Screening for Acute Malnutrition
It is very important that your first assessments of children are done carefully.
You should take your time to do all the necessary steps during admission
and keep appropriate records to enable smooth subsequent follow-up.
mid-upper arm circumference and edema detection are the most appropriate techniques
to be used to detect severe acute malnutrition in a health post context.
Weight is used to follow the progress of the admitted child,
and decide when to discharge him or her.
Bilateral edema is a sign of severe malnutrition;
children with edema need to be in therapeutic feeding programs immediately.
Only children with bilateral edema are recorded as having nutritional edema.
In order to determine the presence of edema,
normal thumb pressure is applied to both feet for three seconds.
If a shallow print persists on both feet, then the child presents edema.
Mid-upper arm circumference is an alternative measure of severe acute malnutrition in children.
Take the following steps to measure the mid-upper arm circumference of a child:
Ask the mother to remove clothing that may cover the child's left arm.
If possible, the child should stand erect and sideways to the measurer
estimate the midpoint of the left upper arm, straighten the child's arm,
and wrap the tape around the arm at the midpoint. Make sure the numbers are right-side-up.
Make sure the tape is flat around the skin.
Inspect the tension of the tape on the child's arm.
Make sure the tape has the proper tension and is not too tight or too loose.
When the tape is in the correct position on the arm, with correct tension,
read and pull out the measurement to the nearest 0.1 cm.
Immediately record the measurement.
Once you have determined that the child has severe acute malnutrition,
you must check to make sure that they do not have additional complications
and can be treated at your OTP.
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