MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS
Date: ____________________________________________
Child’s Name: _____________________________________________________ Age: __________ Sex: __________ Weight: __________ kg Temperature: __________ °C
Address: __________________________________________________________ Mother’s Name: __________________________________________________________
ASK: What are the child’s problems? ____________________________________________________________________ Initial visit? __________ Follow-up: __________
ASSESS (Encircle all signs present)
CHECK FOR GENERAL DANGER SIGNS
NOT ABLE TO DRINK OR BREASTFEED
VOMITS EVERYTHING
CONVULSIONS
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING?
 For how long? ______ days
DOES THE CHILD HAVE DIARRHEA?
 For how long? ______ days
DOES THE CHILD HAVE FEVER? (by history/ feels hot/ temperature 37.5°C or above)
Decide Malaria Risk
 Does the child live in a malaria area?
 Has the child visited/ travelled or stayed overnight
in a malaria area in the past 4 weeks?
 Has the child received blood transfusion for
the past 6 months?
If malaria risk, obtain a blood smear.
(+) (Pf) (Pv) (-) Not done
THEN ASK:
 For how long has the child had fever? ______ days
 If more than 7 days, has fever been present every day?
 Has the child had measles within the last 3 months?
If the child has measles now or within the last 3 months:
ASSESS DENGUE HEMORRHAGIC FEVER
ASK:
 Has the child had any bleeding from the noise or
gums or in the vomitus or stool?
 Has the child had black vomitus or black stool?
 Has the child had persistent abdominal pain?
 Has the child had persistent vomiting?
DOES THE CHILD HAVE EAR PROBLEM?
 Is there ear pain?
 Is there ear discharge?
 If yes, for how long? ______ days
THEN CHECK FOR MALNUTRITION and ANEMIA?
Recording Form
CLASSIFY
GENERAL DANGER SIGNS
ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN PRESENT?
YES ______ NO ______
YES ______ NO ______
 Count the breaths in one minute.
______ breaths per minute. Fast breathing?
 Look for chest indrawing.
 Look and listen for stridor.
 Look and listen for wheeze.
YES ______ NO ______
 Look at the child’s general condition.
Abnormally sleepy or difficult to awaken?
Restless or irritable?
 Look for sunken eyes.
 Offer the child fluid. Is the child:
Not able to drink or drinking poorly?
Drinking eagerly, thirsty?
 Pinch the skin of the abdomen. Does it go back?
Very slowly (longer than 2 seconds)?
Slowly?
YES ______ NO ______
 Look for signs of MEASLES.
 Generalized rash and
 One of these: cough, runny nose, or red eyes
 Look for mouth ulcers.
If yes, are they deep and extensive?
 Look for pus draining from the eye.
 Look for clouding of the cornea.
LOOK AND FEEL:
 Look for bleeding from nose or gums.
 Look for skin petechiae.
 Feel for cold and clammy extremities.
 Check capillary refill ______ seconds.
 Perform tourniquet test if child is 6 months or older AND
has no other signs AND has fever for more than 3 days.
YES ______ NO ______
 Look for pus draining from the ear.
 Feel for tender swelling behind the ear.
YES ______ NO ______
 Look for visible severe wasting.
 Look for edema of both feet.
 Look for palmar pallor.
Severe palmar pallor? Some palmar pallor?
 Determine weight for age.
Very low?
Integrated Management of Childhood Illness ©2009