What is the correct management of pneumonia?

  1. If possible, all children with pneumonia should be admitted to hospital. Only mild cases should be managed at home or in a primary care clinic.
  2. Observe the child carefully. Monitoring the oxygen saturation is very important. Look for signs of severe pneumonia.
  3. Give oxygen by nasal prongs (or catheter) or face mask for severe pneumonia. Monitor with the use of a saturation monitor and give oxygen if saturations are below 90%.
  4. Give an appropriate antibiotic. While oral antibiotics can be used with mild pneumonia, intramuscular or intravenous antibiotics must be used with more severe cases. All children with pneumonia must receive an antibiotic as it is difficult to tell whether the pneumonia is due to a virus or bacteria.
  5. If a wheeze is present give an inhaled bronchodilator.
  6. Give paracetamol to lower the fever.
  7. Remove thick secretion from the nose by gentle suctioning.
  8. Encourage breastfeeding. If the child does not take fluids by mouth, give nasogastric feeds or start an intravenous infusion.
  9. Physiotherapy may be helpful.
  10. All children with signs of severe pneumonia must be urgently referred to hospital. Give the first dose of antibiotic before referring the child.
  11. In very severe cases of pneumonia, intubation and ventilation may be needed.

Oxygen and antibiotics are the main form of treatment for pneumonia.

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