WHO FHIR Implementation Guide (IG): Integrated Management of Childhood Illness (IMCI) in emergencies
0.1.0 - release

WHO FHIR Implementation Guide (IG): Integrated Management of Childhood Illness (IMCI) in emergencies, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-emcare/tree/feature/update-canonical and changes regularly. See the Directory of published versions

## Questionnaire: Ccc.Treatment

Branch:

Profile: SDCBaseQuestionnaire

LinkID | Text | Cardinality | Type | Flags | Description & Constraints
--- | --- | --- | --- | --- | ---
Ccc.Treatment |  |  | Questionnaire |  | https://smart.who.int/ccc/Questionnaire/Ccc.treatment#0.1.0
AgeInMonths | null | 0..1 | integer |  | Value Set:
child | null | 0..1 | group |  | Value Set:
Ccc.C10.IT.DE01 | <h1>Very Severe Disease</h1> <p>➢ <b>Give one dose of rectal diazepam if convulsing now, repeat after 10 minutes if convulsion has not stopped</b></p> <p>➢ <b>Give any pre-referral treatment immediately</b></p> <p>➢ <b>Treat to prevent low blood sugar</b></p> <p>➢ <b>Keep the child warm</b></p> <p>➢ <b>Refer <span class="caps">URGENTLY</span> to hospital*.</b></p> <p>*Exception: If lethargy is the only sign and child is dehydrated, rehydrated and assess.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE02 | <h1>Severe Pneumonia or Very Severe Disease</h1> <p>➢ <b>Give first dose of intramuscular Cefotaxime</b></p> <p>➢If wheezing present, give one dose of rapid acting bronchodilator* pre-referral</p> <p>➢Treat the child to prevent low blood sugar</p> <p>➢Refer <span class="caps">URGENTLY</span> to hospital</p> <p>*Nebulized salbutamol, salbutamol inhaler with spacer, or subcutaneous epinephrine (adrenaline)</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE03 | <h1>Pneumonia</h1> <p>➢**Give oral Amoxicillin twice daily for 5 days**</p> <p>➢If wheezing (or disappeared after inhaled salbutamol) give inhaled or oral salbutamol three times a day for 5 days*</p> <p>➢Soothe the throat and relieve the cough with a safe remedy.</p> <p>➢If coughing for ≥14 days or recurrent wheeze, refer for possible TB or asthma assessment</p> <p>➢Advise mother when to return immediately</p> <p>➢Follow-up in 3 days</p> <p>➢Give oral Zinc once daily for 10-14 days.</p> <p>*If inhaled bronchodilator is not available, oral salbutamol may be tried but not recommended for treatment of severe acute wheeze.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE04 | <h1>Cough or Cold</h1> <p>➢If wheezing (or disappeared after inhaled salbutamol) give inhaled or oral salbutamol three times a day for 5 days**</p> <p>➢Soothe the throat and relieve the cough with a safe remedy.</p> <p>➢If coughing for ≥14 days or recurrent wheeze, refer for possible TB or asthma assessment</p> <p>➢Advise mother when to return immediately</p> <p>➢Follow-up in 5 days if not improving</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE05 | <h1>Severe Dehydration</h1> <p>➢ If child has no other severe classification:* Give fluid for severe dehydration (plan C) OR</p> <p>➢ <b>If child also has another severe classification:</b></p> * <b>Refer <span class="caps">URGENTLY</span> to hospital with mother giving frequent sips of <span class="caps">ORS</span> on the way.</b> * <b>Advise the mother to continue breastfeeding.</b> <p>➢If child is 2 years or older and there is cholera in your area, give oral co-trimoxazole twice daily for 3 days or oral erythromycin 4 times a day for 3 days for cholera.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE06 | <h1>Some Dehydration</h1> <p>➢Give Plan B for some dehydration:</p> <ul> <li>Give <span class="caps">ORS</span> over 4 hrs in clinic, reassess for dehydration and select appropriate plan to continue treatment</li> </ul> <ul> <li>If mother must leave before completing treatment, give <span class="caps">ORS</span> for 4 hr Plan B treatment plus 2 packets as recommended in Plan A</li> <li>At home, give extra fluid (as much as the child will take)</li> <li>Give oral Zinc once daily for 10 &#8211; 14 days</li> <li>Continue feeding (exclusive breastfeeding if under 6 months)</li> </ul> <p>➢ <b>If child also has another severe classification:</b></p> <ul> <li><b>Refer <span class="caps">URGENTLY</span> to hospital with mother giving frequent sips of <span class="caps">ORS</span> on the way.</b></li> <li><b>Advise the mother to continue breastfeeding.</b></li> </ul> <p>➢Advise mother when to return immediately.</p> <p>➢Follow-up in 5 days if not improving.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE07 | <h1>No Dehydration</h1> <p>➢Give Plan A for no dehydration:</p> <ul> <li>Give extra fluid (as much as the child will take)</li> <li>Teach mother how to give <span class="caps">ORS</span> and give 2 packets to use at home</li> <li>Give oral Zinc once daily for 14 days</li> <li>Continue feeding (exclusive breastfeeding if under 6 months)</li> </ul> <p>➢ <b>If child also has another severe classification:</b></p> <ul> <li><b>Refer <span class="caps">URGENTLY</span> to hospital with mother giving frequent sips of <span class="caps">ORS</span> on the way.</b></li> <li><b>Advise the mother to continue breastfeeding.</b></li> </ul> <p>➢Advise mother when to return immediately.</p> <p>➢Follow-up in 5 days if not improving.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE08 | <h1>Severe Persistent Diarrhoea</h1> <p>➢Treat dehydration before referral unless the child has another severe classification.</p> <p>➢Refer to hospital.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE09 | <h1>Persistent Diarrhoea</h1> <p>➢Advise the mother on feeding a child who has persistent diarrhoea.</p> <p>➢Give multivitamins and minerals (including zinc once daily) for 14 days.</p> <p>➢Follow-up in 5 days.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE10 | <h1>Possible Shigella</h1> <p>➢Treat dehydration before referral unless the child has another severe classification.</p> <p>➢Refer to hospital.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE11 | <h1>Dysentery</h1> <p>➢Give Oral Metronidazole three times daily for 10 days.</p> <p>➢Treat dehydration if present.</p> <p>➢Follow-up in 3 days.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE12 | <h1>Throat Abscess or Possible Diptheria</h1> <p>➢ <b>Give first dose of intramuscular Procaine Penicillin pre-referral; if unavailable or allergic to penicillin give first dose of oral Erythromycin pre-referral.</b></p> <p>➢ <b>Give one dose of oral Paracetamol for pain or high fever (38.5°C or above).</b></p> <p>➢ <b><span class="caps">REFER</span> <span class="caps">URGENTLY</span> to hospital.</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE13 | <h1>Streptococcal Sore Throat</h1> <p>➢ <b>Give single dose of intramuscular benzathine penicillin, or if unavailable give oral amoxicillin twice daily for 10 days; if allergic to penicillin give oral erythromycin 4 times daily for 10 days</b></p> <p>➢ **Give oral paracetamol for pain or high fever (38.5°C or above), continue to give every 6 hours (4 times / day) until pain and/or high fever gone. **</p> <p>➢ Soothe the throat with a safe remedy.</p> <p>➢ Follow-up in 5 days if not improving.</p> <p>➢ Advise the mother when to return immediately</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE14 | h1.Non-Streptococcal Sore Throat</p> <p>➢ <b>Give oral paracetamol for pain or high fever (38.5°C or above), continue to give every 6 hours (4 times / day) until pain/high fever gone.</b></p> <p>➢ Soothe the throat with a safe remedy.</p> <p>➢ Follow-up in 5 days if not improving.</p> <p>➢ Advise the mother when to return immediately | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE15 | <h1>No Throat Problem</h1> <p>➢ <b>Give oral paracetamol for pain or high fever (38.5°C or above), continue to give every 6 hours (4 times / day) until pain /high fever gone.</b></p> <p>➢ Advise the mother when to return immediately</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE16 | <h1>Mastoiditis</h1> <p>➢ <b>Give first dose of intramuscular Cefotaxime</b></p> <p>➢ <b>Give one dose of oral Paracetamol for pain or high fever (38.5°C or above).</b></p> <p>➢ <b>Refer <span class="caps">URGENTLY</span> to hospital</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE17 | <h1>Acute Ear Infection</h1> <p>➢ <b>Give an appropriate oral antibiotic:</b></p> <p> * <b>First-line: Oral Amoxicillin twice daily for 10 days</b> * <b>Second-line: Oral Co-trimoxazole twice daily for 10 days</b> * <b>If allergic to amoxicillin and co-trimoxazole, give Oral Erythromycin 4 times daily for 10 days</b></p> <p>➢ <b>Give oral paracetamol for pain or high fever (38.5°C or above), continue to give every 6 hours (4 times / day) until pain/high fever gone.</b></p> <p>➢ If ear discharge: Dry the ear by wicking at least 3 times daily</p> <p>➢ Advise the mother when to return immediately.</p> <p>➢ Follow-up in 5 days</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE18 | <h1>Chronic Ear Infection</h1> <p>➢ Dry the ear by wicking</p> <p>➢ Refer to <span class="caps">ENT</span> specialist.</p> <p>➢ <b>If ear pain or fever, give an appropriate oral antibiotic:</b></p> <ul> <li><b>First-line: Oral Amoxicillin twice daily for 10 days</b></li> <li><b>Second-line: Oral Co-trimoxazole twice daily for 10 days</b></li> <li><b>If allergic to amoxicillin and co-trimoxazole, give Oral Erythromycin 4 times daily for 10 days</b></li> </ul> <p>➢**Give one dose of oral Paracetamol in clinic for pain or high fever (38.5°C or above),** continue to give every 6 hours (4 times / day) until pain/high fever gone.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE19 | <h1>No Ear Infection</h1> <p>➢No treatment</p> <p>➢Refer to <span class="caps">ENT</span> specialist.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE20 | <h1>Very Severe Febrile Disease</h1> <p>➢ <b>Give first dose of intramuscular Cefotaxime</b></p> <p>➢ <b>Treat the child to prevent low blood sugar</b></p> <p>➢ <b>Give one dose of oral Paracetamol for high fever (38.5°C or above).</b></p> <p>➢ <b>Refer <span class="caps">URGENTLY</span> to hospital</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE21 | <h1>Fever: Possible Bacterial Infection</h1> <p>➢ Treat apparent cause of fever.</p> <p>➢ <b>Give one dose of oral Paracetamol in clinic for high fever (38.5°C or above).</b> continue to give every 6 hours (4 times / day) until high fever gone. </p> <p>➢ Follow up in 3 days if fever persists</p> <p>➢ Advise the mother when to return immediately</p> <p>➢ If fever present every day for more than 7 days, refer for assessment</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE22 | <h1>Fever: Bacterial Infection Unlikely</h1> <p>➢ <b>Give one dose of oral Paracetamol in clinic for high fever (38.5°C or above).</b> continue to give every 6 hours (4 times / day) until high fever gone. </p> <p>➢ Follow up in 3 days if fever persists</p> <p>➢ Advise the mother when to return immediately</p> <p>➢ If fever present every day for more than 7 days, refer for assessment</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE23 | <h1>Severe Complicated Measles</h1> <p>➢ <b>Give first dose of oral Vitamin A if the child has not had a dose within the past month and is not on <span class="caps">RUTF</span></b></p> <p>➢ <b>Give first dose of Intramuscular Cefotaxime</b></p> <p>➢ <b>Give one dose of oral Paracetamol for high fever (38.5°C or above).</b></p> <p>➢ <b>If clouding of the of cornea or pus draining from the eye, apply Tetracycline eye ointment 4 times daily until there is no pus discharge</b></p> <p>➢ <b>Treat to prevent low blood sugar.</b></p> <p>➢ <b>Refer <span class="caps">URGENTLY</span> to hospital.</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE24 | <h1>Measles with eye or mouth complication</h1> <p>➢ <b>Give oral Vitamin A if the child has not had a dose within the past month and is not on <span class="caps">RUTF</span> &#8211; first dose in clinic</b> and one dose to give at home the next day</p> <p>➢ <b>If pus draining from the eye, apply Tetracycline eye ointment 4 times daily until there is no pus discharge</b></p> <p>➢ If mouth ulcers, treat twice daily with gentian violet until 48 hrs after the ulcers have been cured</p> <p>➢ **Give one dose of oral Paracetamol in clinic for pain or high fever (38.5°C or above), continue to give every 6 hours (4 times / day) until pain/high fever gone. </p> <p>➢ Follow up in 3 days</p> <p>➢ Advise mother when to return immediately</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE25 | <h1>Possible Measles</h1> <p>➢ Send for blood sample</p> <p>➢ <b>Give oral Vitamin A if the child has not had a dose within the past month and is not on <span class="caps">RUTF</span> &#8211; first dose in clinic</b> and one dose to give at home the next day</p> <p>➢ Advise mother when to return immediately.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE42 | <h1>Severe Anaemia</h1> <p>➢Treat to prevent low blood sugar</p> <p>➢Refer <b><span class="caps">URGENTLY</span></b> to hospital.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE43 | <h1>Anaemia</h1> <p>➢Give oral Iron* once daily for 14 days</p> <p>➢Assess the child`s feeding and counsel the mother on feeding according to the <span class="caps">FOOD</span> box or the <span class="caps">COUNSEL</span> <span class="caps">THE</span> <span class="caps">MOTHER</span> chart.</p> <p>➢Advise mother when to return immediately</p> <p>➢If feeding problem, follow-up in 5 days.</p> <p>➢Follow -up in 14 days &amp; do Hb;</p> <p>➢If no improvement or rise in Hb refer.</p> <p>*Except if the child has sickle cell aneamia or thalassaemia or family history of any hemolytic disease e.g., G6PD which need urgent treatment. <ul> <li>Signs of hemolysis: Jaundice, change color of urine, sudden severe pallor, weakness.</li> </ul></li></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE44 | <h1>No Anaemia</h1> <p>➢Counsel the mother on feeding.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE26 | <h1>Eye Infection</h1> <p>➢ <b>If pus draining from the eye, apply Tetracycline eye ointment 4 times daily until there is no pus discharge</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE27 | <h1>Clouding of the Cornea</h1> <p>➢If clouding of the cornea is new or not previously treated, <span class="caps">REFER</span></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE28 | <h1>Papular Urticaria or Papular Pruritic Eruptions</h1> <p>➢Trim finger nails and avoid scratching.</p> <ul> <li>Apply 1% hydrocortisone to new, inflamed lesions for five days.</li> <li>Give oral antihistamine to relieve itch: <ul> <li>Short term use: Chlorphenamine, oral, 0.1mg/kg/ dose 6-8 hourly</li> <li>Long term use for children 2-6 years: Cetirizine,oral, 5mg once daily</li> <li>Caution: Do not give antihistamines to children< 2 years of age.</li> </ul></li> </ul> <p>➢Refer if no improvement after 2 weeks or if underlying malignancy or systemic disease is suspected.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE29 | <h1>Ringworm (tinea)</h1> <p>➢Avoid sharing clothes, towels and toiletries (e.g. brushes and combs) to prevent spreading the infection to others.</p> <ul> <li>Wash and dry skin well before applying treatment.</li> <li>Apply an imidazole (e.g. clotrimazole 1% cream) three times daily until two weeks after lesions have cleared.</li> <li>For scalp infections (tinea capitis) give oral fluconazole 6mg/kg once daily for 28 days</li> </ul> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE30 | <h1>Scabies</h1> <p>➢All close contacts should be treated simultaneously (even if not itchy).</p> <ul> <li>Wash all bed linen and underwear in hot water</li> <li>Expose all bedding to direct sunlight.</li> <li>Put on clean clothes after treatment. <br /> ➢Treat the child and contacts under 6 years of age with Permethrin:</li> </ul> <ul> <li>Apply permethrin 5% lotion. Leave on overnight and washoff in the morning (may be repeated after one week).</li> <li>Treatment may need to be repeated after one week.</li> <li>Treat secondary bacterial infection, if present, with Oral Cephalexin 12-25mg/kg/dose 6 hourly for 5 days</li> </ul> <p>➢Treat contacts over 6 years of age with Benzyl Benzoate:</p> <ul> <li>Apply benzyl benzoate 25% from the neck to the toes. Allow the lotion to remain on the body for 24 hours, then wash off using soap and water</li> <li>Treatment may need to be repeated after one week.</li> </ul> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE31 | <h1>Chickenpox</h1> <p>➢Limit contact with other children and pregnant women until all lesions have crusted.</p> <ul> <li>Ensure adequate hydration.</li> <li>Cut fingernails short and discourage scratching.</li> <li>Treat itching: <ul> <li>Apply calamine lotion</li> <li>In severe cases, give an oral antihistamine:Chlorphenamine 0.1 mg/kg/dose 6–8 hourly NB: Only children >2 years.</li> </ul></li> </ul> <p>➢Refer urgently if severe rash or complications (e.g. pneumonia, jaundice, meningitis, myocarditis, hepatitis).</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE32 | <h1>Herpes Zoster</h1> <p>➢Keep lesions clean and dry. <ul> <li>Acyclovir 20 mg/kg 4 times daily for 7 days.</li> <li>Give oral Paracetamol for pain relief, continue to give every 6 hours (4 times / day) until pain gone</li> <li>Follow up in 7 days.</li> <li>Refer if disseminated disease, involvement of the eye, pneumonia or features meningitis.</li> <li>Monitor for secondary bacterial infection &#8211; if present, treat with Oral Cephalexin 12-25mg/kg/dose 6 hourly for 5 days</li> </ul></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE33 | <h1>Impetigo</h1> <p>➢Good personal and household hygiene to avoid spread of infection.</p> <p>➢Wash and soak sores in soapy water to soften and remove crusts.</p> <p>➢Apply antiseptic 8 hourly: Povidone iodine 5% cream or 10% ointment.</p> <p>➢Drain pus if fluctuant.</p> <p>➢Give antibiotic if extensive lesions: Cephalexin, oral, 12-25mg/kg/dose 6 hourly for 5 days</p> <p>➢Refer urgently if child has fever and or if infection extends to the muscles.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE34 | <h1>Molluscum Contagiosum</h1> <p>➢Allow to heal spontaneously if few in number. <ul> <li>Apply a tincture of iodine BP to the core of individual lesions using an applicator.</li> <li>Refer children with: <ul> <li>Extensive lesions</li> </ul></li> </ul></p> <p> &#8211; No response to treatment</p> <p> &#8211; Lesions close to the eye (to an ophthalmologist).</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE35 | <h1>Warts</h1> <p>➢May be left alone to wait for improvement</p> <p>➢Apply salicylic acid 15-20% to the warts <ul> <li>Protect surrounding skin with petroleum jelly</li> <li>Apply daily to the wart and allow to dry</li> <li>Occlude for 24 hours-Soften lesions by soaking in warm water, and remove loosened keratin.</li> <li>Repeat process daily until the warts disappear.</li> </ul></li></p> <p>➢Refer if extensive</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE36 | <h1>Seborrhoeic Dermatitis</h1> <p>➢Apply hydrocortisone 1% cream to the face and flexures.</p> <ul> <li>For scalp itching, scaling and dandruff: wash hair and scalp 2-3 times a week with selenium suphide 2.5% suspension.</li> <li>If severe, <span class="caps">REFER</span>.</li> </ul> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE37 | <h1>Fixed Drug Reaction</h1> <p>➢ Stop the offending medication.</p> <ul> <li>In mild cases, apply 1% hydrocortisone for five days.</li> <li>Discuss all cases with a doctor.</li> </ul> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE38 | <h1>Eczema</h1> <p>➢ Bath in warm water using soap substitutes only once daily.</p> <ul> <li>Dry skin gently.</li> <li>Apply Hydrocortisone 1% cream followed by application of moisturizer (emulsifying ointment).</li> <li>If over 2 years of age treat itching oral chlorphenamine 0.1 mg/kg/dose 6–8hourly</li> <li>Treat secondary infection: Oral Cephalexin, 12–25 mg/kg/dose 6 hourly for 5 days OR: Oral Flucloxacillin, 12–25mg/kg/dose 6 hourly for 5 days.</li> <li>Refer if: <ul> <li>severe acute moist or weeping eczema is present</li> <li>no improvement after two weeks</li> <li>Secondary herpes infection (eczema herpeticum) is suspected</li> </ul></li> </ul> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE39 | <h1>Steven Johnson Syndrome (<span class="caps">SJS</span>)</h1> <p>➢ Stop medication</p> <ul> <li><span class="caps">REFER</span> <span class="caps">URGENTLY</span></li> <li>Give frequent sips of <span class="caps">ORS</span> on way to hospital</li> <li>Give one dose of oral Paracetamol for pain pre-referral</li> </ul> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE40 | h1.Mouth Sores or Ulcer</p> <p>➢ Treat mouth ulcers twice daily with gentian violet until 48 hrs after the ulcers have been cured</p> <p>➢ Give oral Paracetamol every 6 hours (4 times / day) for pain until pain is gone</p> <p>➢ Refer if mouth ulcers deep or extensive | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE41 | <h1>Oral Thrush</h1> <p>➢ Give half-strength gentian violet (0.25%) 4 times daily for 7 days.</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE45 | <h1>Very Low Weight for Age</h1> <p>➢ Refer to nutrition clinic for further assessment</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE46 | <h1>Low Weight for Age</h1> <p>➢ Refer to nutrition clinic for further assessment</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE47 | <h1>How Muac or Visual Report of Wasting</h1> <p>➢ Refer to nutrition clinic for further assessment</p> | 0..1 | display |  | Value Set:
yi | null | 0..1 | group |  | Value Set:
Ccc.C10.IT.DE48 | <h1>Possible Serious Bacterial Infection or Very Severe Disease</h1> <p>➢ <b>Give first dose of intramuscuar (IM) antibiotics</b></p> <ul> <li><b>Give a first dose of intramuscular gentamicin</b></li> </ul> <span class="caps">AND</span> <ul> <li><b>Give a first dose of intramuscular ampicillin. OR, if IM ampicillin is not avaialble, give a first dose of oral amoxicillin, at the dose indicated for Pneumonia</b></li> </ul> <p>➢ <b>Treat to prevent low blood sugar</b></p> <p>➢ <b>Advise the mother on how to keep infant warm on the way to hospital</b></p> <p>➢ <b>Refer <span class="caps">URGENTLY</span> to hospital</b> </p> <p>OR</p> <p>➢ <b>If referral <span class="caps">REFUSED</span> or <span class="caps">NOT</span> <span class="caps">FEASIBLE</span> treat in the clinic untill referral is feasible (see charts on pages 12-13, and 19-20 and Treat Possible Serious Bacterial Infection or Very Severe Disease if referral is refused or is not feasible)</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE49 | <h1>Pneumonia</h1> <p>➢ <b>Give oral amoxicillin 2 times per day, for 7 days</b></p> <p>➢ Advise the mother to give home care</p> <p>➢ Follow up in 3 days</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE50 | <h1>Local Infection</h1> <p>➢ <b>Give oral amoxicillin 2 times per day, for 5 days</b></p> <p>➢ Teach the mother how to treat local infections at home</p> <p>➢ Advise the mother to give home care</p> <p>➢ Follow up in 2 days</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE51 | <h1>Infection Unlikely</h1> <p>➢Advise the mother on giving home care to the young infant</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE52 | Severe Jaundice</p> <p>➢ <b>Treat to prevent low blood sugar</b></p> <p>➢ <b>Advise the mother how to keep the infant warm on the way to the hospital</b></p> <p>➢ <b>Refer <span class="caps">URGENTLY</span> to hospital</b> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE53 | <h1>Jaundice</h1> <p>➢Advise the mother to give home care</p> <p>➢Advise the mother to return immediately if the infant&#8217;s palms or soles appear yellow</p> <p>➢If young infant is older than 3 weeks, refer to hospital for assessment</p> <p>➢Follow-up in 1 day</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE54 | <h1>No Jaundice</h1> <p>➢Advise the mother on giving home care to the young infant</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE55 | <h1>Severe Dehydration</h1> <p>➢ <b>If infant has no other severe classification:</b></p> <ul> <li><b>Give fluid for Severe Dehydration (Plan A ) OR</b></li> </ul> <p>➢ <b>If infant has another severe classification:</b></p> <ul> <li><b>Refer <span class="caps">URGENTLY</span> to hospital with the mother giving frequent sips of oral rehydration salts (<span class="caps">ORS</span>) on the way.</b></li> <li><b>Advise the mother to continue breastfeeding.</b></li> </ul> <p>➢ <b>Advise the mother how to keep the infant warm on the way to the hospital.</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE56 | <h1>Some Dehydration</h1> <p>➢Give fluid and breastmilk for Some Dehydration (Plan B)</p> <p>OR</p> <p>➢ <b>If the infant has another severe classification:</b></p> <ul> <li><b>Refer <span class="caps">URGENTLY</span> to hospital with the mother giving frequent sips of <span class="caps">ORS</span> on the way</b></li> <li><b>Advise the mother to continue breast feeding</b></li> </ul> <p>➢Advise the mother when to return immediately</p> <p>➢Follow-up in 2 days if no improvement</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE57 | <h1>No Dehydration</h1> <p>➢Give fluids and breastmilk to treat diarrhoea at home (Plan A)</p> <p>➢Advise the mother when to return immediately</p> <p>➢Follow-up in 2 days if no improvement</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE58 | <h1>Very Low Weight for Age</h1> <p>➢ <b><span class="caps">REFER</span> to hospital for Kangaroo Mother Care</b></p> <p>➢ <b>Treat to prevent low blood sugar</b></p> <p>➢ <b>Advise the mother to keep the young infant warm on the way to hospital</b></p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE59 | <h1>No Feeding Problem</h1> <p>➢Advise mother on giving home care to the young infant</p> <p>➢Praise the mother for feeding the infant well</p> <p>➢If not breastfed, advise mother to continue feeding, and ensure good hygiene</p> | 0..1 | display |  | Value Set:
Ccc.C10.IT.DE60 | <h1>Feeding Problem and / or Low Weight for Age</h1> <p>➢Among infants who are breastfed:</p> <ul> <li>If not well attached or not sucking effectively, teach correct positioning and attachment</li> <li>If not able to attach well immediately, teach the mother to express breastmilk and feed from a cup</li> <li>If breastfeeding less than 8 times in 24 hours, advise the mother to increase the frequency and to breastfeed as often and for as long as the infant wants, day and night</li> <li>If the infant is receiving other foods or drinks, counsel the mother to increase breastfeeding, reduce other foods and drink and use a cup</li> </ul> <p>➢Among infants who are not breastfed: </p> <ul> <li>Counsel about feeding</li> <li>Explain the guidelines for safe replacement feeding and correct preparation of breastmilk substitutes</li> <li>Identify concerns of mother and family about feeding</li> <li>If mother is using a bottle, teach cup feeding</li> <li>Refer for breastfeeding counselling and possible relactation if the mother is alive and caring for the infant</li> </ul> <p>➢If Low Weight for Age, advise the mother on how to feed and keep the low-weight infant warm at home</p> <p>➢If the infant has thrush, teach the mother to treat thrush at home</p> <ul> <li>Give half-strength gentian violet (0.25%) 4 times daily for 7 days. Paint the mouth with gentian violet using a clean soft cloth wrapped around the finger. If gentian violet is not avaialble, write a prescription for the medication for the mother and urge her to visit a pharmacy to purchase the medication. <br /> ➢Advise the mother on giving home care to the young infant</li> </ul> <p>➢Follow up Feeding Problem or Thrush in 2 days</p> <p>➢Among infants who are breastfed, follow up infants who have Low Weight for Age within 14 days</p> <p>➢Among infants who are not breastfed, follow up infants who have Low Weight for Age within 7 days</p> | 0..1 | display |  | Value Set:
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