Imci

‫بسم الله الرحمن الرحيم‬ ‫”قالوا سبحانكل علم لناإل ما علمتنا‬ ‫إنك أنت العليم الحكيم“‬ ‫صدق الله العظيم‬ ‫سورة البقرة ايه ‪32‬‬

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS

IMCI

THE IMCI STEPS

A-Methods of Assessment Ask-1 Look-2 Listen-3 Feel-4

B-Management I-Give 1st aid & Urgently refer to Hospital II-Give treatment in Clinic III-No treatment

C-Counsel the Mother I-Food II-Fluid III-Follow up

IMCI ASK Personal History + Whether it is an initial or follow up visit

Check For Dangerous Signs

Assess & Classify & Treat The Main Symptoms Fever-Cough-Diarrhea

.Check for nutrition & immunization Counsel The Mother

Dangerous signs

CHECK FOR GENERAL DANGER SIGNS ASK

    

LOOK  See if the child is lethargic or unconscious

Is the child able to drink or breast-feed?

 

 Does the child vomit every thing?

See if the child is convulsing now

 Has he had had convulsions? (during present illness)

FEEL SIGNS

CLASSIFY AS

TREAT

Treat convulsions IF present now     Complete assessment immediately st     Give 1 dose of appropriate antibiotic     Treat child to prevent low blood sugar     Refer URGENTLY to hospital     

Any Danger        

Sign

VERY SEVERE DISEASE

does the child has stiff neck

Cough

Does the child have Cough or Difficult breathing? IF YES, ASK

LOOK

•       For how long

  

     Count the breaths in one minute        Look for chest indrawing

listen for stridor for wheeze

       

Any danger sign, OR

       Stridor in calm child, OR        Chest indrawing If Wheeze, go directly to treat wheeze, then reassess)

SEVERE PNEUMONIA OR VERY SEVERE DISEASE

•       Fast breathing (If Wheeze, go directly to treat wheeze, then reassess)

•        No signs of pneumonia or very severe disease

(If Wheeze, go directly to treat wheeze)

    

Give 1st dose of appropriate antibiotic

    Treat wheezing, if present     Treat child to prevent low blood sugar     Refer URGENTLY to hospital

Give appropriate antibiotic for 5 days     Treat wheezing, if present     If coughing more than 30 days ,refer for assessment     Relieve cough with a safe remedy     Advise mother when to return immediately     Follow up in 2 days     

PNEUMONIA

NO PNEUMONIa

Treat wheezing, if present  If coughing more than 30 days ,refer for assessment     Relieve cough with a safe remedy     Advise mother when to return immediately     Follow up in 2 days, if wheezing     Follow up in 5 days if not improving     

Diarrhea

Does the child have diarrhea :IF YES ASK

: LOOK

For how• ?long Is there• blood in the stools

Look at the child’s general• :condition, Is he ?Lethargic or unconscious– ?Restless or irritable– Look for sunken eyes• Offer the child fluid. Is the• :child Not able to drink or drinking– ?poorly ?Drinking eagerly, thirsty–

FEEL: Pinch the skin on the• .abdomen

1-

CLASSIFY FOR DEGREE OF DEHYDRATION

Two of the following signs:        Lethargic or unconscious        Sunken eyes        Drinks poorly or unable to drink

    

SEVERE DEHYDRATION

If child has no other severe classification: Give fluids for severe dehydration (Plan C) OR

   If child has also another severe classification: Refer URGENTLY

       Skin pinch goes back very slowly

to hospital while giving ORS sips Advise to continue breastfeeding

Two of the following signs:

    

dehydration (Plan B)

       Restless, irritable        Sunken eyes        Thirsty, drinks eagerly

Give fluids and food for some

SOME DEHYDRATION

       Skin pinch goes back slowly

   If child has also a severe classification: - Refer URGENTLY to hospital while giving frequent ORS sips -Advise to continue breastfeeding     Advise when to return immediately     Follow up in 5 days IF not improving

•       NO enough signs to classify as some or severe dehydration

NO DEHYDRATION

    

Give fluids and food to treat diarrhea at home (Plan A)

    Advise when to return immediately     Follow up in 5 days IF not improving

CLASSIFY FOR PERSISTENT DIARRHEA-2        

Dehydration present

SEVERE PERSISTENT DIARRHEA

Treat dehydration before referral unless the child has another severe classification     

    

PERSISTENT DIARRHEA        

No dehydration

Refer to hospital

    Advise mother on feeding child with Persistent Diarrhea     Give multivitamin / mineral supplement     Advise mother when to return immediately     Follow up in 5 days

CLASSIFY FOR DYSENTERY .3 •Blood in the stools •DYSENTERY

•Treat for 5 days with an oral antibiotic recommended for Shigella(trimethoprim) for 5 days •Give metronidazole for 10 days •Advise mother when to return immediately •Follow-up in 2 days