Component Task: Structural Anthropometry - Measuring The Mid-Upper Arm Circumference (MUAC) of a Child

This is the process of measuring the circumference of the muscle mass of the upper arm with the aid of a tape measure. It is used to assess the nutritional status of a child over 6 months.

Aims

·         Monitor growth and development

·         Assess nutritional status of the child and counsel accordingly

·         Provide criteria for diagnosing malnutrition

Requirements

·         MUAC tape/tape measure

·         Alcohol rub

·         Child health record card

·         Pen/note pad

·         Percentile/standard deviation chart

·         Cotton wool swabs

·         Disinfectant

·         Examination gloves

Steps

1.        Receive child/care into a comfortable seat

2.      Perform five moments of hand hygiene as and when necessary

3.      Establish rapport (refer steps)

4.      Explain procedure to child/caregiver (refer steps)

5.      Provide privacy

6.      Incorporate developmentally appropriate strategies in dealing with the child

7.       Assist caregiver to remove the child’s diaper and clothing and other accessories (completely undress if the weather is conducive and it is culturally acceptable)

8.      Assist the child to assume the appropriate position (a child under 2 years should be held in the mother’s laps)

9.      Expose the child’s left arm and shoulder

10.    Bend the elbow at a 90° angle with the palm facing upwards

11.      Locate the most prominent part of the child’s shoulder (acromial process/tip of shoulder) and mark it

12.    Measure the distance from the tip of the shoulder to the tip of the elbow (Olecranon process)

13.    Divide the distance by two, which is the midpoint of the child’s upper arm

14.    Mark the midpoint of the child’s upper arm

15.    Release the child’s left arm and let it hang loosely beside the child’s body

16.    Wrap the tape over the marked midpoint (ensure the tape is not upside down)

17.    Pull the tape tightly around the mid-upper arm so that it touches the child’s skin without compressing the underlying tissue

18.    Ensure the measurement is on the outer surface of the child’s arm

19.    Read the measurement and record to the nearest 0.1 cm

20.  Express appreciation to child/caregiver for their cooperation

21.    Disposed off, disinfect and clean used items

22.  Encourage follow up/refer if necessary

23.  Document procedure in nurse’s notes