
By Lorraine Anyango.
Almost every practicing pediatrician has encountered the tragic enigma of children dying within 24 hours after admission, especially when it is the sudden and unexpected death of a previously healthy infant.
To curb this child mortality among emergency pediatric admissions within the first 24 hours, clinical officers and nurses in Kisumu County are undertaking training on triaging.
The course dubbed ‘Emergency Triage and Treatment and Admission will see about 24 officers drawn from the health facilities across the county capacity built with skills to sort the sickest children from the queue for early intervention.

The objective of the training is also to strengthen the use of tools such as the pediatric admission record forms and the neonatal admission record forms.
The two tools were developed by the Kenyan Pediatric Association, in partnership with KEPRICON and KEMRI.
The trainees work in pediatric wards, casualty, Newborn units Outpatient departments which receive patients right from home.

The training imparts skills to provide emergency care to children under the age of five even before admission. It’s putting into consideration clinical signs and symptoms to look out for when triaging.
The week-long training will see trainees taken through the ABCD of triage, Triage drills, clinical signs, how to handle a collapsed baby, and how to check on breathing and circulation of air in such clients.
The largely practical training was sponsored by USAID Boresha Jamii in collaboration with Kisumu County and seeks to impart among others oxygen administration practical skills, sensitization on policies and standards of quality care for sick children, and management of hyperglycemia and convulsions.
The participants had demos in the use of inhalers, intraosseous access which is emergency fluids where drug dosage skills were shown, Diarrhoea and dehydration scenarios were also part of the practical lessons.

The training incorporates lectures on altered conscious levels of severe malaria and meningitis, severe acute malnutrition, newborn resuscitation role plays, care of sick neonates, prematurity and breastfeeding, and respiratory distress.
The County Child Health Coordinator Mr Nicholas Pule was present to demonstrate some of the cases the officers encounter in the process of responding to emergencies among children.
The aftermath of this training will build confidence among clients whose sick children will need emergency attention once they get to the hospital even better death that would occur due to such cases will be averted.
The nurses were trained that part of responding to babies with various symptoms is to get their history properly documented to arrive at a probable diagnosis.
The historical background would include information such as the duration and frequency of the symptoms, this information is drawn from the caregiver present.

Then after the triage, the clinicians and nurses use essential key clinical signs. This would include commonly observed signs of malnutrition, the color of the baby, and fever among others to assess severity indicating the risk of death if there be any.










