A 10 months old child weighing 5 kg and length 65 cm presents with cough and cold. He was found to have a respiratory rate of 48 per minute with no retraction, grunting or cyanosis. There is no history of convulsions. Which of the following is true about this child?
Ans. a. No pneumonia, only cough and cold (Ref: Ghai 8/e p759)Respiratory rate of 48 per minute with no retraction, grunting or cyanosis in a 10 months old child weighing 5 kg and length 65 cm with cough and cold without history of convulsions is suggestive of no pneumonia (only cold and cough).Acute Respiratory Infection (ARI)/ PneumoniaNo Pneumonia: Cough or ColdPneumonia (Not severe)Severe PneumoniaVery Severe Pneumonia* No chest indrawing, No fast breathingQManagement:* No antibiotics necessary* Treat symptomatically* If cough > 30 days, refer for assessment* No chest indrawingQ* Fast breathing presentQSignsQ:* Chest indrawing* Nasal flaring* Grunting* CyanosisManagement:* Give first dose of referral antibiotic (Ampicillin + Gentamicin)* Refer urgently to hospital;* Drugs of ChoiceQ- Benzyl Penicillin (or Ampicillin or Chlorampheniciol) for first 48 hours and then Procaine Penicillin (or Ampicillin or Chiorampheniciol) for next 3 days* Antibiotics to be changed if there is no improvement after first 48 hoursSignsQ:* Convulsions, abnormally sleepy or difficult to awake* Stridor when calm* Stopped feeding* Wheezing* Fever or low body temperature* Severe malnutritionManagement:* Give first dose of referral antibiotic (Ampicillin + Gentamicin)Q* Refer urgently to hospital* Drug of ChoiceQ - Chloramphenicol IM for first 48 hours and then oral chloramphenicol till total 10 days* Antibiotics to be changed (to IM Cloxacillin + Gentamicin) if there is no improvement after first 48 hoursAge groupRespiratory rate0-2 months>60/minute2-12 months>50/minute12 months-5years>40/minuteManagement:* At home* Give antibiotics- Drug of choice CotrimoxazoleQ* Reassessment after 2 days
No pneumonia, only cough and cold
Child has pneumonia
Severe pneumonia
Very severe disease
Disorders of the Respiratory Tract