PIP: Health workers should assess all children with a cough or difficult breathing for pneumonia. They should refer any child with severe pneumonia to a hospital for admission. At the hospital, a distinction is usually made between severe or very severe pneumonia among children 2 months to 5 years old. Signs or symptoms unique to very severe pneumonia are cyanosis and inability to drink. If a child has these signs and has convulsions, hospital personnel should consider a lumbar puncture to check for meningitis. Chest indrawing may also be present in very severe pneumonia cases. Chest indrawing in children with no cyanosis who are able to drink constitutes severe pneumonia. Health workers need to look for a variety of nonspecific signs of severe or very severe pneumonia in babies younger than 2 months: not feeding well, convulsions, abnormally sleepy, fever (38 degrees Celsius), fast breathing (=or+ 60 breast/minute), cyanosis, grunting, or apnea. These signs are also signs for meningitis or sepsis in young infants. Treatment for all 3 conditions is benzylpenicillin plus gentamicin for at least 14 days. Oxygen treatment is also indicated for these young infants. Treatment for both severe and very severe pneumonia cases includes oxygen and an antibiotic (benzylpenicillin and chloramphenicol, respectively). Hospitals should have in stock at all times essential antibiotics (benzylpenicillin, cloxacillin, chloramphenicol, and gentamicin) and an oxygen supply (oxygen cylinder or oxygen concentrator). When the oxygen supply is limited, children with very severe pneumonia should be the priority. Oxygen needs to be delivered at a flow rate of 1-2 liters/minute via nasal prongs or a nasal catheter. Admitted pneumonia cases with fever (39 degrees Celsius) should receive paracetamol to treat the fever. Hospital workers need to keep the airway of pneumonia cases clear and to encourage them to drink and/or breast feed.