INTERNSHIP!

Pediatrics Rotation
Interns Monitor: Dr. Joey Cuayo 09338709767 Oct 2018

A hodge podge of the previous written endorsements, PPT, and the verbal endorsements!!  Must relate every thing to the patient (FOCUS on
Hope it helps! Try to read kahit yung sa current rotation niyo langs! Kung gusto mo ng super the PATIENT!)
in-depth, read our endorsements nung clerk coz being a Pedia intern is like extended  Sequence:
clerkship daw but with no food monitoring YAAAAAY! :D Enjoy Peds! hahahahah
 Hx PE
 Course in the wards
I. PEDIATRICS IN GENERAL
 Discussion
Pedia Department Head: Dr. Mary Beth Tanco 09176304640  Guidelines
Interns’ Cooordinator: Dr. Patricia Reynoso 09228810653  Management
Interns’ Monitor: Dr. Joey Cuayo 09338709767  “Sliding” may be allowed provided that this is coordinated with the
Clerks’ Monitor: Dr. Nikki Barcellano 09338641355 Interns Monitor, Interns Coordinator, and if needed, with the
Department Chair/Academic Heads
A. REQUIREMENTS
 You can get the forms kay Mam Cathy or Med Educ
 Long Exam before the end of rotation II. WARDS
Remind Clerks to update ECDS of SS patients every day 
 Skills List
Guide them as well kung pano mag-PDAR since they are new!
 Case List
Tulungan nalang din hihi sabi nga ni Kuya Vince:
 Ancillary Evaluation forms (4 per student) “Be the intern that you needed when you were a clerk” :’)
 Evaluation to Clinical Faculty (one per faculty ONLY, no overlaps)
 Per SUBROTATION (Wards, ER, Nursery, OPD, NCH): ◍ Patient Load
o Evaluation of Rotation ◌ Complete official medical forms of the patient within 24
o Tool 3 + Professionalism (1 resident each subrot, hours from admission (6 hours for critical cases - PICU,
preferably seniors, no 1st yrs) IMCU)
o Clinical Fac: 1 professionalism + tools appropriate ◌ Know and analyze assigned cases
o Core Fac: 1 complete set! ◌ present to RIC, fellow, consultant
 Precepts Attendance for every precept oki? ◌ Provide the expected patient care appropriate for their level
 Remind the clerks to TEXT assigned consultants at ◌ monitor, follow-up labs, refer to RIC
3 DAYS BEFORE the rotation
 Inform your residents regarding scheduled DON’T FORGET SA SS ENDORSEMENTS:
preceptorials.  Fluids (Maintenance rate? ml/kg/hr?)
o For NCH: You need 4 sets (Tool 3+Prof): 1 set to Dr.
 ABx mkdose mkday and day
Gorospe, 1 set per resident per rotation (ER, ICU, Wards)
 Urine output ml/kg/hr
B. GENERALITIES  Waiting for what (labs, scheduled OR, assessment by a
 PEDIA CON (3rd floor, by the fishies) service, etc)
o Password: *3568  New labs
o Always sign attendance before going to your post  Febrile day keme Afebrile keme
o Call time: 7AM except for Sunday and Holidays 8AM  Basta as complete as possible ;)
o Naglilinya daw soooo be there before 7AM please  Kapag post-op you know naman what to check
 ESSENTIALS!
o Stethoscope!!! Penlight! Measuring tape! SPECIAL ENDORSEMENTS sa WARDS
o Pens! Black for PDAR, Colored for census  If Doc ARM (Agnes Rico Mendoza), magkakaroon ng SIIC.
o Mini Calculator with kodigo na rin ;) After the residents update her of the admission,
o Tongue Dep stash! Haha make nakaw jk subsequent updates will be coming from you. Pag nag
o Growth Chart access! (wag daw mag PedZ  ) rounds si doc ARM, assume the role of the resident. You are
o Optional: Oto-Ophtha (make sure lang na meron 1 per to suggest, PDAR, etc etc. Pag wala yung SIIC, cover
duty group) and cutie toyz for the kiddos nalang co-intern.
 FLOW:  Call or text her 09209064958
o 2 weeks each except ER/OPD (1 week each)
o Nursery  NCH  Wards  ER/OPD A. PREDUTY
 GOOGLE DRIVE  Attend SS endorsements by from duty (7am)
o pediainternsclerks  Get Medical Unit census (or Others if you are others haha)
o password: ilov3c3nsus!  Join SS rounds after
 FOOD FOR THE SOUL AND TUESDAY CONFERENCE:  Wait and JOIN residents during Medical/Others endorsements
o Ask ward residents if may endorsement muna or proceed o Take note of the pending labs, initials etc.
to the confe na agad, venue to be announced by
 Do AM duty work (rounds, referrals, admissions, PDAR, assist
residents (usually MAB Audi)
consultant rounds, edit census/ADDIS until 2PM) **Always join
o Wards sure na kasama (ALL to attend EXCEPT Nursery
consultant SS rounds!**
duty and ER)
 3PM: SS rounds (decking with clerks kasi walang ibang tao sa
 GRAND ROUNDS (every last Friday of the month)
ward, nasa rest deck ung duty)
o Clerks (WARD, OPD) to:
 4PM: Clerk to ask for PM SS endorsements, dapat nakabalik na
 Pick a case
duty people from their “rest deck”
 Make protocol
 Schedule grandrounds  MGH after PM SS endorsements (with go signal of resident)
 Send letters to consultants
 Look for grandrounds moderator (2nd or 3rd year ** Admissions from 0700H to 0400H papers and starting clinsumm
resident) are care of Pre-Duty!** oo kasama na starting ECDS 
 DO history, PE, DDx, Working Impression
o Interns (WARDs to report, OPD to help): B. DUTY
 Do Course in the Wards (Diagnostics, Discussion,  Same-ish with Pre-duty until 12 noon (rounds, receive
Management done specifically to the patient) endorsements) BUT Pre-duty will accomplish database of
 Check/Supervise clerk’s work admissions
o 1st year resident to discuss a journal for the case (make  Rest deck: 12 – 4pm (make sure to sign in and out, provide a sheet
sure to inform them! Write a letter) sa pedcon)
o Reminder:  If may preceptorials or lectures and residents or other ganap, ALL
 Have protocol and letter checked by resident SHOULD ATTEND, even yung duty peeps kahit sakop ng rest
(Resident reactor, Senior Res, and Chief Res) and deck nila. Sorry
give to consultants at least 1 week before  4PM: Receive SS endorsement by Pre-duty
grandrounds  Do PM duty work  After 4PM papers & duties are all yours!
 Have PPT checked by residents (see above) at  If 2 interns on duty, one will be assigned to Other Floors (BUT
least 5 days before grandrounds (have revisions make sure to help out sa Medical Unit kasi mas maraming patient
checked again) doon)
 No need to buy foodams.  Food monitoring c/o Clerks YAY WOOHOO WE ARE DONE
 Double check confe room reservation via Maam Ivy
 Usually yung others yung nag kukuha ng nourishment or nag ffood
o Consultant’s comments:
 Report should only be 20 to 30 minutes long monitor kasi sila yung relatively free hahaha so kahit intern, kusa
 Slides should not be wordy! nalang siguro. Hehe

Batch 2019! <3 Jaye B.; @doggiefreak Page 1 of 4


C. FROM DUTY
 Do SS morning rounds before 0700H
 EDIT AND PRINT Ward Census (Medical Unit/Others) 5 copies
daw pero ask nalang din. Dapat by 0700H printed na lahat!!!
 DON’T FORGET TO PRINT ADDIS! May separate folder yun.
Black, sa tabi ng printers. Nadedemerit daw sila kapag kulang yun
so please facilitate.
 Write all trans-in, admissions on the White board! Before 0700H!
 SS ENDORSEMENTS (mainly clerks but if you are nice go langs
divide and conquer, KAPAG PICU or IMCU, tayo yun SURE
hehe)
 SS rounds again sama you haha especially if wid consultant!
 Backlogs!
o Databases/ECDS *prioritize ECDS of foreigners*
o Don’t forget the Problem List and LAB FLOW SHEET
o Databases SHOULD be signed by PROD before
going home
o COMPLETE DATA especially Z scores and nutritional
status!
 MGH by 12 if you are done! With basbas again of resident . DO
NOT JUST DISAPPEAR hahaha
D. OTHER ACTIVITIES
 Grandrounds & Tues Conference (pls see prev entry)
 Monday AdCon: Saturday duty to prepare PPT to be checked by
1st year (Hx PE sa clerks, Case discussion sa Intern)
 SS Hour: day and time depends on consultant, always ask the
residents  usually Wednesday
 Division of Labor: INTERNS: DDx, Assessment, Management!
III. ER/OPD
A. ER
 Have your wellsoft accounts activated before your scheduled ER
post (IMD, 2nd floor near Uro and Ortho dept)
 AM (7AM to 7PM) or PM (7PM to 7AM) duty
 Remember attendance at PedCon! No holidays/skeletal 
 1 week, 1 off only (no weekends!) FIXED sched
 Same routine as clerkship! May dikit ng sticker sa logbook,
interview, endorse, write your Hx and PE sa wellsoft
 DON’T FORGET TO ASK:
o Last urine output
o Last BM
o Meds Taken (what time if Para) and dose!
o Last antibiotics taken
B. OPD
 7AM parin! Go to Ped Con, listen to the ward endorsements
 If dumaan ng OPD ung admission, OPD clerk to endorse Hx and
PE until ipadala sa ER or direct admission (so make sure na
kilala rin ng interns yung patient kasi pag hindi alam ng clerk, sa
intern itatanong)
 Be at the OPD by 8AM (u may eat bfast there while waiting for
the charts)
 CHARTS!! By prio: Clearance  Newborn  Pedia Sick 
New patient (clerks talaga dito pero pag madami help nalang
din)  Special (Cardio, Gastro, etc.)  Continuity
o Don’t forget nutritional status (again wag daw PedZ
but…) HAHAHA
 When you endorse Sick bibis, always have assessment and
management! AYI INTERN NA :”> HAHA
 Acquisition of vaccines c/o CLERKS woohoo we are done!
Remind em tho
o Letter tapos always return the same day
 Sila rin sa logging but if u are so kind go lang!
 THINGS TO STUDY!
o Preventive Pedia (the red book)
o Growth & Devt Milestones
o Immunizations
o AGE, Pneumonia, URTI, UTI
o Doses!
 Usually MGH by 4 or 5 (depende sa toxicity and sa residents)
 May bulletin board na schedule ng specialties and continuity so
be guided nalang!
 SATURDAY assume ward post!!! MGH by 12 
IV. NURSERY
TOPICS TO STUDY:
 Hx taking of Momshies; Normal Newborn PE
 Hyperbilirubinemia
Batch 2019! <3 Jaye B.; @doggiefreak
Internship Rotation Pediatrics
o (Bhutani, photo level keme) may folder sa Gdrive!
o Plot serum bili check if photo-able, know the risk
 Babies of DM mothers
 11 Signs of Hypoglycemia
 Sepsis
 Transient Tachypnea
 FRICHMOND (fluids, respi, infectious, cardio, hema,
metabolic, output, neuro, drugs) kapag NICU/IMCU
o Weight gain! Post-conceptual age
o Output naka cc/kg/hr same stuff din sa wards
yung mga Abx naka mkdose/ mkday
A. PREDUTY
 AGAIN PedCon attendance muna! Haha preferably charge the
CCHD machine
 Clerk to print census (usually 1 NICU, 2 IMCU, 3 rooming in) but
ask haha para sure
 7am: Attend SS endorsements by from duty
 Sama sa SS rounds
 Attire: Uniform AND BRING SCRUBS
 Do rounds with resident. After, you may proceed with newborn
screening and vaccinations. Tapos, when you are alone, CCHD
galore! Ubusin ang mga bebeng more than 24h na (may logbooks
for each ah! Guard with your lives)
o NBS: INGAT SA DATE!! Or else love letter char
o BCG: 0.05ml LANG HAHA
o OAE: not done by us pero check lang if ano results
 12 noon: relieve duty sa DR complex (ask duty group if need ba ng
printed index cards and ¼ sheet para makapag dala) ASSUME
ROLE NG DUTY
 Decking sa SS rounds, make sure lahat madaanan (NO MORE SS
ENDORSEMENT SA HAPON)
CCHD
 Explain CCHD properly (screening for congenital heart disease)
 Normal O2 > 95%, with preductal (right hand) and post ductal (any
other extremity) difference of not more than 3%
 If O2 95 and below, try again for thrice, then if ganun talaga…
REFER to resident. Repeat CCHD after 1hr
 SIDE NOTES CCHD results ALL the time and LOG!!!
 Text residents CCHD
 Accompany consultants sa rounds
B. DUTY
 PedCon attendance muna! Uniform papunta but bring scrubs!
 Relieve from people inside DR (ON OR BEFORE 7am)
 Await admission (coordinate with OB peeps for scheduled CS)
o Prepare index card, ¼ sheet (compute always!), bundle
pack, 1-2 blank DOS ( we can write, but not required)
o Bundle includes OBHx (required to be complete),
Physician appraisal, Ballards, Problem List (and here
also) .
o EINC NOT INCLUDED SA BUNDLE (nurses will provide
them pag napanganak na si bibi)
o Interview private and SS patients with or without residents.
Always ask OB and Pedia AMD. If PROM, ask for
amniotics fluid details (TIME, CHARACTER) and know if
mag sstart ang OB ng antibiotics, follow-up ung time
(dapat atleast 4 hours before delivery)
 Update residents of admissions (AM ALL; PM duty only)
 Update residents of IE every 1-2 hours or if significant
 Update residents of HOA (especially if abnormal)
 CALL if STAT!!
 IN ALL TABLES, there must be a 1st year and second year. 1st
years usually una to respond tapos hahabol yung second year but
make sure to inform and call.
 Impending TABLE – set up once mother is at 9 – 10 cm or during
epid
o ALL Term and Preterm – 5 white linen and get 1 bonnet
o Prepare:
- Intubrite (get at station from charge nurse, leave ID)
- Pedia steth (from RR/HOA)
- Tacklebox – only when patient is table na
- O2 tube ( yung O2 wag ipasok sa ilong)
- French 8 feeding tube
- 3 ET tubes (actual size, and 1 size up, 1 size down)
- Suction (blue term, gray and blue preterm)
- Bowl with sterile water
- Thermometer (to be given with tacklebox)
Page 2 of 4
 Internship Rotation Pediatrics

- Ambubag  EXCEPT THURSDAY! Everybody is required to

o Confirm/Ask sa resident if OPEN ALL, lalo pag difficult attend Dr. Gorospe’s session regardless of
delivery or preterm or precious baby status! (will explain laters)
o Pre-warm the warmer na rin  MOND or SAT: 2d Echo sesh sa radio dept, ground
 Upon delivery flr (7am-9am, by 2s lang daw po decking kayong
o Stimulate the baby! Wag pabebe pero wag din tanggalin interns, 7-8 tyana 8-9am)
ang balat.  TUES: Neurodev Clinic, 5th flr (9am)
o CLICK APGAR button at warmer!!!  WED: Hema procedures, 4th flr (11am, ICU peeps to
o HEART RATE also pagkalabas. spy if mag poprocedure na)
o Check VS, especially temp q15m for 1st hour  THURS: Nephro OPD, 6th flr (1pm)
o Weigh placenta !! Don’t forget to log after!  FRI: Adcons (8am), from peeps may come
o Latch the bebe to the mami o Weekends
 After OR  Preduty 8am to 12nn
o Return things (especially yang PRETERM mask na yan  Duty 8 am onwards
ginto eh) hehe  From AS RELIEVED!!! (sat sun and holiday)
o Monitor baby at HOA (q15 1st hr, q30 for 2 hrs, then q1)  no weekend off pala -__- sat off lang and sun off,
o REFER if may abnormal! holiday off rin.
- RR > 60
- Grunting, alar flaring, retractions B. ICU
- HR > 160  BRING REVIEWERS HAHAHA dito ka makaka-aral ng wagas.
- T <36.5 or >37.2C  Accompany consultants with rounds. Rounds usually start at 7:30
o Make sure maka latch si baby! and it lasts for 2 hours.
o Apparently may “nipple puller” for inverted nipples pwede  We also accompany when there are referrals to the ICU in other
daw hirmain haha masakit daw so pwede pagawa sa wards! No clerks here OMG
mom BASTA DAPAT MAKA-LATCH!  Matanong consultants:
 Wala na kami internlabas e o Dr. Casas: Know your basics!
o Dr. Monge
 Food monitoring as well!! WOOHOO o Dr. Eluterio: Super nice
 Other tasks!!:
C. FROM DUTY
o Make Rx – deadline is 10AM
 Do morning SS morning rounds before 0700H with PDAR!  1 copy only unless specified ng nurse
 Endorse SS patients by 7AM at NICU  ABx: 1 drug per sheet
 Sama sa SS rounds  Antiseizure: 1 drug per sheet
 Iba na daw format ng ECDS by problem na daw!   The rest: 3 drugs per sheet
o Eg Problem 1 Hyperbilibirunemia, ano ginawa sakanya  Make Rx even for sterile water and IV fluids
ano trend ng serum keme nya. o Radiology forms
o Hindi na daw yung 1st hospital day ganito 2nd ganito  Fill up necessary data, put pertinent history + days
 Update ECDS (some patients ay sa MDportal while some sa intubated + days abx then give to resident for signing
Gdrive) o Clinical Abstract
o SS NICU – interns  Fill up necessary data then give to reseident for
o PVT – interns (mag decking nalang) signing
o SS reg wards – clerks o Database:
 Discharge SS patients (prepare ECDS, newborn card, newborn  Make 1 if directly admitted to ICU pero if from wards
care instructions) (divide and conquer woohoo) dapat may database na tsk haha
 12NN ask for MGH!! o Suction bebes as needed.
 Sabi nila kuya kapag may surplus daw ng update ng clinsumm  Four Rooms:
magpa help daw sa clerk  Tapos kapag nag uupdate may o Respi A1
page as of ganitong date para alam kung san magstart uli  First room to the left
 With 3 cribs for cases of respi infections in ARF or
V. NCH enceph na kasya pa sa crib
A. GENERALITIES/MUST KNOWS!  Maganda daw yung CR dito at banyo!
 1-2 days before your rotation, text Dr. Mundoc (09205658044) ask o Miscellaneous
when yung courtesy call  (usually daw 1st week yung meet)  Second room to the left
 Attendance: BUNDY CLOCK AND LOGBOOK WITH TIME IN  ESBL/MRSA cases oops wag nalang mag CR dito
AND OUT GUYSH o PICU
o Call time: 7AM sharp  Only room to the right
 ADVANCED DAW RELO NILA NG MGA 10  2 adult sized beds and 2 medium cribs
MINUTES -_- GUYS huhu  Semi neuro cases
o 0701 – 0714: minor late (3 minor = 4hrs makeup) o NICU
o 0715 onwards: major late (1 major = 8hrs makeup)  Third room on the left
o Get bundy clock card at receptionist/lobby  Bags are put together sa L-shaped table nearest the elev so baka
o So pag first day be there super early para you could get mawala!!! Huhu take care guys
your card then maka time in ka ng early!
o You cannot make-up while you are in NCH rotation!  So C. SURG WARD
yeah goodluck guys sana wala tayo makeup!  Go to 4th floor of new building and go to the charity patient’s station
o Once it’s announced in national TV na no classes for all (makikita mo kasi may clerks)
levels, wala na daw pasok sa NCH (will confirm)  Try not to bring valuables
 Requirements:  Do rounds with resident/consultant (hard to identify daw kasi di
o Last day: in a brown envelope, grading sheets and time naka coat so be vigilant!)
card of whole group  Be proactive! Know the cases. They ask you to endorse
o Dr. Gorospe grading on the last sesh! (will explain laters) sometimes!
 Rotations:  Ask em whattodo. BAWAL magsulat sa chart
o ICU, Surgical Ward, ER o Pag mag OGT always auscultate, last time may namatay
o Sa AM, pweds magkasama two interns but sa PM daw dahil nag aspirate
maghihiwalay na  You are with clerks! Bring pulse ox daw pero pweds humiram sa
 Schedule: clerk HEHE
o Weekdays  Pag wala yung clerks, tayo mag vitals. (di daw required pero…
 Preduty 7am to 5pm hahaha wala naman daw ginagawa so do it nalang)
 Duty 7am to 7am  Sabi ni Kuya Val ang tulong nya usually Database haha!
 From 7am to 8am  Q1 for 12 hours yung post-op then Q2 then Q4 haha
 Restroom: 417 (payward) right room hehe

Batch 2019! <3 Jaye B.; @doggiefreak Page 3 of 4

 Internship Rotation Pediatrics

 ORS: not allowed to assist!!!! HAHAHA KALMA GUYS AH alam ko

madami gusto mag Surg sa group pero mahirap na. wala daw kasi
sa MOA baka mapano tayo hahaha at your own risk na yan, I know Thanks! Sorry sa kajejehan =))
some interns na naka-assist PERO AT YOUR OWN RISK AH!
Alam niyo na bawal.

D. ER
 Most toxic post!
 Get ER sheet
 Plot growth chart
 Fill out everything
 Get Hx PE – pile (urgent vs nonurgent pile)
 If really emergency, endorse to resident at once.
 If not emergency, put in pile
 Dengvaxia cases have separate pile
o Speaking of!!! Malamok daw ditto so pweds mag change
into scrubs at 6PM pero change back at 7AM before
consultants come ;) HAHA so wag pahuli! Pweds naman
siguro mag off lotion char
 Lockers with keys are available here so your stuff are safe!
 Pabilisan lang dawn g kilos hahaha  The triage form is under the
table “not yet interviewed”
 When you get a triage form (a ½ bond paper with identifying
 You will finf the anthrops in the triage form so plot them sa growth
chart
 Nurses usually refer urgent cases to INTERNS so mas prio natin
yung URGENT!!! Sometimes sa inyo nag rerefer (OMG) kung toxic
yung resident
 FORMS!
o ER consultation form:
 Complete identifying data until CC
 Proceed to the vitals at the back
 BP all regardless of age! Madami daw cuffs
of diff sizes 
 Do the MUAC (mean upper arm
circumference) for children older than 6
months, they place MUAC sa corkboard ng
ER 
 Put Anthrops with Z score
 Leave PE blank
o Growth Chart
 Put name and DOB at top
 May HC parin until 18 (hehe)
 If for admission, growth chart parin kahit OLD
patient)
 BE MASIPAG AND OC daw dapat complete kasi may consultant
daw na nag hahanap ng lahat ng vitals and notorious for asking
kung sino (yung may kulang)
 Once you are done, put sa table na “done interviewing” tapos
residents will get it from there
 Matagal daw talaga turnover especially for nonurgent cases,
reassure them na makikita sila and inform them na may OPD pag
weekdays 
 COMMON CASES:
o Asthma, Pneumonia, Dengue Shock
 If hypotensive, put on trendelenburg and refer!
Hehe
 RESTROOM! Jollibee or GI (second floor of old building)

E. DR. GOROSPE’S SESH

 Thursdays 1pm onwards *usually til 4pm/5pm* sorry from peeps!
 Go to the Nephro OPD – 6th floor of old building
 Interview patients and refer them to Dr. Gorospe directly. She’s
nice and the kids are cute and edematous HAHA. SHE KNOWS
HER PATIENTS well so don’t you dare make imbento
 Wag da masyado OC
o SOAP
o Last seen
o Last med/mx
o Any new subjective complaints (edema! Face/legs,
cough/colds, fever, dysuria, hematuria, oliguroa, how
many CR visits a day, good appetite, activity)
 Most important vital sign: BLOOD PRESSURE!
 When endorsing patient, also bring Rx and lab request for UA
 Prepare clinical microscopy sheet with the patient ID, insert back
sa chart and pila daw accdng to the number.
 STUDY NEPHRO CASES:
o Barter, GItelman, PSGN, FSGS,
o NEPHROTIC SYNDROME
Batch 2019! <3 Jaye B.; @doggiefreak Page 4 of 4