MUACare

Emergency · ER

Decide first how to treat this child. SAM → WHO / Gaza severe-malnutrition emergency protocols (no standard boluses, ReSoMal, 5 mL/kg glucose). Normal child → Palestinian MoH Paediatric Emergency Guidelines 2022 with doses for this weight.

Age · years

+ months

Weight (kg)

Systolic BP (optional)

Palestinian MoH protocol

Palestinian Pediatric Emergency GuidelinesState of Palestine · Ministry of Health · May 2022

Outpatient Clinic

Measure the child, read the WHO indicators, decide: admit or treat as outpatient. Vital signs are taken on admission.

STEP 1 · CHILDIdentification

Name

Age · years

+ months

STEP 2 · ANTHROPOMETRYMeasurements

Weight (kg)

Length / height (cm)

MUAC (mm)

Bilateral pitting oedema

STEP 3 · ADMISSION CRITERIAComplications and appetite

Danger sign or medical complication?

Not able to drink · vomits everything · convulsions · lethargy · fever/hypothermia · pneumonia · dehydration · severe anaemia · dermatosis +++ · eye signs.

Appetite test

Clinic list · saved children and follow-up

Show discharged / closed cases

Start here: enter the measurements and readings. The app classifies the child and opens the right pathway: the SAM pathway (malnutrition rules for fluids and drugs) or the standard pathway (usual paediatric emergency protocols).

Patient

Name

ID number

Age · years

+ months

BACKGROUNDChronic medical illness

Select every chronic condition the child has. The app adapts measurement, classification and the plan.

GMFCS level

Knee height (cm)

Upper arm length (cm)

Tibial length (cm)

Ulna length (cm)

Segments (cm): crown→trochanter

trochanter→knee

knee→heel

Triceps skinfold (mm)

How to measure (Stevenson 1995)

Measure	Landmarks	Stature (cm)
Knee height (preferred; sliding caliper)	Seated/supine, knee and ankle at 90°; plantar heel → anterior distal thigh over femoral condyles	2.69 × KH + 24.2
Upper arm length (tape)	Elbow 90°, forearm across chest; lateral acromion → tip of olecranon	4.35 × UAL + 21.8
Tibial length (caliper/tape)	Supero-medial tibial plateau → tip of medial malleolus	3.26 × TL + 30.8
Segmental length (tape)	Supine: crown → greater trochanter + trochanter → lateral knee line + knee line → heel	Sum of segments
Ulna length	Olecranon tip → styloid process	4.605 × UL + 46.83

Measure the unaffected or least-affected side (hemiplegia, asymmetric contractures).
Take 2–3 measurements and enter the average.
Plot on WHO charts for diagnosis; CP (GMFCS) charts for trajectory.

Stevenson RD, Arch Pediatr Adolesc Med 1995 · Brooks et al., Pediatrics 2011

If length/height cannot be measured, leave it empty: the app uses knee height first, then upper arm, tibia, segmental sum, ulna.

TSF below the 5th centile for age Mealtimes > 3–4 hours/day Aspiration pneumonia / unsafe swallow

READINGS 1Anthropometry

Weight (kg)

Length / height (cm)

MUAC (mm)

Bilateral pitting oedema (press both feet 3 s)

READINGS 2Vital signs and bedside tests

Blood glucose (mmol/L)

Axillary temp (°C)

Resp. rate (/min, full minute)

Heart rate (/min)

SpO₂ (%)

Hb (g/dL) if known

Systolic BP (mmHg)

Potassium K⁺ (mmol/L)

Sodium Na⁺ (mmol/L)

Glucose in mg/dL ÷ 18 = mmol/L. Leave a box empty if not measured.

READINGS 3Consciousness and circulation

C — CIRCULATION

Cold hands and feet Capillary refill > 3 seconds Weak (low volume), fast pulse

Consciousness (AVPU)

Tools

Blood gas, CBC interpretation, NG tube insertion and image reading for labs, X-rays and ECGs.

Tool 1Blood gas · ABG / VBG

pCO₂

HCO₃⁻ (mmol/L)

Base excess

Na⁺ (mmol/L)

Cl⁻ (mmol/L)

Albumin

Lactate (mmol/L)

K⁺ (mmol/L)

Glucose (mmol/L)

PaO₂ (mmHg)

FiO₂ (%)

Na⁺, K⁺ and glucose are copied from Readings when empty here. Enter at least pH, pCO₂ and HCO₃⁻.

Tool 2CBC · complete blood count

Age · years

+ months

Hb (g/dL)

WBC (×10⁹/L)

Neutrophils (×10⁹/L)

Lymphocytes (×10⁹/L)

Eosinophils (×10⁹/L)

Platelets (×10⁹/L)

MCV (fL)

MCH (pg)

RBC (×10¹²/L)

RDW (%)

Age is copied from the current patient. Ranges are approximate paediatric references — use your laboratory's ranges where they differ.

Tool 3Nasogastric tube · insertion protocol

Tool 4Images · labs, X-rays, ECG

Add photos of lab reports, X-rays or ECGs. Images stay on this device for this visit only — they are not saved and are cleared on reload or New patient. Hide the patient's name before taking the photo.

Add photos

Clinical approaches: start from the complaint, or open a system. Every dose is calculated for this child's weight; when the child is on the SAM pathway, the malnutrition changes appear in amber.

MUACare

Emergency · ER

Palestinian MoH protocol

Outpatient Clinic

STEP 1 · CHILDIdentification

STEP 2 · ANTHROPOMETRYMeasurements

STEP 3 · ADMISSION CRITERIAComplications and appetite

BACKGROUNDChronic medical illness

READINGS 1Anthropometry

UNDER 6 MONTHSInfant assessment (WHO Gaza, Aug 2026)

READINGS 2Vital signs and bedside tests

READINGS 3Consciousness and circulation

STEP 1Emergency signs (ETAT) and dehydration

STEP 2History · danger signs and background

IMCI danger signs

Symptoms

Background

STEP 3Examination · complications

Hydration

Chest and infection

Eyes

Skin and mouth

Other

STEP 4RUTF appetite test

STEP 5Classification and decision

STEP 6Investigations

Tools

Tool 1Blood gas · ABG / VBG

Tool 2CBC · complete blood count

Tool 3Nasogastric tube · insertion protocol

Tool 4Images · labs, X-rays, ECG