Page 231 - Learnwell EVS
P. 231
sles
Case management
– A d m it as inp atient child ren with at least o ne m ajo r co m p licatio n: 2 sat.
• Inability to eat/ d rink / suck , o r vo m iting
• A ltered co nscio usness o r seiz ures
• D ehy d ratio n
• S evere p neum o nia ( p neum o nia w ith resp irato ry d istress o r cy ano sis o r O
< 90% )
• A cute lary ngo tracheo bro nchitis (cro 1up )
• C o rneal lesio ns (p ain, p ho to p ho bia, ero sio n o r o p acity )
• S evere o ral lesio ns that p revent eating
• A cute m alnutritio n
– Treat as o utp atient child ren with no m ajo r co m p licatio ns, no co m p licatio ns o r m ino r
co m p licatio ns:
• P neum o nia witho ut severe signs
• A cute o titis m ed ia
• P urulent co njunctivitis (no co rneal lesio ns)
• D iarrho ea witho ut d ehy d ratio n
• O ral cand id iasis that d o es no t interfere with eating
I f in d o ubt, k eep the child und er o bservatio n fo r a few ho urs.
– Iso latio n
• Iso latio n o f ho sp italised p atients
• M easles cases treated as o ut-p atients sho uld be k ep t at ho m e d uring this p erio d .
Treatment
Supportive and preventive treatment
– Treat fever (p aracetam o l, p age 2 6 ).
– M ak e the child d rink (high risk o f d ehy d ratio n).
– G ive sm aller, m o re frequent m eals o r breastfeed m o re frequently (every 2 to 3 ho urs).
– C lear th e naso p h ary nx ( no se- blo w ing o r nasal lavages) to p revent seco nd ary
resp irato ry infectio n and im p ro ve the child ‟s co m fo rt.
– C lean the ey es with clean water 2 tim es d aily and ad m inister retino l o n D 1 and D 2
(see p age 1 2 2 ) to p revent o cular co m p licatio ns.
– I n ch ild ren und er 5 y ears: amoxicillin P O fo r 5 d ay s as a p reventive m easure
(red uctio n o f resp irato ry and o cular infectio ns).
– In the event o f watery d iarrho ea witho ut d ehy d ratio n: o ral rehy d ratio n acco rd ing to
W H O P lan A .
– I nsert a naso gastric tube fo r a few d ay s if o ral lesio ns p revent th e ch ild fro m
d rink ing.
Treatment of complications
S ee fo llo wing p age
1 Symptoms (hoarse crying or voice, difficulty breathing, a high-pitched inspiratory wheeze [inspiratory stridor],
characteristic "barking" cough) are caused by inflammation and narrowing of the larynx. Croup is considered
benign or “moderate” if the stridor occurs when the child is agitated or crying, but disappears when the child is
calm. The child should be monitored during this period, however, because his general and respiratory status can
deteriorate rapidly. Croup is severe when the stridor persists at rest or is associated with signs of respiratory
distress.
190
Case management
– A d m it as inp atient child ren with at least o ne m ajo r co m p licatio n: 2 sat.
• Inability to eat/ d rink / suck , o r vo m iting
• A ltered co nscio usness o r seiz ures
• D ehy d ratio n
• S evere p neum o nia ( p neum o nia w ith resp irato ry d istress o r cy ano sis o r O
< 90% )
• A cute lary ngo tracheo bro nchitis (cro 1up )
• C o rneal lesio ns (p ain, p ho to p ho bia, ero sio n o r o p acity )
• S evere o ral lesio ns that p revent eating
• A cute m alnutritio n
– Treat as o utp atient child ren with no m ajo r co m p licatio ns, no co m p licatio ns o r m ino r
co m p licatio ns:
• P neum o nia witho ut severe signs
• A cute o titis m ed ia
• P urulent co njunctivitis (no co rneal lesio ns)
• D iarrho ea witho ut d ehy d ratio n
• O ral cand id iasis that d o es no t interfere with eating
I f in d o ubt, k eep the child und er o bservatio n fo r a few ho urs.
– Iso latio n
• Iso latio n o f ho sp italised p atients
• M easles cases treated as o ut-p atients sho uld be k ep t at ho m e d uring this p erio d .
Treatment
Supportive and preventive treatment
– Treat fever (p aracetam o l, p age 2 6 ).
– M ak e the child d rink (high risk o f d ehy d ratio n).
– G ive sm aller, m o re frequent m eals o r breastfeed m o re frequently (every 2 to 3 ho urs).
– C lear th e naso p h ary nx ( no se- blo w ing o r nasal lavages) to p revent seco nd ary
resp irato ry infectio n and im p ro ve the child ‟s co m fo rt.
– C lean the ey es with clean water 2 tim es d aily and ad m inister retino l o n D 1 and D 2
(see p age 1 2 2 ) to p revent o cular co m p licatio ns.
– I n ch ild ren und er 5 y ears: amoxicillin P O fo r 5 d ay s as a p reventive m easure
(red uctio n o f resp irato ry and o cular infectio ns).
– In the event o f watery d iarrho ea witho ut d ehy d ratio n: o ral rehy d ratio n acco rd ing to
W H O P lan A .
– I nsert a naso gastric tube fo r a few d ay s if o ral lesio ns p revent th e ch ild fro m
d rink ing.
Treatment of complications
S ee fo llo wing p age
1 Symptoms (hoarse crying or voice, difficulty breathing, a high-pitched inspiratory wheeze [inspiratory stridor],
characteristic "barking" cough) are caused by inflammation and narrowing of the larynx. Croup is considered
benign or “moderate” if the stridor occurs when the child is agitated or crying, but disappears when the child is
calm. The child should be monitored during this period, however, because his general and respiratory status can
deteriorate rapidly. Croup is severe when the stridor persists at rest or is associated with signs of respiratory
distress.
190
