MINISTRY OF HEALTH
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SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
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No. 528/QD-BYT
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Ha Noi, March 03, 2022
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DECISION
GUIDELINES ON HOME TREATMENT OF CHILDREN WITH COVID-19
INFECTION
THE MINISTER OF HEALTH
Pursuant to the Law on
Prevention and Control of Infectious Diseases 2007;
Pursuant to the Law on
Medical Examination and Treatment 2009
Pursuant to the
Government’s Decree No.75/2017/ND-CP dated June 20, 2017 on functions, duties,
powers and organizational structure of the Ministry of Health;
According to the
minutes of meeting dated March 1, 2022 of the Council for the development of
documents, professional guidelines and regulations on assurance about the
diagnosis and treatment of COVID-19 established in accordance with Decision No.
4026/QD-BYT August 20, 2021 of the Minister of Health;
At the request of the
Director of the Vietnam Administration of Medical Services and the Ministry of
Health.
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Article
1. The “Guidelines on home treatment of children with covid-19
infection” is promulgated with this Decision.
Article
2. The “Guidelines on home treatment of children with covid-19
infection” applies to grassroots level and households
Article
3. Departments of Health of provinces or centrally affiliated
cities shall, in consideration of COVID-19 situation in their provinces,
provide guidelines on home treatment children with covid-19 infection in order
to develop and implement this document in their provinces.
Article
4. This Decision takes effect from the date on which it is
signed.
Article
5. Chiefs of the Ministry Offices, Chief Inspectors of
Ministries, General Directors and Directors of Departments affiliated to the
Ministry of Health, Directors of Departments of provinces and centrally
affiliated cities, Directors of Hospitals affiliated to the Ministry of Health,
Healthcare Directors of Authorities shall implement this Decision ./.
PP. MINISTER
DEPUTY MINISTER
Nguyen Truong Son
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ON HOME TREATMENT OF CHILDREN WITH COVID-19 INFECTION
(Issued together with Decision No. 528/QD-BYT dated March 03, 2022 of the
Minister of Health)
LIST OF EDITORS
“GUIDELINES ON HOME TREATMENT OF CHILDREN WITH COVID-19 INFECTION”
Compilation director
Assoc. Prof. PhD.
Nguyen Truong Son
Deputy Minister of
Health
Lead editor
Assoc. Prof. PhD. Luong
Ngoc Khue
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Co-editor
Prof. PhD. Nguyen Gia
Binh
President of Vietnam
National Association of Emergency, Intensive Care Medicine and Clinical
Toxicology.
Prof. PhD. Nguyen Van
Kinh
President of Vietnam
Association for Infection Diseases, Former Director of National Hospital of
Tropical Diseases
Assoc. Prof. PhD.
Nguyen Thanh Hung
Director of the
Children's Hospital 1 of Ho Chi Minh city
Participants in
compilation and appraisal
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Assoc. Prof. PhD.
Nguyen Hoang Anh
Director of the
National Centre of Drug Information and Adverse Drug Reactions Monitoring –
Ha Noi University of Medicine and Pharmacy, Deputy Head of Pharmacy
Department of Bach Mai Hospital
PhD. Nguyen Vinh Chau
Vice Director of the
Department of Health of Ho Chi Minh city
PhD. Vuong Anh Duong
Vice Director of the Vietnam
Administration of Medical Services - Ministry of Health
Specialist level II
Doctor. Nguyen Hong Ha
Vice - President
of Vietnam Association for Infection Diseases, Former Vice Director of
National Hospital of Tropical Diseases
PhD. Le Quoc Hung
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Dr. Truong Huu Khanh
Vice President of Ho
Chi Minh Association for Infection Diseases, Adviser on Infection Diseases of
the Children's Hospital 1 of Ho Chi Minh city
PhD. Nguyen Trong Khoa
Vice Director of the
Vietnam Administration of Medical Services - Ministry of Health
PhD. Nguyen Phu Huong
Lan
Head of Laboratory
Department – Ho Chi Minh City Hospital of Tropical Diseases
Dr. Luong Chan Lap
Specialist of the
Professional Department - the Department of Health of Ho Chi Minh city
Specialist level II
Doctor. Bui Nguyen Thanh Long
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MD. Ngo Thi Huong Minh
Deputy Head of Deparment
of Pharmacy Sales, Drug Administration of Vietnam
Assoc. Prof. PhD. Phung
Nguyen The Nguyen
Head of Department of
Children of Ho Chi Minh City University of Medicine and Pharmacy, Head of
COVID-19 Department - the Children's Hospital 1 of Ho Chi Minh city
MD. Nguyen Thi Thanh
Ngoc
Person in charge of the
Department of Professional Competence – Inspection – Protection of Health of
Officers, Vietnam Administration of Medical Services - Ministry of
Health
MD. Truong Le Van Ngoc
Deputy Head of the
Department of Professional Competence – Inspection – Protection of Health of
Officers, Vietnam Administration of Medical Services – Ministry of Health
MD. Cao Duc Phuong
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Assoc. Prof. PhD. Pham
Thi Ngoc Thao
Vice Director of Cho
Ray Hospital
Specialist level II
Doctor. Nguyen Minh Tien
Vice Director of the
Department of Health of Ho Chi Minh city
Specialist level II
Doctor. Nguyen Thanh Truong
Vice Director of Ho Chi
Minh Hospital of Tropical Diseases
PhD. Ta Anh Tuan
Head of ICU – Internal
Medicine Ward – Central Children’s Hospital
MD. Nguyen Thanh Tuan
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PhD. Cao Viet Tung
Vice Director of
Central Children’s Hospital
PhD. Vu Dinh Phu
Head of Intensive Care
Unit – National Hospital of Tropical Diseases
Editor secretaries
Assoc. Prof. PhD. Phung
Nguyen The Nguyen
Head of Department of
Children of Ho Chi Minh City University of Medicine and Pharmacy, Head of
COVID-19 Department - the Children's Hospital 1 of Ho Chi Minh city
PhD. Ta Anh Tuan
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MD. Truong Le Van Ngoc
Deputy Head of the
Department of Professional Competence – Inspection – Protection of Health of
Officers, Vietnam Administration of Medical Services – Ministry of Health
Dr. Nguyen Thi Dung
Specialist of the Vietnam
Administration of Medical Services – Ministry of Health
Pharmacist. Do Thi Ngat
Specialist of the
Vietnam Administration of Medical Services – Ministry of Health
APPENDIX
I. CRITERIA FOR HOME
TREATMENT OF CHILDREN WITH COVID-19 INFECTION
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III. NECESSARY
PREPARATION FOR HOME TREAMENT OF CHILDREN
1. Necessary items
2. Medicine
3. Isolation, infection
prevention
4. Means of communication
IV. GUIDELINES ON HOME
TREATMENT OF CHILDREN WITH COVID-19 INFECTION
1. Guidelines on monitoring
the health of children with COVID-19 infection
2. Medicine
3. Implement measures for
preventing infection
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V. DUTIES OF HEALTH
STATIONS AND HOME TREATMENT MANAGEMENT FACILITIES
GUIDELINES
ON HOME TREATMENT OF CHILDREN WITH COVID-19 INFECTION
I.
CRITERIA FOR HOME TREATMENT OF CHILDREN WITH COVID-19 INFECTION
1. Clinical criteria
- Is a child who is ≤ 16 years old and confirmed cases of SARS-CoV-2 infection
by real-time RT-PCR method or rapid antigen test that is done at home by
caregivers; healthcare workers or medical facilities.
- Do not have underlying
conditions, or such conditions are under stable treatment.
2. Caregivers
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II.
HEALTH DECLARATION
1. Rapid assessment of
home treatment of children: Health workers, medical facilities or caregivers
shall assess children who are subject to home treatment specified in Section I
above.
2. Caregivers shall
notify health stations of districts, communes or facilities that manage
COVID-19 patients at home... according to guidelines of local authorities of
personal information, time of being confirmed cases of COVID-19 infection,
ability to treat children at home, at the end of isolation and home treatment.
3. The health stations of
communes or facilities that manage children with COVID-19 infection shall
collect information and make a list of COVID-19 patients at home according to
the form specified in Decision No. 261/QD-BYT dated January 31, 2022 of the
Minister of Health on the promulgation of the “guidelines on management of
covid-19 patients at home”
III.
NECESSARY PREPARATION FOR HOME TREAMENT OF CHILDREN
1. Necessary items at
home:
a) Thermometer;
b) SpO2 Pulse Oximeter
for personal use (if any);
c) Medical mask;
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d) Necessary personal
items;
e) Container containing
infectious waste with lids.
2. Medicine
a) Paracetamol (powders;
granules for suspensions or tablets with content of 80mg, 100mg, 150mg or 250mg
that are sufficient for use within 5-7 days).
b) Oresol and other
electrolytes
c) Cough suppressants
(herbal medicine which is preferable) that are sufficient for use within 5-7
days.
d) Nasal sparys: 0.9%
natriclorua that are sufficient for use within 5-7 days.
dd) Medicine for
treatment of underlying conditions (if any, that are sufficient for use within
01-02 week (s))
3. Isolation,
infection prevention
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b) The children with
COVID-19 infection ( ≥ 2 years old), caregivers, family members and children
who are ≥ 2 years old shall wear medical masks.
c) Keep a distance that
is at least 2 meters between a child with COVID-19 infection and others (if
possible).
4. Means of
communication
Telephones, phone numbers
of medical facilities (medical stations, health centers of districts, emergency
transportation centers, doctors, community consultation teams, rapid response
teams, etc.).
GUIDELINES
ON HOME TREATMENT OF CHILDREN WITH COVID-19 INFECTION
1. Guidelines on
monitoring the health of children with COVID-19 infection
1.1. Children who are
under 5 years old
a) Monitor symptoms,
including: mental signs, breathing rate, pulse, skin color, mucous membranes,
digestive disorders, breastfeed and eating; measure SpO2 (if any) and body
temperature at least 2 times/day
b) Report abnormal
symptoms to medical staffs or take the children to the nearest medical facility
for medical examination and treatment when they have one of the following
abnormal symptoms:
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(2) Continuous
fever >39◦C. It is difficult to lower body temperature by antipyretic drugs
+ applying warm water The fever does not improve after 48 hours
(3) Rapid breathing
rate
- Children under 2 months
old: ≥ 60 times/minute
- Children from 2 to 12
months old: ≥ 50 times/minute
- Children from 1 to 5
years old: ≥ 40 times/minute
(4) Children with
abnormal breathing: dyspnea, nose flaring, intercostal retractions, abdominal
external oblique muscles
(5) Signs of
dehydration: dry lips, sunken eyes, thirst, little or no urination<0}
(6) Cyanosis
(7) SpO2 < 96%
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(9) Drinking,
eating and breast refusal
(10) Children with
underlying conditions: Dengue fever; Hand, foot and, mouth disease….
(11) Other abnormal
symptoms that are serious
1.2. Children who are
above 5 years old
a) Monitor symptoms,
including: mental signs, breathing rate, pulse, skin color, mucous membranes,
digestive disorders, eating, stomachache, chest pain, smell and taste; measure
SpO2 (if any) and body temperature at least 2 times/day
b) Report abnormal
symptoms to medical staffs or take the children to the nearest medical facility
for medical examination and treatment when they have one of the following
abnormal symptoms:
(1)
Dyspnea;
(2) Continuous
cough
(3) Drinking/eating
refusal
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(5) Nausea
(6) Chest pain
(7) Diarrhea
(8) Withdrawal from
interaction
(9) SpO2 < 96%
(10) Rapid
breathing rate: children from 5 to under 12 years old: ≥ 30 times/minute;
children above 12 years old: ≥ 20 times/minute
(11) Abnormal
breathing: intercostal retractions, abdominal external oblique muscles
(12) Other abnormal
symptoms that are serious
b) Electrolyte
replacement in case of dehydration (due to fever, diarrhea, fatigue): Encourage
children to drink a lot of water, juice or Oresol (use according to instructions).
If children do not want drink Oresol, thay can drink cooled boiled water or
juice. Do not use industrial soda that is not produced from fruit for the
purpose of rehydration;
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d) Use symptomatic drugs
(if necessary)
- Cough: cough
suppressants (herbal medicine which is preferable)
- Nasal congestion, runny
nose: nasal sprays, nasal drops with 0.9% natriclorua.
- Diarrhea: probiotics
and digestive enzymes
dd) Continue to use
medicines for outpatient treatment for underlying conditions according to
instruction.
e) Note:
- Do not use antiviral
drugs, antibiotics, anti-inflammatory drugs... without the direction of medical
staffs
- Do not steam children.
3. Measures for
prevention of infection
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- Do not leave the
isolation area during the isolation time.
- Do not share items with
other people.
- Do not eat or drink
with other people.
- Do not have close
contact with other people or pets.
b) Caregivers
- Regularly wash or
disinfect hands . Disinfect objects and contact surfaces, including
countertops, doorknobs, toilets, sinks...
- Classify and collect
infectious waste according to regulations.
- Wear masks, face
shields (if any), wash their hands before and after taking care of children.
4. COVID-19 test for
the purpose of ending the medical isolation and home treatment:
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b) In case the test
result is still positive after 7 days, the children who are fully vaccinated
shall continue to isolate within 10 days according to regulations.
V.
DUTIES OF HEALTH STATIONS, FACILITIES THAT MAGEMENT HOME TREATMENT OF CHILDREN
1. Manage a list of
children with COVID-19 infection at home according to the form specified in
Decision No. 261/QD-BYT dated January 31, 2022 of the Minister of Health on the
promulgation of the “guidelines on management of covid-19 patients at home”
2. Assess and classify
home management of children with COVID-19 infection.
3. Direct caregivers to
monitor the health of children with COVID-19 infection
4. Implement emergency
and direct caregivers to transfer the children to the nearest medical
facilities in case of abnormal signs and symptoms.
5. Confirm the recovery
of chilldren according to applicable regulations
6. Perform other duties
according to applicable regulations.
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GUIDELINES ON PARACETAMOL
DOSAGE FOR CHILDREN ACCORDING TO AGE
(only use in case of unknown weight– Calculation of a paracetamol
dose in children should be based on body weight)
Age
Medicine
Dose
Under one year
Paracetamol 80mg
1 pack x 4 times/day
From 1 to under 2 years
old
Paracetamol 150mg
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From 2 to under 5 years
old
Paracetamol 250mg
1 pack x 4 times/day
From 5 to 12 years old
Paracetamol 325mg
1 tablet x 4 times/day
Above 12 years old
Paracetamol 500mg
1 tablet x 4 times/day
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