LOOK and LISTEN for stridor. Stridor is a harsh noise made when the child breathes IN. Stridor happens when there is a swelling of the larynx, trachea or epiglottis. This swelling interferes with air entering the lungs. It can be life-threatening when the swelling causes the child's airway to be blocked. A child who has stridor when calm has a dangerous condition. To look and listen for stridor, look to see when the child breathes IN. Then listen for stridor. Put your ear near the child's mouth because stridor can be difficult to hear. Sometimes you will hear a wet noise if the nose is blocked. Clear the nose, and listen again. A child who is not very ill may have stridor only when he is crying or upset. Be sure to look and listen for stridor when the child is calm. You may hear a wheezing noise when the child breathes OUT. This is not stridor.
7 3.2 CLASSIFY COUGH OR DIFFICULT BREATHING There are three possible classifications fora child with cough or difficult breathing. They are SEVERE PNEUMONIA OR VERY SEVERE DISEASE or PNEUMONIA or NO PNEUMONIA COUGH OR COLD Here is the classification table for cough or difficult breathing. SIGNS CLASSIFY TREATMENT Any general danger signor Chest indrawing or • Stridor in calm child SEVERE PNEUMONIA OR VERY SEVERE DISEASE Give first dose of injectable chloramphenicol if not possible give oral amoxycillin) Refer URGENTLY to hospital. Fast breathing PNEUMONIA Give Amoxycillin for 5 days. Soothe the throat and relieve the cough with a safe remedy if child is 6 months or older. Advise mother when to return immediately Followup in 2 days. No signs of pneumonia or very severe disease NO PNEUMONIA COUGH OR COLD If coughing more than 30 days, refer for assessment Soothe the throat and relieve the cough with a safe home remedy if child is 6 months or older Advise mother when to return immediately Followup in 5 days if not improving Here is a description of each classification for cough or difficult breathing.