Integrated management of neonatal and childhood illness

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module 5
Recording Form for the sick child age 2 months up to 5 years
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Respiratory infections can occur in any part of the respiratory tract such as the nose, throat, larynx, trachea, air passages or lungs. A child with cough or difficult breathing may have pneumonia or another severe respiratory infection. Pneumonia is an infection of the lungs. Both bacteria and viruses can cause pneumonia. In developing countries, pneumonia is often due to bacteria. The most common are Streptococcus pneumoniae and Hemophilus
influenzae. Children with bacterial pneumonia may die from hypoxia (too little oxygen) or sepsis (generalized infection. There are many children who come to the clinic with less serious respiratory infections. Most children with cough or difficult breathing have only a mild infection. For example, a child who has a cold may cough because nasal discharge drips down the back of the throat. Or, the child may have a viral infection of the bronchi called bronchitis. These children are not seriously ill. They do not need treatment with antibiotics. Their families can treat them at home. Doctors need to identify the few, very sick children with cough or difficult breathing who need treatment with antibiotics. Fortunately, doctors can identify almost all cases of pneumonia by checking for these two clinical signs fast breathing and chest indrawing. When children develop pneumonia, their lungs become stiff. One of the body's responses to stiff lungs and hypoxia (too little oxygen) is fast breathing. When the pneumonia becomes more severe, the lungs become even stiffer. Chest indrawing may develop. Chest indrawing is a sign of severe pneumonia.


A child with cough or difficult breathing is assessed for How long the child has had cough or difficult breathing Fast breathing Chest indrawing
Stridor in a calm child. Here is the box in the "Assess" column that lists the steps for assessing a child for cough or difficult breathing

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