Professional Documents
Culture Documents
PEDIATRICS (ER)
ADMISSION
Please admit
Please admit to room of choice/ PICU under the service of Dr._____
SKIN TEST ORDER
Monitor VS
Monitor VS Q4H/QHourly and record
Diet: NPO/DAT/No
Diet: NPO/DAT/No Dark colored foods
Venoclysis::
Venoclysis (-)erythema *Negative Skin Test(NST) to
LABS: CBC,
LABS: CBC, APC, S. Na, K, U/A, F/A, Chest Xray APL (-) induration CEFUROXIME(Zegen)
TRANSOUT ORDERS
Thank you.
Resident/Intern
C.W.O Dr(consultant)/Resident/Intern
Meds:
Meds:
*Salbutamol ½ nebule +2cc of PNSS; PAI 1 nebule x 3 doses every Diet: Cont.Breastfeeding
Diet: Cont.Breastfeeding
Venoclysis::
Venoclysis
15mins(DOB) LABS: CBC,
LABS: CBC, APC, S. Na, K, U/A, F/A, Chest Xray APL
*Salbutamol ½ nebule+2cc PNSS Q8H prn for DOB Meds:
Meds:
*Hydrocortisone(5mg/kg/dose)Q4H *Amicillin 50-100mg/kg/day TID
S/O: 02
S/O: 02 at _LPM/standby O2 at bedside *Cefotaxime or Ceftazidime(30-50mg/kg/day)BID or TID
MIO Qshift and record S/O: Daily
S/O: Daily cord care
Relay labs once in Phototherapy
Will inform Dr.___ of this admission MIO Qshift and record
Watch out for any untowards S/Sx Relay labs once in
Refer accordingly Will inform Dr.___ of this admission
Thank you. Watch out for any untowards S/Sx
Refer accordingly
Thank you.
DENGUE FEVER W/ OR W/o WARNING SIGNS or SYSTEMIC VIRAL
INFECTION
HYPERSENSITIVITY REACTION
Please admit to room of choice under the service of Dr._____
Please
Monitor VS
Monitor VS Q4H and record Please admit to room of choice/ PICU under the service of Dr._____
Please admit
Diet: NPO/DAT
Diet: NPO/DAT Monitor VS
Monitor VS Q4H/QHourly and record
Venoclysis::
Venoclysis Diet: Hypoallergenic
Diet: Hypoallergenic Diet
LABS: CBC, APC, S. Na, K, U/A, F/A, Chest Xray APL, Dengue NS1Ag,
LABS: Venoclysis::
Venoclysis
Blood and Rh Typing LABS: CBC,
LABS: CBC, APC, S. Na, K, U/A, F/A, Chest Xray APL
Meds:
Meds: Meds:
*Paracetamol __mg/__ml;__ml Q4H prn for fever 37.8- *Epinephrine 0.3cc IM now
38.5C(10mg/kg/dose) *Diphenhydramine(1 mg/kg/dose)IV now
*Paracetamol__mg prn for fever >38.5C(10mg/kg/dose) *Hydrocortisone (5mg/kg/dose) Q8H
*Ranitidine __mg Q8H SIVTT(NPO)(1mg/kg/dose *PAI Salbutamol 1 nebule +2cc NSS Q15 mins x 3 doses
S/O: MIO
S/O: MIO Qshift and record S/O: MIO Qshift and record
Relay labs once in Relay labs once in
Will inform Dr.___ of this admission Will inform Dr.___ of this admission
Watch out for any untowards S/Sx Watch out for any untowards S/Sx
Refer accordingly Refer accordingly
Thank you. Thank you.
Resident/Intern
Partially Compensated
VACCINATION
Vaccine Age of # of Dose Route SIte Completely Compensated N
1st doses
dose Respiratory Alkalosis (Change in pCO2 is greater than change in HCO3) (pCO2 is
BCG Birth 1 0.05ml ID R deltoid decreased)
decreased)
R buttocks Uncompensated N N
DPT 6 3(6th, 0.5ml IM Upper thigh
weeks 10th,14th Vastus Partially Compensated
month) lateralis
OPV 6 3(6th, 2- Oral Mouth Completely Compensated N
weeks 10th, 14th 3drops
month)
COMON MEDICATIONS THAT ARE USED
Hepa B Birth 3(0,4th, 0.5ml IM Vastus
Anti-emetic/Anti-vomiting
8th week) lateralis
Measles 9 1 0.5ml SQ R deltoid *Metoclopramide-dopamine receptor blocker
month Recommended Dose:
MMR 12-15th 2 (12th - 0.5ml SQ R deltoid 0.5mg/kg/dose- ORAL
month 15th R buttock 0.2mg/kg/dose- IV
month, Preparation:
4-6Y.O) Ampule:10mg/2ml Syrup: 5mg/ml
5mg/2ml Tab: 10mg
Anto-Spasmodic
*Dicycloverine-anticholinergic activity
Recommended Dose:
2.5-5mg/kg/day-TID
Preparation:
Drops: 5mg/ml Syrup:2mg/ml
Syrup:125mg/5ml 500mg
250mg/5ml
Ampule:300mg/ml
*Ibuprofen-prostaglandin synthesis inhibitor
Recommended Dose:
5-10mg/kg/dose(Q6-8H)
Preparation:
Suspension: 100mg/5ml
Capsule:200mg/cap
*Aluminum/Magnesium Hydroxide
(Q6H)
*Omeprazole 40mg/OD(Proton pump inhibitor)
*Pantoprazole 40mg/OD(Proton-pump inhibitor)
*Esomeprazole 40mg/OD(Proton-Pump inhibitor)
Urinalysis:
Sugar RBC
Albumin Pus
Squamous Spec.gravity
*To comeback
*Watch out forafter __ days forS/Sx
any untowards suture removal
*Advised
*Thank You
Suture Choice:
Nylon 4.0 and 5.0- Face or less muscular area
Nylon 3.0-Extremeties
Suture Removal:
COMMONLY USED TERMS/ PHRASES/ SYMBOLS IN INTERNSHIP Face: 3-5 days
*Physical Examination Extremeties 7-10 days
AS-Anicteric Sclerae
PC-Pinkish Conjunctiva
CLADS-Cervical Lymphadenopathy
SCE-Symmetrical Chest Expansion
CBS-Clear Breath Sounds
AP-Adynamic
RCRR-Regular Precordium
Cardiac Rate and Rhythm *Animal
required) Bite(only dogs and cats- if rodents NO HRIG or verorab
NVE-Neck vein Engorgement Plans:
*For Xray of ___, ___ view
*Internal Examination *TT 0.5ml/amp via deep IM now
I-Introitus (Admits 2 fingers) *HTIG 250IU/Amp via deep IM now
C-Cervix (Smooth, soft) *HRIG 300IU/amp (dosage), ½ to be infiltrated
U-Uterus (level of umbilicus/symphysis pubis) surrounding the bite site; ½ via deep IM
A-Adnexa (No adnexal mass nor tenderness) *Verorab 0.5ml/amp via deep IM now, then on Day 3, 7, 14, 28
D-Discharges (Minimal bloody discharge) *Patient opted for HRIG injection at WVMC(very expensive)
E-Episiotomy( well-coaptated episiotomy site *Sultamicillin tosylate (dosage) BID x7 days
*FF. Up Official Xray result after 3 days
*Digital Rectal Exam *Watch out for any untowards S/Sx
No external mass *Advised
No internal masses/haemorrhoids *Thank You
No tenderness
No
No discharges
blood/Minimal fecal material Rabies Immunoglobulin dosage:
HRIG: 20IU/kg
ERIG: 40IU/kg
MURMUR GRADING
*Burns
I So faint
Plans:
*TT 0.5ml/amp via deep IM now II Quiet but can be heard by stethoscope
*HTIG 250IU/Amp via deep IM now III Loud
*Silver Sulfadiazine ointment apply thinly/thickly to affected IV Moderately loud with thrill
area V Very loud, audible with stet partly off
*Cefalexin(dosage) TID x7days
the chest
*Daily dresseing
*Daily Wound Care
VI Very loud, audible with stet removed
*Watch out for any untowards S/sx from the chest
*Advised
*Cellulitis
Plans:
*TT 0.5ml/amp via deep IM now(situational)
*HTIG 250IU/Amp via deep IM now(situational)
*Sultamicillin (dosage) BID x7 days
*Daily wound care
*Watch out for any untowards S/Sx
*Advised
*Pregabalin 75mg/cap(neuropathic)
*Xray___ view, (with hx of fall)
FF up official Xray result after 3 days
TCB with untowards S/Sx
Advised
GRADING OF MURMURS
1 –
– Faint
Faint
2 –
– Audible
Audible
3 –
– Moderately
Moderately Loud
4 –
– Loud
Loud with palpable thrill
5 –
– Loud
Loud with thrill, stet partially off
6 –
– Loud
Loud with thrill, w/o stet
MUSCLE STRENGTH
O –
– No
No muscular contraction
1 –
– Trace
Trace contraction
contraction
2 –
– Active
Active movement with gravity eliminated
3 –
– Active
Active movement against gravity
4 –
– Active
Active movement against gravity & slight resistance
5 –
– Against
Against full resistance