All sick children are examined for danger signs indicating the need for immediate referral. If absent, then the chief complaint and common problems such as cough, diarrhea, fever or ear problems are evaluated..
Assessment
Ask the mother what the child's problems are. Determine if this is an initial vs follow-up visit.
(1) If this is an initial visit, assess the child (see below).
(2) If this is a follow-up visit, use the follow-up instructions on "Treat the Child" chart.
Check for general danger signs:
(1) Is the child able to drink or breastfeed?
(2) Does the child vomit everything?
(3) Has the child had convulsions?
(4) Is the child lethargic or unconscious?
Ask about main symptoms. Does the child have cough or difficult breathing?
If the child shows:
(1) any general danger sign, OR
(2) chest indrawing, OR
(3) stridor in a calm child
then classify the child as severe pneumonia or very severe disease.
If the child shows fast breathing, then classify the child as pneumonia.
where:
• The child must be calm when assessing respiration.
• Fast breathing for ages 2 to 12 months is >= 50 breaths a minute.
If there is no symptom of pneumonia or very severe disease, then classify as no pneumonia (cough or cold).
Management
If the child shows any general danger sign, then the child needs urgent attention. Complete the assessment and any pre-referral treatment immediately so that referral is not delayed.
If the child is classified as severe pneumonia or very severe disease:
(1) treat: give the first dose of an appropriate antibiotic.
(2) refer urgently to hospital.
If the child is classified as pneumonia:
(1) treat: give an appropriate antibiotic for 5 days.
(3) soothe the throat and relief the cough with a safe remedy
(4) advise the mother when to return immediately
(5) follow-up in 2 days
If the child is classified as no pneumonia:
(2) refer for assessment if coughing more than 30 days
(3) soothe the throat and relief the cough with a safe remedy
(4) advise the mother when to return immediately
(5) follow-up in 5 days if not improving
