DISCHARGE SUMMARY

DEPARTMENT OF NEONATOLOGY
Discharge Time:-01:00 Pm
Name:- B/O

Delivery Center:-

Obstetrician:-

Referring Pediatricians:-

Obstetric History

Gravid/Para:-

E.D.D.:-

Blood Group:-

P.R.O.M:-

Antenatal Steroids:-

H.T./D.M./Other illness:-

VDRL/HIV/HbsAg:-

Antenatal U / S:-

Indoor No:- I
Indoor Date:-

Birth History O/E

DOB/TOB:- Respiratory distress:- NO
Birth Weight:- kg Cyanosis:- NO
Mode of Delivery:-Spontaneous Shock:- NO
Vaginal /LSCS
Gestational Age:- sex- Pallor:- NO
Male/Female
Liquor:- Clear, Meconium Stained Reflexes:- Normal
Cried:- Immediate/Delayed Cry/Tone/Activity:- Normal/
Normal/Alert & Active
A.P.G.A.R:- Not known Ant. Fontanel:-At level
Resuscitation:- Tactile stimulation Congenital Anomalies:- NO
Outcome:- Discharge

Investigations Treatment
CXR:- Antibiotics:- Inj Tazact, Levoflox,
Meropenom
Opening ABG:- Oxygen:- NO/YES
CRP:- Surfactant Given:- NO/YES
Blood C/S:- No Growth Inotropes:- NO/YES
CSF:- Assisted Ventilation:- NO/YES
Baby Blood group:- Phototherapy:- NO/YES
USG Brain:- Vitamin K:- Given
2D ECHO:- Blood Transfusion:- NO/YES
G6PD:- Exchange Transfusion:- NO/YES

Course in the NICU:-

Indoor No:- I

Indoor Date:-

Procedure in NICU:- Warmer care,

Final Diagnosis:-

Treatment on Discharge:

** Keep Baby warm

** Head up position
** Feeding BF+SF ad lib (Minimum = 31 ml /2 hrly TF = 120 ml/kg/day) (EBM/FAREX 1)
** Drops Perinorm (0.2mg/kg/dose) 0.6ml + 2CC EBM P/O 8 Hrly
** Tab Lanzole Junior (1 TAB +10 ML D/W) 3.1ml + 2ml EBM P/O 24 Hrly
** Vitanova D3 Drops 5 Drops 12 hrly
** Vaccination as per schedule

Date of Discharge:- Weight:- kg HC:- cm Length:- cm

Plan:- P.T.O,