Topic: ARI and Diarrhea of under five and their management.
Question: Describe the clinical features and management of very severe pneumonia as per national ARI control program.
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Clinical features and management of very severe pneumonia as per the National ARI Control Program:
Clinical Features:
– Cough or difficult breathing
– Severe respiratory distress
– Grunting
– Very fast breathing (≥70 breaths/min in infants, ≥60 in older children)
– Convulsions
– Inability to drink or breastfeed
– Vomiting everything
– Altered sensorium
– Cyanosis
– Chest in-drawing
Management:
1. Admit to hospital
2. Secure airway and breathing
3. Give oxygen therapy via face mask or nasal prongs
4. Antibiotics:
– Injectable ampicillin 50mg/kg + gentamicin 7.5mg/kg IV/IM
– Injectable ceftriaxone 80mg/kg IV/IM once daily
5. Bronchodilators (salbutamol) if wheezing
6. Antipyretics for high fever (paracetamol)
7. Clear airway secretions
8. Monitor vital signs, oxygen saturation, hydration
9. Nutritional support if needed
10. Watch for complications like respiratory failure, sepsis
11. Monitor for treatment response
12. Discharge on oral antibiotics once child stabilizes
13. Counsel caregivers on danger signs and follow up
The key is prompt recognition, oxygen therapy, antibiotics and supportive care in very severe pneumonia to prevent mortality
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