ACUTE RESPIRATORY INFECTIONS.pptx

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1. ACUTE RESPIRATORY INFECTIONS BY KOMAL UPRETI B.Sc.(Nursing) 3 rd semester,2 nd year

2. CONTENT INTRODUCTION ACUTE RESPIRATORY INFECTION 1.SIGNS AND SYMPTOMS 2.EPIDEMIOLOGICAL DETERMINANTS (A) Agent factors (B) Host factors (C) Mode of transmission (D) Risk factors 3.CONTROL 4.PHYSICAL EXAMINATION

3. PNEUMONIA ETIOLOGY OF PNEUMONIA CLASSIFICATION AND MANAGEMENT 1. No Pneumonia 2. Pneumonia 3. Severe Pneumonia 4. Very Severe Pneumonia HIGH RISK CHILDREN FOR PNEUMONIA COMPLICATION OF PNEUMONIA TREATMENT FOR PNEUMONIA IMMUNIZATION FOR PNEUMONIA

4. INTRODUCTION Infections of respiratory tract are perphaps the most common human aliment. While they are a source of discomfort ,disability and loss of time for most adults, they are a substantial cause of morbidity and mortality in young children and the elderly.

5. Many of these infection run their natural course in older children and in adults without complications. However, in young infants,small children and in the elderly or in the persons with impaired respiratory tract reserves, it increases the morbidity and mortality rates

6. ACUTE RESPIRATORY INFECTIONS Acute respiratory infections(ARI) may cause inflammation of the respiratory tract anywhere from nose to alveoli, with a wide range of combination of signs and symptoms. ARI are classified on the basis of site of infection: (a) Acute Upper Respiratory infection(AURI) (b) Acute Lower Respiratory infection(ALRI)

7. The URTI include common cold, pharyngitis and otits media The LRTI include epiglottitis,laryngitis,laryngotracheitis, bronchitis, bronchiolitis and pneumonia .

8. SIGNS AND SYMPTOMS Running nose Cough Sore throat Difficulty in breathing Ear problem Fever Cold

9. EPIDEMIOLOGICAL DETERMINANTS AGENT FACTORS 1. BACTERIA (a) Boredetella pertusis (b) Corynebacterium diphtheriae (c) Haemophilus influenzae (d) Klebsiella pneumoniae (e) Legionella pneumophila (f) Staphylococcus pyogens (g) Streptococcus pneumoniae (h) Streptococcus pyogens

10. ` 2. VIRUS (a) Enteroviruses (b) Influenza A,B,C (c) Adenoviruses (d) Measles (e) Parainfluenza 1,2,3 (f) Respiratory syncytial virus (g) Rhinoviruses (h) Coronavirus

11. HOST FACTORS Small children(age group of 0-5 years) Adult women Under 3 years of boys are affected more often and severely Malnutrition,anaemia,immune deficiences decrease normal resistance to infection. Allergies ,cardiac abnormalities,cystic fibrosis,weaken respiratory defense mechanism of the individuals .

12. RISK FACTORS Many risk factors for respiratory tract infections have been identified. They include not only the climatic conditions but also the housing,level of industralization and socio-economic development. In developing countries; overcrowded dwellings,poor nutrition,low birth weight and intense indoor smoke pollution . Maternal cigarette smoking increasing the risk of respiratory tract infection .

13. Infection more common in preschool children attending day care centres. Infection tend to be more common in urban communities than in rural communities. Local mortality rates are particularly affected by the extent of influenza epidemics.

14. CONTROL Improving primary medical care services. Better methods for early detection and treatment. Poor hygeine and sanitation Wash hands with soap and water Cover mouth and nose while coughing and sneezing Health education

15. PHYSICAL EXAMINATION Count the breath in one minute Look for chest indrawing Look for wheeze Check for severe malnutrition Fever or lowbody temperature Abnormal sleep and difficult to wake Cyanosis(sign of hypoxia)

16. PNUEMONIA Inflammation of the lung parenchyma and is associated with the consilidation of the alveolar spaces. or Inflammation of the lungs caused by bacterial or viral infections in which air sac filled with pus and may become solid.

17. Developed world * viral infections * low morbidity and mortality Developing world * common cause of death * bacteria in 65%

18. ARI Case management by WHO * 84% reduction in mortality * Respiratory rate,recession,ability to drink * cheap,oral and effective antibiotics( co-trimoxazole , amoxycillin) * Maternal Education

19. Types of pneumonia Segments affected from pneumonia BRONCHIAL PNEUMONIA LOBAR PNEUMONIA SEGMENTAL PNEUMONIA BILATERAL PNEUMONIA …

20. INTERSTITIAL PNEUMONIA ALVEOLAR PNEUMONIA NECROTIZING PNEUMONIA

21. ETIOLOGY Vary according to- Age, Immune status Community acquired (a) Developing countries - Streptococcus pneumoniae - Haemophillus influenzae - Staphylococcus aureus - Viruses (40%) - Others: Mycoplasma,Chlamydia,Moraxella

22. (b) Developed countries - Viruses - Bacterial(5-10%)

23. ETIOLOGY ACCORDING TO AGE In Neonates Caustive organisms : E.Coli Group B Sterptococcus Klebsiella Staphylococcus aureus In Infants Caustive organisms : Pneumococcus Chlamydia

24. In Children 1-5 years Caustive organisms : Respiratory viruses Pneumococcus Haemophillus influenza Staphylococcus aureus In 5-18 years Causative organisms : Pneumococcus Haemophillus influenza Type B

25. CLASSIFICATION AND MANAGEMENT No Pneumonia Cough, No tachypnea * MANAGEMENT - Home care - Soothe the throat and relieve cough - Consult the physician if within 5 days it is not improving

26. 2. Pneumonia Cough, tachypnea, No rib or sternal retraction, able to drink, No cyanosis * Management - Home care - Antibiotic for 5 days - Soothe the throat and releive cough - Consult again the physician if not cure within 2 days

27. 3. Severe Pneumonia Cough, tachypnea, rib and sternal retraction, No cyanosis, Able to drink, Nasal flaring, Grunting * Management - Admit in hospital - Give recommended antibiotics( IM injections of Benzy Penicillin or Ampicillin or Chloramphenicol) - Manage airway - Treat fever (if present)

28. 4. Very Severe Pneumonia Cough, tachypnea, chest wall retraction, Unable to drink, convulsions, Cyanosis, Malnutrition * MANAGEMENT -Admit in hospital -Give antibiotics -Oxygen therapy -Manage airway -Treat fever

29. HIGH RISK CHILDREN FOR PNEUMONIA Significant risk factors -Younger age(2-6 months) -Low parental education -Smoking at home -Low birth weight -Weaning from breast at < 6 months -A negative history of diphtheria,pertusis,tetanus vaccination

30. -Anaemia -Malnutrition -Over crowding

31. COMPLICATIONS OF PNEUMONIA Emphysema Lung abscess Pneumothorax Pleural effusion Respiratory failure Metastatic septic lesions

32. TREATMENT ANTIBIOTICS * Under 5 years First line treatment- AMOXICILLIN Alternatives- coamoxiclav, Cefaclor, Macrolides * Over 5 years First line treatment- AMOXICILLIN Alternatives- Macrolides or Flucloxacillin + Amoxicillin

33. ANTIBIOTICS FOR SEVERE PNEUMONIA * Co-amoxiclav; Cefotaxine; Cefuroxime * oxygen therapy *Hydration = 50-80 ml/kg/day * Temperature control * Airway obstruction management * chest drain – for fluid or pus collection in lungs

34. IMMUNIZATION Vaccines hold promise of saving millions of children from dying of pneumonia. MEASLES VACCINE (0.5 ml/subcutaneous ) HIB VACCINE PNEUMOCOCCAL PNEUMONIA VACCINE(PPV)

35. CASE STUDY In INDIA during the year 2013 about 31.7 million cases of ARI were reported. During 2013 about 3,278 people died of ARI 2,597 died of pneumonia Pneumonia was responsible for about 18% of all under 5 years death in INDIA