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World Health Organization Publication : Year 2005 ; Issue 9241546875 - in English: Manual for Participants

By World Health Organization

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Book Id: WPLBN0000197597
Format Type: PDF eBook
File Size: 0.6 MB
Reproduction Date: 2005
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Title: World Health Organization Publication : Year 2005 ; Issue 9241546875 - in English: Manual for Participants  
Author: World Health Organization
Language: English
Subject: Health., Public health, Wellness programs
Collections: Medical Library Collection, World Health Collection
Publication Date:
Publisher: World Health Organization


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Organization, W. H. (n.d.). World Health Organization Publication : Year 2005 ; Issue 9241546875 - in English. Retrieved from

Medical Reference Publication

A nine-month old baby boy is carried into the children’s section of the outpatient department in his mother’s arms. He appears to be asleep. At the triage desk he is seen by a nurse and found to have lips and tongue that are grey/blue in colour, and he is taken straight into the resuscitation room as an emergency. In the resuscitation room he is given oxygen from an oxygen concentrator. He is noted to be grunting and breathing very fast. His hands are cold to touch and the capillary refill time is prolonged to four seconds. An intravenous cannula is placed. A blood sample is taken at the same time for blood glucose, haematocrit and other investigations. An intravenous infusion of normal saline is commenced at 20ml/kg to run as fast as it can go. Other treatments are given, depending on the result of the investigations and the response to the treatment he receives. It is now 18 minutes since the baby came through the outpatient department’s door, and his situation is stable. It is now time to take a full history and carry out a full examination to make a definitive diagnosis. He is diagnosed as having very severe pneumonia, and receives specific treatment for this. However, before coming to this diagnosis, no time was wasted, his status was stabilized, based on a few leading signs and symptoms, even when the medical staff did not know exactly what was wrong with him.

Table of Contents
Table of contents Introduction 1 Learning objectives for the training course 2 Module One: Triage and the “ABCD” concept 3 The “ABCD” concept 4 Priority signs 4 The triaging process 4 When and where should triaging takes place? 5 Who should triage? 5 How to triage? 5 Assessing priority signs 6 General treatment for priority signs 8 The need for frequent reassessment 9 Assessment questions: Triage 10 Module Two: Airway and breathing 13 Assessment of the airway 13 Is the child breathing? Is the airway obstructed? 13 Management of the airway 14 Management of the choking child 14 Positioning to improve the airway 15 Is trauma of the neck a possibility? 16 Assessment breathing 17 Is the child breathing? 17 Does the child show central cyanosis? 17 Does the child have severe respiratory distress? 18 Management of breathing problems 18 Ventilate with bag and mask 18 Insertion of an oropharyngeal (Guedel) airway 19 Give oxygen 20 Assessment questions: Airway and breathing 23 Module Three: Circulation 25 Assess the circulation 26 Are the child’s hands warm? 26 Is the capillary refill longer than 3 seconds? 26 Is the pulse weak and fast? 27 Shock 27 Treatment of shock 27 Assessment questions: Circulation 32


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