This document discusses the assessment and classification of acute respiratory infections (ARI) and pneumonia in children. It outlines steps for history taking and physical examination of children under 5 years old and less than 2 months old who may have ARI or pneumonia. Signs and symptoms are provided to classify illnesses as no pneumonia, pneumonia, severe pneumonia, or very severe disease. Treatment recommendations are given for each classification.

1. ARI and Pneumomia
Dr Anuradha Davey
Associate Professor

2. • History taking
• Clinical assessment

3. • Less than 2 months old child
• 2 month -5 year old child

4. History taking
• Able to drink
• Stopped feeding well
• Antecedent illness
• Such as measles
• h/o any fever
• Excessive drowsy or difficulty in walking
• Any h/o convulsion
• h/o child turning blue
• Any h/o tt during the illness

5. Physical examination
• Count the breathe for one min
• Look for chest in drawing
• Look and listen for stridor
• Look for wheeze
• Abnormal sleepy or difficult to wake
• Feel fever or low body temperature
• Check for sever malnutrition
• Cynosis

6. Count the breathe in one minute
• Fast breathing: if-
• >60 /min: child less than 2 months
• > 50 /min: child 2 months to 1 year
• > 40 per min: for child 1 year – 5 year
• Repeat the count for confirmation esp in young infants

7. Look for chest in drawing
• When breathe IN
• Of lower chest----- Which goes IN

8. Look AND Listen for Stridor
• When Breathing IN
• Harsh noise…also called as croup
• Narrowing of the trachea, larynx and epiglottis which interfere with air entry

9. Look for Wheeze
• When breathing Out
• Soft Whistling noise
• Narrowing of the air passage in lungs and require efforts

10. Abnormal sleepy
• Drowsy most of the time when he or she should be awake and alert

11. Classification of the Illness
2months- 5 year
• Very severe disease
• Severe Disese
• Pneumonia
• No Pneumonia (Cough and cold)

12. No Pneumonia
No chest in drawing
No fast breathing
Home based tt
Treat fever
Assess for er infection
Treat wheezing

13. Pneumonia
Sign Tt
Fast breathing
No chest indrawing
Home based tt
Antibiotics
Mother advise counselling
Treat fever
Treat wheezing
Follow up in 2 days or earlier if child is
getting worse

14. Severe Pneumonia
Sign Treatment
Fast breathing
Chest Indrawing
Nasal flaring
Cynosis
Wheezing
Refer URGENTLY
Give first dose of antibiotics
Treat fever
If cerebral malaria : treat malaria

15. Very severe Disease
Sign Treatment
Not able to drink
Convulsion
Abnormal sleepy or difficult to
wake up
Stridor in calm child
Severe malnutrition
Refer URGENTLY
Give first dose of antibiotics
Treat fever
If cerebral malaria : treat malaria

16. Classification of the ARI in young infants
less than 2 months
• Very severe pneumonia
• Severe pneumonia
• No pneumonia

17. No pneumonia
No fast breathing
No severe chest indrawing
Home care
Keep young infant warm
Breast feed frequently
Clear nose

18. Severe Pneumonia
Fast breathing
Chest indrawing
Refer
Keep infant warm
Give first dose of antibiotics

19. Very Severe Pneumonia
Stopped feeding well
Convulsions
Abnormal sleepy
Stridor in calm patients
Wheezing
Fever or low body temp
Refer URGENTLY
Keep young infants warm
Give first dose of antibiotics