INTRODUCTION
   • Acute Malnutrition (wasting) is a rapid decline of weight while height 
    remains unchanged. 
   • It is a reflection of inadequate dietary intake or acute infection.  
   • It is classified into severe acute malnutrition (SAM) and moderate 
    acute malnutrition (MAM) according to the degree of wasting and 
    the presence or absence of oedema. 
   SEVERE ACUTE MALNUTRITION 
   • It is defined as edema of both feet and visible severe wasting
   • Diagnostic Criteria 
    • Visible severe wasting 
    • Edema of both feet 
    • Weight for length/height <-3SD 
    • MUAC < 11.5 cm 
   Investigations
   • • RBG 
   • • BS for MPS 
   • • Septic screening; Urine culture, Blood culture, Swab cultures 
   • • FBP 
   • • HIV screening 
   • • Chest X ray  
                  Treatment of Severe Acute 
                  Malnutrition 
                  • The management of severe malnutrition involves 10 steps in three Phases: stabilization, transition and 
                     rehabilitation. 
                  • Those 10 steps are;
                  i.     Hypoglycemia (RBG <3mmol/L or 54 mg/dL )
                  ii.    Hypothermia (Axillary temp <35ºC or Rectal temp<35.5ºC) 
                  iii.   Dehydration 
                  iv.    Electrolytes imbalance
                  v.     Infections 
                  vi.    Micronutrients supplementation
                  vii. Dietary management
                  viii. Growth - Catch up (Recover Lost weight)
                  ix.    Sensory Stimulation and Emotional Support
                  x.     Prepare for Discharge and Follow up
   PHASES
   • Stabilization: This is the initial phase in the management of SAM where 
    by acute complications and metabolic derangements are addressed.  
   • Treat Complications like: Hypoglycaemia (bolus of 10% glucose IV 
    5ml/kg or 50ml of 10% glucose or sugar water by NGT for unconscious, 
    lethargic or convulsing child.)
   • Hypothermia, 
   • Dehydration 
   • Electrolytes
   • Micronutrients