Updates on IMNI - ART , Management and Treatment

Ppt on recent update on IMNCI

1. Question Shivani, a one-and-a-half-year-old child was brought to Makali PHC by her mother with fever, cough, and cold . On observation, the child was well nourished, calm, and playful , had normal chest movements , and a respiratory rate of 50 per minute. a) How would you classify and manage this child as per IMNCI guidelines? b) What is the advice you would give the child’s mother? c) Along with cough assessment , what other symptoms and conditions you will check and assess for before treatment? 5/6/2024 1

2. Integrated Management of Neonatal and Childhood Illness  (IMNCI) 5/6/2024 2

3. IMNCI WHO and UNICEF developed the strategy known as IMCI The strategy combines improved management of childhood illness with aspects of nutrition, immunization, and other important disease prevention and health promotion elements 5/6/2024 3

4. IMNCI Objective: To reduce preventable mortality, minimize illness and disability, and promote healthy growth and development of children under five years.  Management of young infants aged up to 2 months (0 to 59 days old) Management of sick children 2 months to 5 years (2 to 59 months) 5/6/2024 4

5. Major Illness covered (2-59 months) Major Illness covered: Acute Respiratory Illness Acute Diarrhoeal disease Measles Malaria Malnutrition 5/6/2024 5

6. Steps 5/6/2024 6

7. Assessment of the child: Routinely assess for danger signs: Convulsion Lethargy Unconsciousness Inability to drink Vomiting 5/6/2024 7

8. Ask for the main symptom • H/o Cough or Difficulty in breathing If yes, then the examination : Count the breaths in one minute. Look for chest indrawing. Look and listen for stridor 5/6/2024 8

9. Assessment based on respiratory rate Fast breathing is present when the respiratory rate is : 60 breaths per minute or more in a child less than 2 months of age 50 breaths per minute or more in a child aged 2 months up to 12 months 40 breaths per minute or more in a child aged 12 months upto 5 years . 5/6/2024 9

10. STRIDOR – Its inspiratory sound with origin in upper airway (larynx/upper part of trachea). Narrowing as obstruction while breathing in. WHEEZING – Whistling sound. Breathing in and the sound originates from air pockets. 5/6/2024 10

11. Assessment Assess Malnutrition Immunization history Prophylatic Iron and Vitamin A status 5/6/2024 11

12. Classify : Classify children or young infants’ illnesses using the colour -coded triage system 5/6/2024 12

13. Classification 5/6/2024 13

14. Treatment for ARI Oral Antibiotics: Amoxycillin is the drug of choice. Given 80 mg/kg/day in 2 divided doses for 5 days. Injectable Antibiotics: Inj Ampicillin 50 mg/kg given 6 hourly for 5 days and Inj Gentamycin 7.5mg/kg given once daily for 5 days If child does not improve, shift to Inj Ceftriaxone. 5/6/2024 14

15. Counsel the mother Teach the mother when to give the drug Counsel the mother when to return to the hospital immediately 5/6/2024 15 Any sick child If the child has NO PNEUMONIA Not able to drink or breastfeed Fast breathing Becomes sicker Difficult breathing Develops a fever

16. Counsel the mother Counsel the mother to come for a follow-up Within two days if the child was having pneumonia 5/6/2024 16

17. Question Shivani, a one-and-a-half-year-old child was brought to Makali PHC by her mother with fever, cough, and cold . On observation, the child was well nourished, calm, and playful , had normal chest movements , and a respiratory rate of 50 per minute. a) How would you classify and manage this child as per IMNCI guidelines? b) What is the advice you would give the child’s mother? c) Along with cough assessment , what other symptoms and conditions you will check and assess for before treatment? 5/6/2024 17

18. THANK YOU 5/6/2024 18