaled as a vapour. This is why they are called "rapid acting". Salbutamol is the most common and effective bronchodilator.
  • 7. z Give inhaled salbutamol for trial before classifying cough or difficulty breathing  All children presenting with a wheeze and either fast breathing or chest in drawing should get a trial with a rapid acting bronchodilator, given up to three times 15-20 minutes apart, before their cough or difficulty breathing is classified. If chest in drawing or fast breathing disappears, then antibiotic treatment is not needed.
  • 8. z Give inhaled salbutamol for home treatment  Children with wheezing should continue getting 2 puffs of inhaled bronchodilator three times daily for 5 days. In settings where an inhaler is not available, oral salbutamol may be the second choice.
  • 9. z PARACETAMOL FOR HIGH FEVER (>38.5°C) OR PAIN  Paracetamol lowers fever and reduces pain.  If a child has a high fever, regardless of the classification, give one dose of paracetamol in clinic.  If the child has ear pain, give the mother enough paracetamol for 1 day, that is, 4 doses. Tell her to give one dose every 6 hours or until the ear pain is gone.
  • 10. z VITAMIN A  One dose of vitamin A is given to all children every 6 months to prevent serious illness any time after 6 months of age.  One extra dose of vitamin A is given to treat children with measles or PERSISTENT DIARRHOEA if they have not received a dose of vitamin A within the past month.  Vitamin A helps resist the measles virus infection in the eye as well as in the layer of cells that line the lung, gut, mouth and throat. It may also help the immune system to prevent other infections. Corneal clouding, a sign of vitamin A deficiency, can progress to blindness if vitamin A is not given.
  • 11. z Cont. IRON  A child with some palmar pallor may have anaemia. A child with anaemia needs iron. Give syrup to the child under 12 months of age. If the child is aged 12 months or older, give iron tablets. Give the mother enough iron for 14 days. Tell her to give her child one dose daily for the next 14 days. Ask her to return for more iron in 14 days. Also tell her that the iron may make the child's stools black. MEBENDAZOLE  If hookworm or whipworm is a problem in your area, give mebendazole as a single dose in the clinic to each child that is 1 year old or older and has not had a dose in the previous 6 months.  Hookworm or whipworm infections contribute to anaemia because of iron loss through intestinal bleeding. These infections also contribute to malnutrition.  Give 500 mg mebendazole as a single dose in the clinic. Give either one 500 mg tablet or five 100 mg tablets.
  • 12. z ARV PROPHYLAXIS FOR HIV EXPOSED BREASTFEEDING CHILD  A young infant classified as HIV EXPOSED should be given cotrimoxazole and nevirapine, based on the weight of the baby. Nevirapine is given from birth or from the time HIV exposure is recognised.