When signs and symptoms should raise suspicion for PCAP?
Cough or Fever
PLUS
Any of the ff positive predictors of radiographically-confirmed pneumonia:
a. Tachypnea
3 months to 12 months old: ≥50 breaths per minute
>1 year old to 5 years old: ≥40 breaths per minute
>5 years to 12 years old: ≥30 breaths per minute
>12 years old: ≥20 breaths per minute
b. Retractions or chest indrawing
c. Nasal flaring
d. O2 saturation <95% at room air
e. Grunting
Auscultatory lung findings such as decreased breath sounds, crackles or rales, wheeze and rhonchi were not included due to their low sensitivity (<80%) or positive likelihood ratio (<2) for diagnosing pneumonia mainly due to interobserver variability.
Risk Stratification of PCAP
PCAP LR
PCAP HR
No respiratory signs
Respiratory Signs
Cyanosis/ Hypoxemia
Head bobbing
Chest indrawing/Retractions
Apnea
Grunting
CNS signs
None or irritable but consolable
Altered sensorium: lethargic/stuporous/comatose/ GCS <13
Convulsion
No circulatory signs
Circulatory signs
Poor perfusion: CRT >3 sec or in shock
Pallor
General considerations
None or mild malnutrition
Age > 6 months
General consideration
Moderate to severe malnutrition
Some or severe signs of dehydration
Age < 6 months
Ancillary Parameters
O2 Sat >= 94% fpr 20-30 mins
CXR or UTZ findings of consolidation, multifocal disease, moderate to large pleural effusion, abscess, or air leaks
<= 93% O2 at room air for 20-30 mins
Last changed2 years ago
