guidelines for the integrated management of severe acute malnutrition
guidelines for the integrated management of severe acute malnutrition
guidelines for the integrated management of severe acute malnutrition
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ACF-In Guidelines <strong>for</strong> <strong>the</strong> <strong>integrated</strong> <strong>management</strong> <strong>of</strong> SAM Annexes 163<br />
Date (dd/mo)<br />
Weight (kg.g)<br />
Weight Change<br />
(+ / 0 /- )<br />
MUAC (mm)<br />
Diarrhoea<br />
(0 to #d)<br />
Stools/d<br />
(0, 1-3,3-5,5+)<br />
Vomiting<br />
(0 to #d)<br />
Fever<br />
(0 to # d)<br />
Cough<br />
(0 to #d)<br />
Appetite<br />
(good/mod/poor)<br />
Pale Conj<br />
(0 to ++)<br />
Respir.rate /min<br />
Temp. C?<br />
App.test<br />
(Pass/Fail)<br />
Trt carer choice<br />
(in/out)<br />
RUTF given (#<br />
sachets)<br />
O<strong>the</strong>r foods<br />
Amoxicillin dose<br />
Malaria trt dose<br />
SAM Unique N0_______/________/_______/________ Target Weight<br />
Height (cm)<br />
Oedema (0 to ++)<br />
W/H<br />
(Z- Score or %)<br />
Folic Acid dose<br />
Vitamin A dose<br />
Notes :<br />
De-Worming<br />
Measles<br />
vaccination<br />
Person in charge<br />
OUTCOME<br />
Adm 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16<br />
Anthropometric In<strong>for</strong>mation<br />
Questionnaire's carer<br />
Medical examination<br />
Nutrition<br />
Medical treatment<br />
A : Absent - DF: Defaulter - TI: Transfer In Patient - TO: Transfer ano<strong>the</strong>r Out Patient - X: died - C: Cured - RT: Refuse Transfer -<br />
HV: Home visit - NR: non Respondent - U: Unknown
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