WHO Clinical Care in Crisis Implementation Guide for Children
0.1.0 - ci-build
WHO Clinical Care in Crisis Implementation Guide for Children - Local Development build (v0.1.0). See the Directory of published versions
LinkId | Text | Cardinality | Type | Flags | Description & Constraints |
---|---|---|---|---|---|
CHE.B10-16.Signs.2m.p | Questionnaire | https://fhir.dk.swisstph-mis.ch/matchbox/fhir/Questionnaire/che.b10-16.signs.2m.p#0.1.0 | |||
Cough | null | 0..1 | boolean | Expressions:
| |
Difficulty Breathing | null | 0..1 | boolean | Expressions:
| |
Danger Signs | null | 0..1 | boolean | Expressions:
| |
Fever | null | 0..1 | boolean | Expressions:
| |
Diarrhoea | null | 0..1 | boolean | Expressions:
| |
Ear Problem | null | 0..1 | boolean | Expressions:
| |
Ear discharge | null | 0..1 | boolean | Expressions:
| |
Skin problem | null | 0..1 | boolean | Expressions:
| |
cought_difficulty | null | 0..1 | group | Expressions:
| |
CHE.B24.DE01.Respiratory.Rate | Respiratory rate | 0..1 | group | ||
CHE.B10S2.DE03 | Chest Indrawing | 1..1 | boolean | ||
CHE.B10S2.DE03-help | <p><b><span class="caps">NORMAL</span>:</b> When child breaths <b>IN</b>, chest wall moves **OUT<br /> CHEST <span class="caps">INDRAWING</span>:** When child breaths <b>IN</b>, chest wall moves <b>IN</b></p> <p>Chest indrawing occurs when the child needs to make a greater effort than normal to breathe in. <b>You will look for chest indrawing when the child breathes IN.</b></p> <p>In normal breathing, the whole chest wall (upper and lower) and the abdomen move <span class="caps">OUT</span> when the child breathes IN. <b>The child has chest indrawing if the lower chest wall (lower ribs) goes IN when the child breathes IN.</b></p> | 0..1 | display | ||
CHE.B10S2.DE04 | Stridor in a calm child | 1..1 | boolean | ||
CHE.B10S2.DE04-help | <p><b>Stridor is a harsh noise made when a child breathes IN.</b><br /> Put your ear near the child’s mouth because stridor can be difficult to hear. Sometimes you will hear a wet noise if the child’s nose is blocked. Clear the nose, and listen again.</p> <p><b>Be sure to look and listen for stridor when the child is calm.</b> <br /> A child who is not very ill may have stridor only when he is crying or upset. However, a child who is calm and also has stridor has a dangerous situation.</p> | 0..1 | display | ||
CHE.B10S2.DE05 | Wheezing | 1..1 | boolean | ||
CHE.B10S2.DE05-help | **Wheeze is a high-pitched whistling or musical sound heard at the end of the breathing <span class="caps">OUT</span>. The child’s small air passages narrow to cause wheezing.<br /> To hear wheezing, put your ear near to the child’s mouth when the child is calm. Look at the child’s breathing while you listen to check that the sound mainly occurs when the child breathes out** | 0..1 | display | ||
CHE.B10S2.DE06 | Recurrent Wheeze | 0..1 | boolean | Expressions:
| |
CHE.B10S2.DE06-help | Recurrent wheezing can be a sign of asthma, tuberculosis or other important health problems which require further assessment | 0..1 | display | ||
CHE.B10S2.DE07 | Oxygen Saturation (%) | 1..1 | quantity | Expressions:
| |
CHE.B10S2.DE07-help | If pulse oximeter is available, determine oxygen saturation (SpO2). <br /> After turning on, position the appropriate probe based on the child’s size. If using on a finger or toe, make sure the area is clean and without nail varnish. <b>Ensure that a good (even) pulse signal (waveform) is displayed before taking the reading.</b> If uncertain that the probe is working, check by testing on your own finger. <br /> <b>Normal oxygen saturation at sea level is 95 – 100%. Oxygen should be given if saturation drops to less than 90%,</b> and may be needed for children with severe illness if SpO2 less than 94%. Different cut-offs may be used at high altitude. | 0..1 | display | ||
CHE.B10S2.DE08 | Oxygen Saturation < 90 % | 1..1 | display | Expressions:
| |
CHE.B10S2.DE08-help | <span class="caps">ALERT</span>: Check that the value you have entered is correct. Children with oxygen saturation less than 90% need oxygen if available and urgent referral. | 0..1 | display | ||
CHE.B11S2.DE01 | Sunken eyes | 1..1 | boolean | Expressions:
| |
CHE.B11S2.DE01-help | <b>The eyes of a child who is dehydrated may look sunken.</b> Decide if you think the eyes are sunken. Then ask the mother if she thinks her child’s eyes look unusual. Her opinion can help<br /> you confirm.<br /> NOTE: In a severely malnourished child who is wasted, the eyes may always look sunken, even if the child is not dehydrated. Still use the sign to classify dehydration. | 0..1 | display | ||
CHE.B11S2.DE02 | Skin pinch of Abdomen | 0..1 | choice | Options: 3 options Expressions:
| |
CHE.B11S2.DE02-help | To assess dehydration using the skin pinch<br /> 1. <b><span class="caps">ASK</span></b> the mother to place the child on the examining table so that the child is flat on his back with his arms at his sides (not over his head) and his legs straight. Or, ask the mother to hold the child so he is lying flat on her lap.<br /> 2. <b><span class="caps">USE</span> <span class="caps">YOUR</span> <span class="caps">THUMB</span> <span class="caps">AND</span> <span class="caps">FIRST</span> <span class="caps">FINGER</span></b> to locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. Do not use your fingertips because this will cause pain. The fold of the skin should be in a line up and down the child’s body.<br /> 3. <b><span class="caps">PICK</span> UP</b> all the layers of skin and the tissue underneath them.<br /> 4. <b><span class="caps">HOLD</span></b> the pinch for one second. Then release it.<br /> 5. <b><span class="caps">LOOK</span></b> to see if the skin pinch goes back <b>very slowly</b> (more than 2 seconds), <b>slowly,</b> (less than 2 seconds, but not immediately), or <b>immediately.</b> If the skin stays up for even a brief time after you release it, decide that the skin pinch goes back slowly. | 0..1 | display | ||
CHE.B11S2.DE06 | Restless and Irritable | 1..1 | boolean | ||
CHE.B11S2.DE06-help | A child is restless and irritable if s/he is restless and irritable all the time or every time s/he is touched and handled. If an infant or child is calm when breastfeeding but again restless and irritable when he stops breastfeeding, s/he has the sign restless and irritable. Many children are upset just because they are in the clinic. Usually these children can be consoled and calmed, and do not have this sign. | 0..1 | display | ||
CHE.B12S2.DE01 | Stiff neck | 1..1 | boolean | Expressions:
| |
CHE.B12S2.DE01-help | <b>A stiff neck may be a sign of meningitis, cerebral malaria or another very severe febrile disease. It requires urgent treatment with injectable antibiotics and referral to a hospital.</b><br /> <b><span class="caps">WATCH</span> <span class="caps">THE</span> <span class="caps">CHILD</span>:</b> While you talk with the caregiver during the assessment, look to see if the child moves and bends his or her neck easily when looking around. If the child is moving and bending his or her neck, the child does not have a stiff neck.<br /> <b><span class="caps">TEST</span> <span class="caps">THE</span> <span class="caps">CHILD</span>:</b> If you did not see any movement, or if you are not sure, draw the child’s attention to his or her umbilicus or toes. For example, you can shine a flashlight on the toes or umbilicus or tickle the toes to encourage the child to look down. Look to see if the child can bend his or her neck when looking down at his or her umbilicus or toe<br /> <b><span class="caps">FEEL</span> <span class="caps">FOR</span> <span class="caps">STIFF</span> <span class="caps">NECK</span>:</b> If you still have not seen the child bend his or her neck himself, ask the caregiver to help you lay the child on his or her back. Lean over the child, gently support the child’s back and shoulders with one hand. With the other hand, hold the child’s head. Then carefully bend the head forward towards the child’s chest. If the neck bends easily, the child does not have stiff neck. If the neck feels stiff and there is resistance to bending, the child has a stiff neck. Often a child with a stiff neck will cry when you try to bend the neck. | 0..1 | display | ||
CHE.B12S2.DE02 | Refusal to use a limb | 1..1 | boolean | Expressions:
| |
CHE.B12S2.DE02-help | The child is unable to use a limb (arm or leg) on examination. It is important to assess for refusal to use a limb which could be a sign of a bone or joint infection when the child has reported or measured fever. | 0..1 | display | ||
CHE.B12S2.DE03 | Warm Tender or Swollen Joint or Bone | 1..1 | boolean | Expressions:
| |
CHE.B12S2.DE03-help | The child has a warm tender or swollen joint or bone which could be a sign of a infection when the child has reported or measured fever. | 0..1 | display | ||
CHE.B12S2.DE05 | Runny nose | 1..1 | boolean | Expressions:
| |
CHE.B12S2.DE05-help | The child has a runny nose | 0..1 | display | ||
CHE.B13S2.DE01 | Tender swelling behind the ear | 1..1 | boolean | Expressions:
| |
CHE.B13S2.DE01-help | <b>If both tenderness and swelling are present, the child may have mastoiditis, a deep infection in the mastoid bone.</b> Feel behind both ears. Compare them and decide if there is tender swelling of the mastoid bone. In infants, the swelling may be above the ear. Do not confuse this swelling of the bone with swollen lymph nodes. | 0..1 | display | ||
CHE.B13S2.DE02 | Pus seen draining from the ear | 1..1 | boolean | Expressions:
| |
CHE.B13S2.DE02-help | Look inside the child’s ear to see if pus is draining. That is a sign of infection, even if the child is not feeling any pain. Draining pus is a sign of infection | 0..1 | display | ||
CHE.B13S2.DE03 | Pus Seen Draining from the Ear for how long? | 1..1 | choice | Options: 2 options Expressions:
| |
CHE.B13S2.DE03-help | How long the child has had the discharge from the ear. <br /> - Less than 14 days (Less than 2 weeks)<br /> - 14 days or more (2 weeks or more) | 0..1 | display | ||
CHE.B14S2.DE01 | Red Eyes | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE01-help | The child has “red eyes” if there is redness in the white part of the eye. In a healthy eye, the white part of the eye is clearly white and not discoloured. | 0..1 | display | ||
CHE.B14S2.DE02 | Pus Draining from Eye | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE02-help | Pus draining from the eye is a sign of conjunctivitis. Conjunctivitis is an infection of the conjunctiva, the inside surface of the eyelid and the white part of the eye.<br /> <b>If you do not see pus draining from the eye, look for pus on the conjunctiva or on the eyelids.</b> Often the pus forms a crust when the child is sleeping and seals the eye shut. You can gently open the eye, making sure that your hands are clean.<br /> Wash your hands after examining the eye of any child with pus draining from the eye. | 0..1 | display | ||
CHE.B14S2.DE03 | Clouding of the Cornea | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE03-help | The cornea is usually clear. When clouding of the cornea is present, the cornea <b>may appear clouded or hazy.</b> The cornea may look the way a glass of water looks when you add a small amount of milk. <b>The clouding may occur in one or both eyes.</b><br /> A child with corneal clouding may keep his or her eyes tightly shut when exposed to light. The light may cause irritation and pain to the child’s eyes. To check the child’s eye, wait for the child to open his or her eye. Or gently pull down the lower eyelid to look for clouding.<br /> <b>Corneal clouding is a dangerous condition.</b> It may be the result of vitamin A deficiency that has been made worse by measles. If the corneal clouding is not treated, the cornea can ulcerate and cause blindness. A child with clouding of the cornea needs urgent treatment with vitamin A. | 0..1 | display | ||
CHE.B14S2.DE04 | Is clouding of the cornea a new problem | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE04-help | If there is clouding of the cornea, ask the caregiver how long the clouding has been present. If the caregiver is certain that clouding has been there for some time, ask if the clouding has already been assessed and treated at the hospital. If it has, you do not need to refer this child again for corneal clouding. | 0..1 | display | ||
CHE.B14S2.DE05 | Has Clouding of the Cornea previously been treated | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE05-help | If the clouding has already been assessed and treated at the hospital, you do not need to refer this child again for corneal clouding. | 0..1 | display | ||
CHE.B14S2.DE06 | Generalised or Localised Skin Problem | 1..* | choice | Options: 3 options Expressions:
| |
CHE.B14S2.DE06-help | A generalised skin problem is a skin problem which affects the whole body, a large area of the body, or several parts of the body, whereas a localised skin problem is limited to one area of the body.<br /> This question is prompted either if a skin problem has been noted already, or if the child has fever with one or more of cough, runny nose or red eyes (in order to assess for measles) | 0..1 | display | ||
CHE.B14S2.DE10 | Measles rash | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE10-help | <p>In measles, <b>a rash begins behind the ears and on the neck</b>. It <b>spreads to the face.</b> During the next day, the rash <b>spreads to the rest of the body, arms and legs. After 4 to 5 days, the rash starts to fade and the skin may peel.</b></p> <p>Some children with severe infection may have more rash spread over more of the body. The rash becomes more discoloured (dark brown or blackish), and there is more peeling of the skin. A measles rash does not have vesicles (blisters) or pustules. The rash does not itch.</p> <p>Do not confuse measles with other common childhood rashes such as chicken pox, scabies, or heat rash. Chicken pox rash is a generalized rash with vesicles. Scabies occurs on the hands, feet, ankles, elbows, buttocks and axilla (underarm). It also itches. Heat rash can be a generalized rash with small bumps and vesicles, which itch. A child with heat rash is not sick.</p> | 0..1 | display | ||
CHE.B14S2.DE11 | Measles within the last 3 months | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE11-help | Ask the caregiver or check the child’s health record to see if they have had measles in the last 3 months. If the caregiver is not sure, explain the symptoms (a generalised rash all over the body, starting from behind the ears and on the neck, spreading to the face, then the body, arms and legs, accompanied by runny nose, red eyes or cough). | 0..1 | display | ||
CHE.B14S2.DE11A | Itchy Skin | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE11A-help | The child is reported to have or appears to have itchy skin | 0..1 | display | ||
CHE.B14S2.DE012 | Blisters, Sores or Pustules | 1..1 | boolean | Expressions:
| |
CHE.B14S2.DE012-help | The child has skin blisters, sores or pustules | 0..1 | display | ||
CHE.B14S2.DE13 | Type of Skin Problem | 0..1 | group | Expressions:
| |
CHE.B14S2.DE14 | Abscess – Hot Tender Swelling | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE14-help | The child has an abscess – Hot tender swelling | 0..1 | display | ||
CHE.B14S2.DE15 | Deep or extends to muscle | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE15-help | The child has an abscess that is deep or extends to muscle | 0..1 | display | ||
CHE.B14S2.DE16 | Cellulitis – Hot Tender Skin | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE16-help | The child has cellulitis – warm / hot tender skin – appears red in paler skin tones and dark red, dark brown, grey or purple in darker skin tones | 0..1 | display | ||
CHE.B14S2.DE17 | Rapidly spreading, extensive, or not responding to oral antibiotics | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE17-help | The child has cellulitis which is rapidly spreading, extensive, or not responding to oral antibiotics | 0..1 | display | ||
CHE.B14S2.DE19 | Ringworm (Tinea) | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE19-help | Ringworm (Tinea) – An itchy circular lesion with a raised edge and fine <br /> scaly area in the centre with loss of hair. May also be found on body or web on feet | 0..1 | display | ||
CHE.B14S2.DE20 | Extensive Ringworm (Tinea) | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE20-help | The child has extensive ringworm | 0..1 | display | ||
CHE.B14S2.DE23 | Herpes Zoster | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE23-help | The child has Herpes Zoster – Vesicles in one area on one side of body with intense pain or scars plus shooting pain. <br /> Uncommon in children except where they are immuno-compromised (e.g. if infected with <span class="caps">HIV</span>) | 0..1 | display | ||
CHE.B14S2.DE24 | Eye Involvement | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE24-help | The child has Herpes Zoster with Eye Involvement | 0..1 | display | ||
CHE.B14S2.DE25 | Impetigo or Folliculitis | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE25-help | The child has Impetigo / Folliculitis – Red, Tender, Warm Crusts or Small lesions | 0..1 | display | ||
CHE.B14S2.DE26 | Signs of Severe Impetigo / Folliculitis | 0..* | choice | Options: 5 options Expressions:
| |
CHE.B14S2.DE26-help | Signs of severe impetigo / folliculitis include:<br /> - Skin Lesions 4 cm or larger<br /> - Red Skin Streaks<br /> - Tender Nodes (Nodules) under the skin<br /> - Skin infection extends to muscle<br /> - No signs of severe Impetigo / Folliculitis | 0..1 | display | ||
CHE.B14S2.DE31 | Molluscum Contagiosum – Skin coloured pearly white papules with central umbilication. Most commonly seen on face and trunk in children. | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE31-help | The child has Molluscum Contagiosum – Skin coloured pearly white papules with central umbilication. Most commonly seen on face and trunk in children. | 0..1 | display | ||
CHE.B14S2.DE32 | Warts – Papules or nodules with a rough (Verrucous) surface | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE32-help | The child has Warts – Papules or nodules with a rough (Verrucous) surface | 0..1 | display | ||
CHE.B14S2.DE33 | Seborrhoea | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE33-help | The child has Seborrhoea – Greasy scales and redness on central face and body folds | 0..1 | display | ||
CHE.B14S2.DE34 | Severe Seborrhoea | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE34-help | The child has severe seborrhoea – requiring referral. | 0..1 | display | ||
CHE.B14S2.DE35 | Fixed Drug Reactions – Generalised red, wide spread with small bumps or blisters; or one or more dark skin areas | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE35-help | The child has a Fixed Drug Reaction – Generalised red, wide spread with small bumps or blisters; or one or more dark skin areas | 0..1 | display | ||
CHE.B14S2.DE36 | Eczema – Wet oozing sores or excoriated, thick patches | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE36-help | The child has Eczema – Wet oozing sores or excoriated, thick patches | 0..1 | display | ||
CHE.B14S2.DE37 | Steven Johnson Syndrome | 0..1 | boolean | Expressions:
| |
CHE.B14S2.DE37-help | The child has Steven Johnson Syndrome – Severe reaction due to cotrimoxazole or <span class="caps">NVP</span> involving the skin as well as the eyes and the mouth. Might cause difficulty in breathing | 0..1 | display | ||
CHE.B14S2.DE43 | Add a Skin or Mouth or Eye Problem | 0..1 | group | Expressions:
| |
CHE.B14S2.DE43-help | On examination, the child has been found to have a skin, mouth or eye problem not reported by the caregiver, or not already assessed. | 0..1 | display | ||
CHE.B14S2.DE44 | null | 0..* | choice | Options: 1 option Expressions:
| |
CHE.B14S2.DE44-help | The child has a skin problem | 0..1 | display | ||
CHE.B14S2.DE45 | null | 0..* | choice | Options: 1 option Expressions:
| |
CHE.B14S2.DE45-help | The child has Oral Sores or Mouth Ulcers | 0..1 | display | ||
CHE.B14S2.DE46 | null | 0..* | choice | Options: 1 option Expressions:
| |
CHE.B14S2.DE46-help | The child has an Eye Problem | 0..1 | display | ||
CHE.B14S2.DE38 | Oral Sores or Mouth Ulcers | 0..* | choice | Options: 4 options Expressions:
| |
CHE.B14S2.DE38-help | <p>Examination for oral Sores or Mouth Ulcers should be carried out at the end of the physical examination so as not to upset / aggitate the child before completing other physical examinations signs. </p> <p>Ulcers are painful open sores on the inside of the mouth and lips or the tongue. They may be red or have white coating. <br /> Severe mouth ulcers are ‘Deep and extensive’ and require referral.</p> <p>If the child has measles, note that mouth ulcers are different than the small, irregular, bright red spots with a white spot in the centre called Koplik spots which occur inside the cheek during early stages of the measles infection. They do not interfere with drinking or eating. They do not need treatment.</p> | 0..1 | display | ||
CHE.B15S2.DE01 | Palmar Pallor | 0..1 | choice | Options: 3 options | |
CHE.B15S2.DE01-help | <b><span class="caps">LOOK</span></b> at the skin of the child’s palm. Hold the child’s palm open by grasping it gently from the side. Do not stretch the fingers backwards. This may cause pallor by blocking the blood supply. Compare the colour of the child’s palm with your own palm and with the palms of other children. The child has <b>some palmar pallor</b> if the skin of the child’s palm is pale. The child has <b>severe palmar pallor</b> if the skin of the palm is very pale or so pale that it looks white. | 0..1 | display | ||
CHE.B15S2.DE05 | Malaria Risk | 0..1 | choice | Options: 3 options | |
CHE.B15S2.DE05-help | The area is a high / low / no malaria risk area | 0..1 | display | ||
CHE.B16S2.DE01 | Oedema of both feet | 0..1 | boolean | ||
CHE.B16S2.DE01-help | The client has oedema of both feet | 0..1 | display | ||
timestamp | null | 0..1 | dateTime | Expressions:
| |
Documentation for this format |
Option Sets
Answer options for CHE.B11S2.DE02
Answer options for CHE.B13S2.DE03
Answer options for CHE.B14S2.DE06
Answer options for CHE.B14S2.DE26
Answer options for CHE.B14S2.DE44
Answer options for CHE.B14S2.DE45
Answer options for CHE.B14S2.DE46
Answer options for CHE.B14S2.DE38
Answer options for CHE.B15S2.DE01
Answer options for CHE.B15S2.DE05