Lesson 1Decision rules for outpatient management vs admission: WHO and AAP guidance on pneumonia severity and admission criteriaRules for sending baby home or admitting, using WHO and AAP on oxygen levels, feeding, breathing effort, and home support factors in Kenyan facilities.
WHO pneumonia severity categoriesAAP criteria for hospital admissionRole of oxygen saturation and work of breathingFeeding ability and home support factorsPlanning safe follow-up and reviewLesson 2Triage and red flags requiring urgent referral: severe respiratory distress, hypoxia, poor oral intake, recurrent apneas, cyanosisSorting sick babies: danger signs like hard breathing, low oxygen, no feeding, stop-breathing spells, blue colour – steps to stabilise and refer fast.
Recognizing severe respiratory distressIdentifying hypoxia and cyanosisRecurrent apnea and altered consciousnessPoor oral intake and dehydration riskStabilization before transfer or referralLesson 3Differential diagnoses for fever with cough and fast breathing: bronchiolitis, community-acquired pneumonia, pertussis, viral URTIMain causes for fever, cough, fast breathing in babies: small airway inflammation, lung infection, whooping cough, simple cold virus – signs and test/treatment choices.
Clinical features of bronchiolitisCommunity-acquired pneumonia patternsRecognition of pertussis in infantsFeatures of viral URTI and overlapRed flags suggesting alternative diagnosesLesson 4First-line investigations: chest radiograph indications, nasopharyngeal viral testing, full blood count and CRP when indicatedWhen to x-ray chest, swab for viruses, or check blood cells and inflammation marker in sick-breathing babies, avoiding extra tests.
Chest radiograph indications and limitationsNasopharyngeal viral PCR and rapid testsRole of full blood count and CRPInterpreting mixed viral and bacterial resultsLesson 5Pathophysiology and common causes of cough, fever, and tachypnea in infantsBaby airways and lungs basics, how germs, bugs, smoke cause cough, fever, fast breathing – linking to common illnesses like small airway blockage or lung infection.
Infant airway anatomy and complianceMechanisms of cough and mucus productionCauses of fever in respiratory infectionsEtiology of tachypnea in young infantsLesson 6Clinical signs of respiratory distress: nasal flaring, chest indrawing, grunting, tachypnea age-specific cutoffsBreathing trouble signs in babies: nose widening, chest sinking, grunt sounds, fast breathing rates by age – how to score and track at bedside.
Nasal flaring and head bobbingChest indrawing and retraction patternsGrunting and use of accessory musclesAge-specific tachypnea thresholdsScoring systems for distress severityLesson 7Treatment principles: oxygen therapy thresholds, bronchiolitis supportive care, indications for oral vs IV antibiotics, bronchodilator and corticosteroid guidanceTreatment basics: oxygen when needed, support for small airway illness, antibiotics choice, no routine asthma drugs or steroids unless clear need.
Oxygen therapy thresholds and deliverySupportive care in bronchiolitisOral versus IV antibiotic indicationsBronchodilator and corticosteroid useMonitoring response and treatment failureLesson 8Initial bedside tests: pulse oximetry interpretation, respiratory rate measurement, capillary refill, point-of-care glucoseQuick checks: finger oxygen reader, count breaths, skin refill time, instant sugar test – tips for right results in young babies.
Correct pulse oximetry techniqueMeasuring respiratory rate accuratelyAssessing capillary refill and perfusionPoint-of-care glucose indicationsIntegrating bedside findings into triageLesson 9Key history questions: duration and onset of symptoms, feeding and fluid intake, immunization, household contacts, exposure to smokeMain questions: how long symptoms, feeding amounts, jabs done, sick people at home, cooking fire smoke – for risk check.
Symptom onset, duration, and progressionFeeding, fluid intake, and output historyImmunization status and missed vaccinesHousehold contacts and sick exposuresEnvironmental smoke and pollutant exposureLesson 10Caregiver counselling: home care, when to return, home hydration and fever management, immunization reinforcementAdvise parents: home care tips, return signs, fluids and fever paracetamol, stress all jabs on time.
Explaining diagnosis and expected courseHome hydration and feeding strategiesSafe fever management and medicationsReturn precautions and danger signsReinforcing routine and catch-up vaccinesLesson 11Guideline references: WHO Integrated Management of Childhood Illness (IMCI) pneumonia recommendations, AAP bronchiolitis guidance, national pediatric respiratory protocolsKey points from WHO child illness guide, AAP small airway advice, Kenyan breathing protocols – matching local practice to best standards.
WHO IMCI pneumonia classificationsAAP bronchiolitis management guidanceNational pediatric pneumonia protocolsAdapting guidelines to local resourcesLesson 12Fluid and feeding management for infants with reduced intakeCheck fluids and feeds in sick babies, work out needs, safe mouth, tube, or drip fluids, watch to avoid dry or overload.
Assessing hydration and urine outputOral and nasogastric feeding strategiesIndications for IV fluids and ratesMonitoring for fluid overload and hyponatremia
