Assess cough or difficult breathing

Cough is a way of removing foreign material or mucus from the respiratory tract. It is a symptom of respiratory problems.

Difficult breathing is any unusual pattern of breathing. Mothers or caregivers describe this in different ways; they may say that their child's breathing is "breaths faster" or "noisy" or "interrupted."

To assess coughs or difficult breathing, firstly you need to know about the anatomy of the respiratory system.

See the figure above to differentiate the airway or respiratory tract structures. It consists of the nose, throat, larynx, trachea and bronchi and lung. Coughs or difficult breathing may occur when there is an infection of the respiratory tract. These infections may be severe respiratory tract infections such as pneumonia (acute) which require antibiotics for treatment, or they can be mild infections such as a cold, which can be treated by the family at home.

You are expected to identify sick children who have a cough or difficult breathing, which need treatment with antibiotics in your health post. And to refer those with a severe form of a cough or difficulty of breathing. You are now going to look at the steps involved in assessing and classifying children with a cough or difficult breathing. For all sick children you encounter in your work place, you should ask every mother or caregiver whether the child has a cough or difficult breathing. You will ask the mother for the time duration for how long the child with a cough or difficult breathing.

The terms used in the assessment of a cough or difficult of breathing are the following:

• Fast breathing: breathing rate per minute of children counted higher than the normal breathing rate.
  
• Chest in-drawing: the lower chest moves inward when the child breathes in.
  
• Stridor: an abnormal, harsh and noisy respiratory sound heard during inspiration.
  

If the child is convulsing now, manage the airways and treat the child with Diazepam.

A child with any general danger sign needs URGENT attention; complete the assessment and any pre-referral treatment immediately so that referral is not delayed;