Diarrhoea ppt

care of diarrhoea general n IMNCI

1. IMNCI: IMNCI is an integrated approach to child health that focuses on the well-being of the whole child. IMNCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMNCI includes both preventive and curative elements that are implemented by families and communities as well as by health facilities.

2. Objectives: 1 )Reducing infant mortality. 2)Reducing the incidence and seriousness of illnesses and health problems. 3)Improving growth and development during the first five years of a child's life

3. STRATEGY: The strategy includes three main components: Improving case management skills of health-care staff Improving overall health systems Improving family and community health practices. In health facilities, the IMCI strategy promotes the accurate identification of childhood illnesses in outpatient settings, ensures appropriate combined treatment of all major illnesses, strengthens the counseling of caretakers, and speeds up the referral of severely ill children. In the home setting, it promotes appropriate care seeking behaviors, improved nutrition and preventative care, and the correct implementation of prescribed care.

4. Emphasis on: Prevention of disease -Promotion of Child health and development -Provision of Standard Case management

5. Diarrhoea & Its Management according to IMNCI

6. INTRODUCTION: Diarrhoea is defined as passage of unusually loose or watery stools usually at least 3 times in 24 hour period (WHO) Consistency is important rather than number of stool. Passage of even one large watery stool in young child is diarrhea. Frequent passage of normal stool is NO DIARRHOEA.

7. 6-12 months of children are affected severely & account for high mortality

8. Diarrhoea produces under nutrition& growth failure. A brief episode of diarrhoea leads to loss of 1-2% of body weight among children.

9. Leading causes of death in children<5 year of age:

10. Incidence : Diarrhoeal disease is the second leading cause of death in children under five years old. It is both preventable and treatable. Each year diarrhoea kills around 525 000 children under five. A significant proportion of diarrhoeal disease can be prevented through safe drinking-water and adequate sanitation and hygiene. Globally, there are nearly 1.7 bill ion cases of childhood diarrhoeal disease every year. Diarrhoea is a leading cause of malnutrition in children under five years old.

11. Causes of Diarrhoea:

12. Why children are at Risk:

13. IMNCI case management process: Assess the young infant/child Classify the illness Identify treatment Treat the young infant Counsel the mother Follow-up care

14. Signs of dehydration:

15. Sign of dehydration & treatment plan:

16. Principles of management of acute diarrhoea:

17. ORS: It is a balanced mixture of glucose and electrolytes Almost all deaths from diarrhoea can be prevented by ORS MECHANISM OF ACTION: Sodium promotes absorption of water from intestine. Glucose promotes absorption of sodium & water from the intestine.

18. How to make ORS at HOME?????

19. NO SIGN OF DEHYDRATION: PLAN A: Counsel mother about 3 Rules of Home treatment: Give extra fluids Continue feeding When to return

20. NO DEHYDRATION:

21. Some dehydration: Kept under observation Providing ORS PLAN B REHYDRATION THERAPY

22. PLAN B:

23. SEVERE DEHYDRATION: Admit child Rehydration by intravenous therapy include: R/L SOLUTION N/S When R/L is not available ½ N/S with 5% dextrose is acceptable. -PLAN C

24. PLAN C: Reassess the infant every 15-30 min, until strong radial pulse is present Reassess by skin pinch & LOC at least every 1 hour Give ORS (5ml/kg/ hr ) as soon as infant can drink Reassess infant after 6 hr & classify hydration then choose appropriate plan (A,B,C)to continue treatment Before discharge, 2 packets of ORS to be given

25. Recommendation for use of Zn: 20mg/day for 14 days 10 mg/day for infants 2-6 months

26. Prevention of diarrhoea:

27. Dysentery: Dysentery is diarrhoea presenting with loose frequent stools containing blood. (WHO)

28. MANAGEMENT: Medication ORS Give first dose of intramuscular gentamycin& ampicillin Treat to prevent low blood sugar Keep infant warm on way to hospital Refer to hospital

29. When to come to hospital: Increased frequency of stools Continue diarrhoea after treatment Repeated vomiting Increasing thirst Refusal to feed Fever Blood in stool