INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESSES (IMNCI)

INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESSES (IMNCI) Mrs.Sharin Neetal D'souza

INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESSES (IMNCI) Prepared by: Mrs.SharinNeetalD’souza Lecturer Dept.Child health nursing Yenepoya nursing college Reviewed by: Prof.Umarani J Dr.PriyaReshmaAranha Mrs.Sharin Neetal D'souza

Learning objectives At the end of the class students will be able to • define IMNCI • list the objectives • find the beneficiaries of IMNCI • enumerate the components • explain the principles • explain the colour codes of IMNCI Mrs.Sharin Neetal D'souza

Mrs.Sharin Neetal D'souza

IMCI Strategy Mrs.Sharin Neetal D'souza

IMNCI strategy under RCH-2 Mrs.Sharin Neetal D'souza

Learningobjectives At the end of the class students will be able to • list the elements of IMNCI • explain the management of child with various disease conditions under IMNCI process with the age group of below 2months and 2months – 5years Mrs.Sharin Neetal D'souza

ELEMENTS:- Assess Danger signs, nutrition and immunization status Other problems Classify as per Color Coding Identify Specific Treatment Provide Treatment Pre referral Medical treatment Home Management Counsel Feeding problems Mother’s health Follow-up care( Textbook of PSM, Park’s 22nd edition) Mrs.Sharin Neetal D'souza

Fast breathing Mrs.Sharin Neetal D'souza

Look for severe chest in drawing Mrs.Sharin Neetal D'souza

Nasal flaring Mrs.Sharin Neetal D'souza

Grunting Mrs.Sharin Neetal D'souza

Bulging fontanels Mrs.Sharin Neetal D'souza

Pus draining from the ear Mrs.Sharin Neetal D'souza

Skin pustules Mrs.Sharin Neetal D'souza

Temperature Mrs.Sharin Neetal D'souza

Lethargy / unconsciousness Mrs.Sharin Neetal D'souza

Jaundice Mrs.Sharin Neetal D'souza

Jaundice • It is visible manifestation of hyperbilirubinemia . • Yellow discolouration of skin is visible in a neonate when the bilirubin is > 5mg/dl • occurance of jaundice within 24 hrs of life, yellow discolouration of palms and soles at any time is always pathological and requires urgent refferal. Mrs.Sharin Neetal D'souza

CLASSIFICATION OF JAUNDICE Severe jaundice jaundice Mrs.Sharin Neetal D'souza

jaundice • Severe jaundice : • Is one who has yellow palms and soles or has jaundice at age 14 days or more . This infant should be referred urgently to the hospital. • Jaundice; • Is one who has jaundice but the palms and soles are not yellow and the age of the infant is 1-13 days . This infant should be advised when to return immediately and should be seen is follow up in 2 days Mrs.Sharin Neetal D'souza

SEVERE JAUNDICE • Yellow palms and soles • Age < 24 hours • Age 14 days or more Mrs.Sharin Neetal D'souza

TREATMENT • Refer urgently to the hospital after being given treatment to prevent hypoglycemia • Advice to keep the baby warm Mrs.Sharin Neetal D'souza

JAUNDICE • Palms and soles not yellow • Age 1 to 13 days Mrs.Sharin Neetal D'souza

TREATMENT • Home care • Follow up in 2 days Mrs.Sharin Neetal D'souza

CHECK FOR POSSIBLE DIARRHOEA Mrs.Sharin Neetal D'souza

ASK:- • Does the child have diarrhea? • IF YES THEN , FOR HOW LONG? • LOOK AND FEEL:- • Look at the general conditions. Is he/she • -lethargic or unconscious? • -restless and irritable? • Look for sunken eyes • Pinch the skin of abdomen , • and notice how it goes back: • -very slowly( longer than two seconds)? • -slowly? • -immediately? • (IMNCI Module 2 WHO, UNICEF, MOHFW) Mrs.Sharin Neetal D'souza

TURGOR’S SIGN (IMNCI Module 2 WHO, UNICEF, MOHFW) it is a sign commonly used by health care workers to assess the degree of fluid loss or dehydration. Locate the area on the child's abdomen halfway between the umbilicus and the side of the abdomen; then pinch the skin using the your thumb and finger. Place your hand in such a way that when the skin is pinched, the fold of skin will be in a line up and down the child's body and not across the child's body. It is important to firmly pick up all of the layers of skin and the tissue under them for fifteen to thirty seconds and then release it. Mrs.Sharin Neetal D'souza

When released, the skin pinch goes back either • very slowly (longer than 2 seconds), • slowly (skin stays up even for a brief instant), • immediately. TURGOR SIGN Mrs.Sharin Neetal D'souza

SIGNS OF DIARRHOEA Mrs.Sharin Neetal D'souza

Classification: Mrs.Sharin Neetal D'souza (IMNCI Module 2 WHO, UNICEF, MOHFW)

INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESSES (IMNCI)