Identify urgent pre-referral treatment

The first dose treatments below are urgent because they can prevent serious complication such as progression of bacterial infection or cerebral malaria, corneal rupture due to lack of Vitamin A, or brain damage from low blood sugar and are also important to prevent worsening of the illness.

When a child needs an urgent referral, you must quickly identify and begin the most immediate treatments for that child. The following are urgent treatments. You will give the first dose of the drugs before referral in your health post. Give appropriate antibiotic and other drugs as follows and see the dose from each classification of childhood illness.

First dose of Cotrimoxazole for:

• Severe pneumonia or very severe disease.
• Very severe febrile disease.
• Severe complicated measles.
• Dysentery.

First dose of Vitamin A for:

• Severe persistent diarrhoea without oedema.
• Persistent diarrhoea.
• Severe complicated measles.

First dose of paracetamol for:

• Very severe febrile disease.
• Any fever ≥ 38.5C.
• Acute ear infection.

First dose Artesunate rectal suppository for children ≥ 5 kg.:

• Very febrile disease.

First dose of Tetracycline eye ointment:

• Clouding of cornea in severe complicated measles
• Pus draining from the in severe complicated measles

Treat the child to prevent low blood sugar (this involves giving breast milk, other milk, or sugar water as described on the home care.

When the child has a severe persistent diarrhoea, provide ORS solution and refer the child urgently.