IMCI training video: Exercise G - Case study Josh

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Summary

This video presents a case study of a 6-month-old infant named Josh, detailing the assessment and classification of his illness based on IMCI (Integrated Management of Childhood Illness) guidelines. The video walks through checking for general danger signs, assessing cough or difficult breathing, and evaluating diarrhea including signs of dehydration.

Highlights

Introduction to Josh's Case Study
00:00:25

The video introduces Josh, a 6-month-old infant weighing 6 kg with a temperature of 38°C, brought to the clinic for diarrhea. The initial assessment starts by checking for general danger signs.

Assessing General Danger Signs
00:00:50

The assessment begins by checking if Josh can drink, if he is vomiting, has had convulsions, or is lethargic/unconscious. The mother confirms Josh can drink, is not vomiting, and has not had convulsions. The viewer is asked to assess if Josh is lethargic or unconscious and note if any general danger signs are present.

Assessing Cough or Difficult Breathing
00:01:36

Next, Josh is assessed for cough or difficult breathing. The mother states Josh has had a cough for 3 days. The viewer is instructed to count Josh's breaths per minute to determine if he has fast breathing.

Checking for Chest Indrawing and Stridor
00:03:23

The assessment continues by checking for chest indrawing and listening for stridor. The viewer is prompted to record their observations for both signs. This completes the assessment for cough or difficult breathing, prompting the viewer to classify the illness.

Assessing Diarrhea and Dehydration
00:04:50

The focus shifts to diarrhea. Josh has had diarrhea for 5 days with no blood in the stool. The assessment then moves to identifying signs of dehydration. This includes assessing general condition (lethargy/unconsciousness, restlessness/irritability), sunken eyes, drinking ability (not able to drink, drinking poorly, eagerly, or normally), and skin pinch (returns very slowly, slowly, or immediately).

Our Assessment of General Danger Signs
00:07:34

The video then reveals its own assessment and classification of Josh's illness. For general danger signs, Josh was able to drink, wasn't vomiting, had no convulsions, and was not lethargic or unconscious, indicating no general danger signs.

Our Assessment of Cough and Breathing
00:08:22

Josh's cough had lasted 3 days. His breathing rate was 56 breaths per minute, which is classified as fast breathing for his age (6 months). Josh did not have chest indrawing or stridor. Therefore, Josh is classified as having pneumonia due to fast breathing, placing him in the yellow row of the IMCI classification table.

Our Assessment of Diarrhea and Dehydration Status
00:09:59

Josh had diarrhea for 5 days with no blood in the stool. For dehydration, Josh was not lethargic, restless, or irritable. His eyes were sunken, and his skin pinch returned very slowly. These signs (sunken eyes and a very slow skin pinch) indicate severe dehydration, placing him in the pink row.

Final Classification of Josh's Illness
00:11:22

Considering all factors, Josh was not classified for persistent diarrhea (duration less than 14 days) or dysentery (no blood in stool). Therefore, Josh is definitively classified as having diarrhea with severe dehydration and pneumonia.

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