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VIPIN KUMAR. CONTROL OF ACUTE RESPIRATORY TRACT INFECTIONS. History taking Physical examination. History taking. Age Duration of illness Has the young infant stopped feeding? Any other illness H/o irregular breathing. PHYSICAL EXAMINATION. No : of breaths/min Chest indrawing
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VIPIN KUMAR CONTROL OF ACUTE RESPIRATORY TRACT INFECTIONS
History taking • Physical examination
History taking • Age • Duration of illness • Has the young infant stopped feeding? • Any other illness • H/o irregular breathing
PHYSICAL EXAMINATION • No : of breaths/min • Chest indrawing • Stridor • Wheeze • Drowsiness • Malnutrition • Fever • Cyanosis
CLASSIFICATION OF ILLNESS • Child aged 2 months – 5 yrs • Very severe disease • Severe pneumonia • Pneumonia • No pneumonia
B . Illness of young infants (< 2 months) a. Very severe disease b . Severe pneumonia c . No pneumonia
TREATMENT2MONTHS– 5 YRS VERY SEVERE DISEASE Refer to the hospital immediately Intensive monitoring $ O2 therapy Chloramphenicol im DOC 48hrs No improvement Improvement + Shift to oral Chloramphenicol X 10 days Cloxacillin + Gentamicin i. m
Severe pneumonia Benzyl Penicillin 50000 IU/Kg/dose 6 hrly i.m. Or Ampicillin 50mg/kg/dose 6 hrly i.m x48hrs Or Chloramphenicol 25mg / kg/dose 6 hrly i.m No improvement Improvement + Change the antibiotic for the next 48hrs Procaine Penicillin 50000IU/kg Once i.m. Or Ampicillin 50mg/kg/dose 6hrly oral Or Chloramphenicol 25mg /kg/dose 6hrly oral x 3 days Continue Rx orally Symptomatic Rx for fever ,wheezing… Monitor fluid and food intake Advice on home Mx
Pneumonia Cotrimoxazole 48 hrs Improves Worsens Same Continue Rx for the next 3 days Re-assess after 48 hrs REFER immediately
YOUNG INFANT Pneumonia Start Rx with cotrimoxazole by Health worker and refer If pneumonia suspected , Rx with Benzyl Penicillin • Keep the child warm and dry. • Breast feeding promoted
DOES NOT require any antibiotic treatment No pneumonia in children Advice to the mother Symptomatic treatment and care at home
PREVENTION OF ARI • Improvement in living condition • Better nutrition • Reduction of smoke pollution • Immunization • Health Education