1. Cough or Difficulty of Breathing

2. One of the most common infections among children May be pneumonia or a less serious respiratory infection Strep. pneumoniae is the most common bacterial cause of pneumonia in the Phil. Children can die from hypoxia or sepsis Check for fast breathing and chest indrawing to identify very sick children

3. Cough or Difficulty of Breathing If yes, ask: for how long? LOOK LISTEN FEEL: count the breaths in one minute look for chest indrawing look and listen for stridor If no, ask the next main symptoms: diarrhea, fever, ear problems If the child is: fast breathing is: 2-12 months 50 bpm or more 1-5 years 40 bpm or more Ask: does the child have cough or difficulty breathing? CLASSIFY

4. Cough or Difficulty of Breathing Any general danger sign or Chest indrawing or Stridor in a clam child SEVERE PNEUMONIA OR VERY SEVERE DISEASE Give first dose of an appropriate antibiotic Refer URGENTLY to a hospital Fast breathingPNEUMONIAGive an appropriate oral antibiotic for 5days Soothe the throat and releive the cough with a safe remedy Advise mother when to return immediately Follow-up in 2days No signs of pneumonia or very severe disease NO PNEUMONIA, COUGH OR COLD If coughing >30days refer for assessment Soothe the throat and releive the cough with a safe remedy Advise mother when to return immediately Follow-up in 6days if not improving SIGNS CLASSIFY AS IDENTIFY TREATMENT

5. Treatment Soothe the throat, releive the cough with a safe remedy –Safe remedies to recommend: Breastmilk for exclusively breastfed infant; tamarind, calamansi, ginger –Harmful remedies to discourage: Codeine cough syrup Other cough syrups Oral and nasal decongestants

6. Treatment for Pneumonia or Very Severe Disease Age or Weight Cotrimoxazole Give 2 times daily for 5 days Amoxicillin Give 3 times daily for 5 days Adult tab. 80mg TMP 400mg SMX Syrup 40mg TMP 200mg SMX Tablet 250mg Syrup 125mg/5mL 2-12 mos (4-10 kg) 1/25.0 mL1/25.0 mL 12 mos – 5 yrs (10-19 kg) 17.5 mL110 mL

7. Vitamin A Given to a child with measles and severe malnutrition Helps resist measles virus infection in the eye and lining of lungs, gut, mouth and throat Prevents corneal clouding which is a sign of Vit A deficiency Preparations: blue-green capsule – 100,000; red capsule – 200,000

8. Vitamin A Supplementation for Severe Pneumonia or Very Severe Disease AgeVitamin A Capsule 100,000 IU200,000 IU 6 – 12 mos1 capsule½ capsule 12 mos – 5 yrs2 capsules1 capsule