 | Essential Community Child Health Care: Charts (WHO - OMS, 2000, 18 p.) |
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CHECKLIST FOR MONITORING CLINICAL CARE
Date ____________ HW's Name___________________________________ HW's N°_____ Village Supervisor_________________________________
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Child's number |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
Total | |
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Child's age in months | | | | | | | | | | | | | | |
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What are the child's problems? | | | | | | | | | | | | | | |
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Does the child have General Danger Signs? | | | | | | | | | | | | | | |
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Not able to drink or breast-feed | | | | | | | | | | | | | | |
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Convulsions |
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Abnormally sleepy or difficult to wake | |
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VERY SEVERE DISEASE | | | | | | | | | | | | | | |
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NO GENERAL DANGER SIGNS | | | | | | | | | | | | | | |
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Does the child have cough or difficult breathing? |
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Ask "for how long?" |
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Fast breathing |
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SEVERE PNEUMONIA |
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PNEUMONIA | |
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COUGH OR COLD |
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Does the child have diarrhoea? | |
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Blood in the stools? |
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Abnormally sleepy or difficult to wake? | |
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Restless or irritable | | | | | | | | | | | | | | |
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Sunken eyes |
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Not able to drink or drinks poorly | | | | | | | | | | | | | | |
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Child thirsty |
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Skin pinch very slow |
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Skin pinch slow |
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SEVERE DEHYDRATION | | | | | | | | | | | | | | |
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SOME DEHYDRATION | | | | | | | | | | | | | | |
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NO DEHYDRATION | | | | | | | | | | | | | | |
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Does the child have fever? | | | | | | | | | | | | | | |
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Stiff neck | |
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VERY SEVERE FEVER DISEASE | | | | | | | | | | | | | | |
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MALARIA | |
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Child referred for any reasons (referral is possible) | | | | | | | | | | | | | | |
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Referral is not possible | | | | | | | | | | | | | | |
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AMOXYCILLIN TAB. GIVEN | | | | | | | | | | | | | | |
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PACKETS OF ORS GIVEN |
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CHLOROQUINE TAB. GIVEN | | | | | | | | | | | | | | |
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ADVISE THE CARER |
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Note |
COMMENTS |
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CHECKLIST FOR MONITORING CLINICAL CARE-B
Date____________ HW's Name___________________________________ HW's N°_____ Village Supervisor ___________________________
|
Child's number |
13 |
14 |
15 |
15 |
16 |
17 |
18 |
19 |
20 |
21 |
22 |
23 |
Total | ||
|
Child's age in months | | | | | | | | | | | | | | ||
|
What are the child's problems? | | | | | | | | | | | | | | ||
|
Does the child have General Danger Signs? | | | | | | | | | | | | | | ||
|
Not able to drink or breast-feed | | | | | | | | | | | | | | ||
|
Convulsions |
| | |
| | |
| | |
| | |
| ||
|
Abnormally sleepy or difficult to wake | |
| | |
| | |
| | |
| | | ||
|
VERY SEVERE DISEASE | | | | | | | | | | | | | | ||
|
NO GENERAL DANGER SIGNS | | | | | | | | | | | | | | ||
|
Does the child have cough or difficult breathing? |
| | | | | | | | | | | | | ||
|
Ask "for how long?" |
| | |
| | |
| | |
| | |
| ||
|
Fast breathing |
| | |
| | |
| | |
| | |
| ||
|
SEVERE PNEUMONIA |
| | |
| | |
| | |
| | |
| ||
|
PNEUMONIA | |
| | | | | | | | | | | | ||
|
COUGH OR COLD |
| | |
| | |
| | |
| | |
| ||
|
Does the child have diarrhoea? | |
| | |
| | |
| | |
| | | ||
|
Blood in the stools? |
| | |
| | |
| | |
| | |
| ||
|
Abnormally sleepy or difficult to wake? | |
| | |
| | |
| | |
| | | ||
|
Restless or irritable | | | | | | | | | | | | | | ||
|
Sunken eyes |
| | |
| | |
| | |
| | |
| ||
|
Not able to drink or drinks poorly | | | | | | | | | | | | | | ||
|
Child thirsty |
| | |
| | |
| | |
| | |
| ||
|
Skin pinch very slow |
| | |
| | |
| | |
| | |
| ||
|
Skin pinch slow |
| | |
| | |
| | |
| | |
| ||
|
SEVERE DEHYDRATION | | | | | | | | | | | | | | ||
|
SOME DEHYDRATION | | | | | | | | | | | | | | ||
|
NO DEHYDRATION | | | | | | | | | | | | | | ||
|
Does the child have fever? | | | | | | | | | | | | | | ||
|
Stiff neck | |
| | | | | | | | | | | | ||
|
VERY SEVERE FEVER DISEASE | | | | | | | | | | | | | | ||
|
MALARIA | |
| | | | | | | | | | | | ||
|
Child referred for any reasons (referral is possible) | | | | | | | | | | | | | | ||
|
Referral is not possible | | | | | | | | | | | | | | ||
|
AMOXYCILLIN TAB. GIVEN | | | | | | | | | | | | | | ||
|
PACKETS OF ORS GIVEN |
| | |
| | |
| | |
| | |
| ||
|
CHLOROQUINE TAB. GIVEN | | | | | | | | | | | | | | ||
|
ADVISE THE CARER |
| | |
| | |
| | |
| | |
| ||
|
Note |
COMMENTS |
Note |
COMMENTS | ||||||||||||
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