If a sick child is managed as an outpatient, the parents should be given instructions for when to bring the child back immediately for assessment. A number of these criteria are listed in the Integrated Management of Childhood Illness (IMCI) program.


Indications for bringing a sick child back immediately for an assessment:

(1) the child is unable to drink or breastfeed

(2) the child the child has diarrhea and is drinking poorly

(3) the child has become sicker

(4) the child has developed a new onset of fever

(5) the child has bloody diarrhea

(6) the child is breathing rapidly

(7) the child is having difficulty breathing



• Deterioration in level of consciousness can be included under becoming sicker.

• Severe vomiting and drinking poorly would also seem to be a good reason to come back.

• Similar indications with different wording are given in 44.04.15 (above).



(1) the child had the same fever when previously evaluated.

(2) the child had blood in the stool when previously evaluated


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