Skip to content
New issue

Have a question about this project? Sign up for a free GitHub account to open an issue and contact its maintainers and the community.

Sign up for GitHub

By clicking “Sign up for GitHub”, you agree to our terms of service and privacy statement. We’ll occasionally send you account related emails.

Already on GitHub? Sign in to your account

Jump to bottom

Chapter3 #48

Merged
merged 13 commits into from
May 22, 2019
Merged

Chapter3 #48

Changes from all commits
Commits
Show all changes
13 commits
Select commit Hold shift + click to select a range
f1e2e93
modified chapter 3
michaeldera May 20, 2019
381206f
modified chapter 3
michaeldera May 20, 2019
cf4ec5b
modified chapter 3
michaeldera May 20, 2019
72653ed
modified chapter 3
michaeldera May 20, 2019
11835ba
modified chapter 3
michaeldera May 20, 2019
47cda7a
modified chapter3
michaeldera May 21, 2019
82d0d40
modified chapter3
michaeldera May 21, 2019
5a56596
modified chapter3
michaeldera May 21, 2019
b4dbefa
modified chapter3
michaeldera May 21, 2019
0c70e26
modified chapter3
michaeldera May 21, 2019
b90d842
modified chapter3
michaeldera May 21, 2019
64f5b0d
modified chapter3
michaeldera May 21, 2019
4992dcf
modified chapter3
michaeldera May 21, 2019
File filter

Filter by extension

Filter by extension
Conversations
Failed to load comments.
Loading
Jump to
Jump to file
Failed to load files.
Loading
Diff view
Diff view
135 changes: 104 additions & 31 deletions src/Data/Chapters/chapter_three.js
View file
Open in desktop
Original file line number Diff line number Diff line change
Expand Up @@ -3,8 +3,20 @@ import React from 'react';
export let chapter_three = {
short_title: "Chapter 3",
long_title: "Paediatric Conditions",
subsections: [{
short_title: "Section 0",
subsections: [
{
short_title: "Section 0",
long_title: "General Notes",
content:
<div>
<h2>General Notes</h2>
<p>The content of this chapter reflects the major causes of infant mortality and morbidity in Zimbabwe - prematurity, neonatal sepsis,perinatal asphyxia, acute respiratory infections, diarrhoeal diseases, malnutrition and, immunisable diseases. Some of the paediatric conditions may have underlying HIV infection.</p>
<p>Other paediatric conditions have been described in the relevant chapters in EDLIZ, and where possible paediatric doses have been given.</p>
<p>Note: doses are also given by age and weight wherever possible, and volumes of liquids or injections to be administered are indicated. <strong>Always check</strong> the concentration of the preparation however, as preparations may change. This should not be seen as a &quot;short-cut&quot; to calculating the proper dose.</p>
</div>
},
{
short_title: "Section 1",
long_title: "Neonatal Conditions",
content:
<div>
Expand All @@ -25,7 +37,14 @@ export let chapter_three = {
</table>
<small>NB: Not for gentamicin &mdash; see table 3.2</small>
<small>For example: Benzyl pencillin dose 100,000u/kg/dose (0.1MU/kg) Thus a 2kg pre-term baby 5 days old would receive 200,000u Benzyl penicillin every 12 hours, whilst a 2kg term baby 5 days old would receive 200,000u every 8 hours.</small>
<h3>Routine Management at Birth</h3>
</div>
},
{
short_title: "Section 2",
long_title: "Routine Management At Birth",
content:
<div>
<h2>Routine Management at Birth</h2>
<ul>
<li>Do not suction mouth routinely, only if there is something (e.g. thick meconium) to suck out.</li>
<li>Dry and wrap up, preferably in a dry pre-warmed soft towel</li>
Expand All @@ -44,6 +63,15 @@ export let chapter_three = {
</li>
<li>Hand the baby to the mother for her to put immediately to breast</li>
</ul>

</div>

},
{
short_title: "Section 3",
long_title: "Rescuscitation of the newborn",
content:
<div>
<h4>Resuscitation of the newborn</h4>
<p>Essential Newborn Care</p>
<ul>
Expand All @@ -53,41 +81,86 @@ export let chapter_three = {
<li>Put baby skin to skin with the mother</li>
<li><strong>Do not leave the baby alone</strong></li>
</ul>
</div>
<p>Ensuring adequate warmth and ventilation (either by mask or intubation) is much more important than administering any medicines.</p>
<p>The following may be useful:</p>
<table>
<caption>For respiratory depression,but only if the mother was given pethidine in labour:</caption>
<tr><th>Medicine</th><th>Codes</th><th>Paed dose</th><th>Frequency</th></tr>
<tr><td rowSpan="4">naloxane neonatal 20mcg/ml im <br/><em>NB: Note strength</em></td><td rowSpan="4">B V</td><td>&lt; 0 to 1kg: 10mcg = 0.5ml</td><td rowSpan="4">repeat as necessary</td></tr>
<tr><td> 1 to 2kg: 20mcg = 1ml</td></tr>
<tr><td> 2 to 3kg: 30mcg = 1.5ml</td></tr>
<tr><td>more than 4kg: 40mcg = 2ml</td></tr>
<tr><td>adrenaline dilute 1:10 000</td><td>C V</td><td>10mcg 1ml/kg</td><td>repeat as necessary</td></tr>
</table>
<table>
<caption><strong>Only</strong> if the baby has no spontaneous breathing after 5 minutes of ventilation, give a <strong>slow intravenous injection directly into the umbilical vein:</strong></caption>
<tr><th>Medicine</th><th>Codes</th><th>Paed dose</th></tr>
<tr><td>sodium bicarbonate<br/>slow iv 4.2%</td><td>B N</td><td>4 to 6 ml/kg</td></tr>
</table>
<small><strong>or</strong> 2-3 ml/kg of 8.4% solution diluted with equal quantity of water for injection, if only strength available.</small>
<h4>Helping babies survive</h4>
<p>Every newborn baby must receive the &quot;Essential Care for Every Baby&quot; package of care is essential for preventing and managing common illnesses in the first 24hrs of life when newborn mortality is highest</p>
<small>See management algorithm on the next page</small>
</div>
},
{
short_title: "Section 1",
long_title: "Paediatric Conditions",
content:
short_title: "Section 4",
long_title: "Feeding and Fluids",
content:
<div>
<h1>Paediatric Conditions</h1>
<p>Common paediatric conditions such as acute respiratory infections (ARI), diarrhoea, child with fever (axillary temperature 37.5<sup>o</sup>C and above); severe malnutrition (PEM) are now incorporated in the Integrated Management of Childhood Illness (IMCI).</p>
<p><strong>General guidelines on the use of </strong></p>
<p>Paediatric doses are given in Tables 2.6 and 2.7 (Neonatal doses are given separately in Table 2.3)</p>
<ul>
<li>always do blood cultures in suspected sepsis.</li>
<li>supportive measures are often more important than antibiotics themselves: for example, fluids in diarrhoea and vomiting;</li>
<li>antibiotics should be given in the full dosage appropriate for the age and weight of the child;
<strong>dosage is best calculated according to body weight</strong> up to 40kg (do not exceed the adult dose);</li>
<li>change to oral administration wherever possible (except for meningitis); benzylpenicillin intramuscularly/ intravenously can be changed to procaine penicillin intramuscularly (if response is good) once child is afebrile. </li>
</ul>
<p><strong>Check for General Danger Signs:</strong></p>
<p><strong>Ask:</strong></p>
<h2>Feeding and Fluids</h2>
<p>In general, babies should breast-feed on demand from birth. There is no need for supplemental water or other feeds.</p>
<p>For babies requiring special care (low birth weight, birth asphyxia,infection, etc) the following fluid regimen based on birth weight is recommended:</p>
<h3>Oral feeds</h3>
<ul>
<li> if the child is not able to drink or breastfeed</li>
<li> if the child is vomiting everything</li>
<li> if the child has had convulsions</li>
<li> if there are periods of not </li>
<li>Day 1: 60ml per kg per 24 hrs. [40ml/kg/24hrs in severe birth asphyxia and meningitis].</li>
<li>Day 2 and subsequently: Increase by 20-30ml per kg per 24hrs depending on the general condition, to 150ml/kg/24hrs. If this is well tolerated increase further to 180-200ml/kg/24hrs</li>
</ul>
<p><strong>Look</strong> to see:</p>
<h3>Intravenous Fluids</h3>
<p><em>If intravenous not possible, try nasogastric feeding.</em></p>
<ul>
<li> If the child is lethargic or unconscious.</li>
<li>Day 1
<table>
<tr><th>Medicine</th><th>Codes</th><th>Paed dose</th><th>Freq</th><th>Duration</th></tr>
<tr><td>dextrose 10% iv infusion</td><td>A N</td><td colSpan="3">60ml/kg/24hrs</td></tr>
</table>
</li>
<li>Day 2
<table>
<tr><th>Medicine</th><th>Codes</th><th>Paed dose</th><th>Freq</th><th>Duration</th></tr>
<tr><td>darrows half strength / dextrose 2.5% iv with 10% dextrose infusion*</td><td>C V</td><td colSpan="3">Same as for oral fluids up to a max. of 150ml/kg/24hrs – inclusive of all fluids Administered</td></tr>
<tr><td colSpan="5">or</td></tr>
<tr><td>neonatalyte iv infusion</td><td>B N</td><td colSpan="3">oral, nasogastric and intravenous.</td></tr>
<small>*This can be made up by withdrawing 30 ml from a 200 ml bag of half strength Darrows/dextrose 2.5% and replacing with 30 ml of 50% dextrose</small>
</table>
</li>
</ul>
<p>A child with <strong>any</strong> general dcptrial sign needs <strong>urgent</strong> attention.</p>
</div>
},
{
short_title: "Section 2",
<p>Consider transfer to a specialist unit for babies unable to feed and requiring intravenous fluids for longer than 3 days. <strong>Always keep the baby warm</strong></p>
</div>
},
{
short_title:"Section 5",
long_title: "Neonatal Infections",
content:
<div>
<h2>Neonatal Infection</h2>
<table>
<caption>Table 3.2 Gentamicin dosages:</caption>
<tr><th colSpan="4">Premature or full term neonates up to 7days old</th></tr>
<tr><th>Weight</th><th>Age</th><th>Dose</th><th>Frequency</th></tr>
<tr><td>less than 1000gm</td><td>28 weeks</td><td>2.5mg/kg</td><td>once every 24hrs</td></tr>
<tr><td>more than 1000gm</td><td>&gt;28weeks</td><td>2.5mg/kg</td><td>every 12hrs</td></tr>
<tr><th>Neonates more than 7 days old</th></tr>
<tr><td colSpan="2">less than 1200gm</td><td>2.5mg/kg</td><td>every 12hrs</td></tr>
<tr><td colSpan="2">more than 1200gm</td><td>2.5mg/kg</td><td>every 8hrs</td></tr>
</table>
<small>*consider -once daily gentamicin dosing in neonates &lt;35 weeks gestation: 3mg/kg every 24 hours, &gt;35 weeks gestation: 4mg/kg every 24hours and &gt;37 weeks: 5mg/kg</small>
<p>There are usually few localising signs in infants, and accurate diagnosis may not be possible. The following regimens are recommended for suspected sepsis.</p>
</div>

},
{
short_title: "Section 12",
long_title: "Acute Respiratory Infections",
content:
<div>
Expand Down