` Department : PICU Date: January 01/02 /2023 sunday

Bed NO. Patient Data Diagnosis / Active Problems Management Follow Up

Res:
10 years old medically free - RA ,face mask - Hold 6 am dose of
Name: Came with hx of urti for 6 days then - pulmicort 500 mic neb q 12 hr vancomycin
Jumana fever for 3 days - - recontact ID
Abdullah regarding ABX
Patient admitted to PICU as a case of choice
Age: BPN with Allergic reaction to ID: - For cbc , chemistry
10 yr- 7 m Cephalosporins (Ceftrixone) - clindamycin 400 mg IV q 8 hr (d/c) , crp , blood culture
- ciprofloxacine 300 mg IV q 8 hr (d/c) chest xray morning
Active Issue : - amikacin 155 mg IV q 8 hr (d/c)
- vancomycin
1
1-Shifted from step down yesterday - imipenem
xray showed pleural effusion - tamiflu 60 mg PO BID
2- during the oncall she developed
allergic reaction to vancomycin 1-2 Git:
hours after insuion . - IVF D5% NS at rate of 35 ml/hour (1/2 m)
- Diphenhydramine 30 mg po Q8H PRN
Took stat hydrocort 100mg IV
Diphenhydramine 30 mg IV
Ventolin nebs

3- fever spike 39.9 12 am

2 CNS:
5 months old boy ,Product of SVD, FT,
NAME Hx of NICU Admission for 1 week in
SANAD KFAH as RD , diagnosed with CHD no
795438 report , not intubated
Presented to our ER with hx of cough ,
SOB and fever for 3 days .
AGE:
5M # Admitted as case of Acute
Broncholitis with CHD
- Impaired LVF, ( early DCM),closing
VSD,PFOEF46-49%.>>ECHO  60 
49%
- Fentanyl infusion = 0.8 ML/HR KEEP PATIENT NPO AT
- Midazolam infusion = 2 ML/HR 6:00 AM FOR POSSIBLE
- Ketamine infusion = 2.5 ML/HR EXTUBATION
- Precedex infusion = 1.4 ML/HR
IVF D5NS - TFI 30 ml/hr
RESP:
- decarse PEEP to 6 , PS to 7 , PIP to 14
- Salbutamole 0.5 ml + 3 ml NS neb Q4H
- Pulmicort 250 mic neb Q12H
- Normal saline nasal drops Q4H
- dexamethazone 2 mg IV q 6 hr
- CXR Tmw
- VBG OD

CVS:
- milirinone off
Page 1 of 10
Active issue : UOP +300 took stat lasix
stat - start lasix infusion 1.3 ml/hr ( 0.2 mg/kg/hr)
d/c calcium gluconate - Captobril 1.3 mg Po Q8H
- follow up with Cardiology today

GIT:
- TFI 30 ml/hr
- Strict input/output chart
- NGT feeding 85 ml q3h
- Omeprazole 7 mg IV OD
- Blood Suger Q6H
- Chemistry OD
- CBC Twice/ week

ID:
- off antibiotics

Page 2 of 10
 Name: - D/c dexa if not
Yazan needed
796540 - If spiked again go
CNS:
PSS
- Only Ketamine 1ml/hr
Age: 10 years k/c/o SCD , G6PD, not - - f/u vanco level
RES:
10 year foujhllowing up present to ER with - If tolerating oral
- extubated to HFNC , tolerating
3 Cough and fever for 2 Days intake change rate
- Salbutamol 0.5ML + 3 ML NS nebs Q4H
of IVF
- Xray Daily
#Admitted as Case of SCD with Fever - For daily cbc and
- start dexamethazone 6 mg IV q 6 hr
and ACS and hemolysis retics
GIT:
- Finshed 10 cycles of blood exchange
- TFI 70ml/hr all included
27/1/2023
- feeding : started soft diet
- paracetamol 240mg po Q4H.
-#Active Issues :
- IBUPROFEN 360mg po Q6H
- ACS : extubated yesterday
- bradycardia : resolved
ID:
- Fever one spike 39 at 1 am
- Vancomycin 360 mg Iv Q6H
- biltaeral leg pain improving with
- imipenine 500 mg Q6hours .
paracetamol reguler
- Azythromycin 240 mg po OD
- no ibuprofen available
HEM:
- last HB 30/1 8.5

Page 3 of 10
 CNS:
- Midazolam 0.4 mg IV PRN
4 NAME -Precedex 0.2ML+198 ML NS Rate: 0.8ML/HR
SULTAN ( 0.2MIC/KG/HR)
795400
CVS:
3 month old , Ft, NICU for 3 week (?TTN - for ECHO today
on CPAP for 1 week)
Res:
AGE # Admitted as a case of recurrent chest -HFNC Flow: 8 Fio2:50
3M infection for investigation - Cardiopulmonary monitor -to send Bronchoscopy
- resolved Pneumothorax was on right - 3% NACL 3 ml nebulizer q4 hr referral to rule out
chest tube removed 2/1/2023 - Salbutamol 0.3ml+3ml normal saline nebs q4hrs Tracheomalacia
- VBG PRN - NPO for smalle feeds
UPDATE : now on room air 95%, he - pulmcort 125 mic + 3 ml ns nebz q8h - f/u cultures
desated once 88% and was on nasal
canula 0.5ml GIT:
- Full feeding
# Active Issue - omeprazole 6 mg PO OD
RD - send chmiestry today
- For Gastrographine study today
- IVF D5% normal saline at rate 19 ml/hr

ID:
- No Abx, cultures negative
- home care referal

5 - CNS : - Consider Cardiology

2 years old girl, known case of ,mild - Midazolam ( 4mcg/kg/min) = 5ml/hr consultation to rule out IE
Name: muscular VSD, milk allergy, came from - Ketamine ( 5 mcg/kg/min) = 5 ml/hr - Consider Immunology
Shorouk Althaghar hospital as a life saving - Fentanyl ( 4 mcg/kg/hr )= 5ml/hr consultation to rule out
789746 presented with Hx of fever and SOB for - Midazolam 1 mg PRN (if systolic SBP more than immunodefincy
1 day 80)
Page 4 of 10

Age: patient came from Althaghar hospital as
1 yr 11m a life saving patient in respiratory
distress RR was 60 SPO2 65% in room
air and 93 % on 15 L NRM
chest x-ray: right side lung collapse
# Admissted as a case of :
- sever respiratory distress and
- bronchopneumnia , intubated
24/1/2023 at 9 pm .
Active issue :
- Low blood pressure 74/43 , HR 114 , on
dopamine
- Respiratoty distress on high frequency
ventalation
Active Issue : respiratory alkalosis
Vbg at 9 pm bicarb , held 6 am dose of
lasix and to repat vbg
Page 5 of 10
- Rocrunium 8 mg IV PRN Q6hours Chest xray , chemitrsy
CVS :
- Dopimine infusion 1 ml/h
- milirlinone 1.6 ml/hr
- furosamide 5 mg IV q 12 hr
RES:
- on High Frequency ventilation
- Frequency 9 ampiltude 44 MAP 17 Fio2 60%
- methylprednsolone 5 mg IV q 8 hr
- VBG q8h
- Daily Chest X-ray
GIT :
- TFI : 42ml/hr including all medication
- Strict input output chart
- IVF D5% 1/2 NS + potassium chloride 30meq/
500 ml = Rate 23 ml/hr
- Start NGT feeding 10ml Q 3hours by neocate
formula
- omeprazole 10mg iv od
- CBC and Chemistry Daily
ID :
- imipenum 200 mg IV q 6 hr
- vancomycin 200 mg IV Q8h
- Tamiflu 30 mg po BID

2 year and 4 month old girl
known case of: developmental delay
(motor and mental) / seizure disorder
NAME: since 10 months on Keppra
Lara presented to ER with hx of cyanosis ,
787387 fever and shortness of breath for 1 day
AGE: # admitted as a case of:
2Y - respiratory distress with chest
infection on Trachiostomy
- Chronic Patient
# active issue :
6 - fever
- eye infection
Page 6 of 10
CNS:
- keppra 320 mg NGT BID ( 60 mg/kg/day )
- carbamazepine 130 mg PO q12h
- Phebobrarbital 25 mg PO/NGT Q12H (
5mg/kg/day )
- Midazolam ( 1 MICOGRAM/KG/MIN) = 1 ML/HR
- Diazepam 2.7 mg IV PRN F/U PSS
Resp:
- Cradiopulmonary monitor
- Chest Physiotherapy
- left side up position
- M.VP-SIMV mode PEEP: 6 , FiO2: 50% rate 20
DELTA PIP 10 D- PS 8
- Salbutamol 0.5ml + 3ml NS nebs q4h
- glycopyrrolate 0.115 mg IV q8h (115 mic IV q8h)
GI/GU:
- Omeprazole 10 mg PO/NGT OD
- Feeding 60 ml q3h
- Paracetamole 160 mg IV Q6H PRN
ID:
-Discontinue Amikacin
-Gentamyin eye drops 1 drop q8hrs
-Levofloxacillin 90mg IV Q12hr BID
(10mg/kg/dose)
 CNS:
- Midazolam (3mcg/kg/min) = 4ml/hr
- Fentanyl ( 3mcg/kg/hr )= 3ml/hr
- PRECEDEX (0.2 MIC/KG/HR) =1.6 ML/HR
- PRN ketamin 8mg IV Q4hours
NAME :
Moaz al fefe
796411 RESP :
2 years and 7 month old , baby boy , he - HFVO frequency 8 , fio2 50 % amplitude 35 ,
Age : was a product of FT , C/S due to MAP18
2 y -9 m previous C/S , no NICU admission - salbutamol 0.5 ml + 3 ml normal saline neb
according to his mother but he has Q2hours
regular follow up at KFMH, follow up - VBG Q8 hours
7
with neurology and genatic becouse he - daily chest xray
has dismorphic feature but still no clear
diagnosis CVS:
K/C: of bronchial asthma on salbutamol - hydralazine (0.2 mg /kg/dose) = 1.6 mg IV PRN 4
nebulizer PRN hurly if BP >130/80
vaccinated - Furosamide 0.5 mg/kg/dose q6H = 4 mg IV q 6 hr
- f/u chem , chest xray ,
- for nephrolohy counsaltaion (Done) to follow the
cultures
admitted as BA exacerbation with recommendations
Accpetable PH 7.25
bronchopneumonia
Accpetable spo2 88%
GIT:
Active issue : - TFI 60 ml/hr
- labs taken at 31/1/2023 at 1830h is not - start NGT feeding 5ml Q3hours
correct and was mixed with another - omeprazol 9 mg IV OD
patient , so please cancel it - IVF D5% Normal Saline at rate of 60ml/hr
- Albumin 8 GM IV infusion over 10 hours with
- Hyper natremia 164 ,IVF Lasix 8mg IV Mid transfusion, Monitor BP during
changed to 1/4 NS 31/1 transfusion
- AKI : improving BUN 39 -> 36
- Creat worsen : 2.1 -> 2.34 Hematology:-
- Metabolic/resp acidosis - Vitamin K 2mg IV OD for 3 days
- FFP 80ML IV over 30 minutes (10ML/KG)
- PRBC 120ML IV OVER 3 HOURS (15ML/kg)
- RBS q 6 hr
- chmiestetry q 12 hr
- dially CBC and coagulation profile

ID :
- imipenem 160 mg Q 12 hours

Page 7 of 10
 CNS:-
Name: 10 y/o old boy, k/c sanjid sakati and BA -Midazolam 0.8mg IV PRN
Abdullah present with 3 days sob, cough, and -Ketamine 8mg IV PRN
Abdulaziz subjective fever, recived antibiotics
749903 CEFIXIME 2 days CVS:- - f/u labs
-for Echo f/u sensitivity of tracheal
Age: # admited as case case of aspirate
11 year Bronchopneumonia with RD Resp:-
-SIMV Rate: 20 PS:12 PEEP:5 Fio2: 50%
# active issue -Salbutamol 2 PUFFS Q3H
tracheal aspirate : heavy growth of -3% Sodium Chloride 3ml nebs q6hrs
candida - fluconazole 24 mg IV OD for
total 14 days GI/GU:-
8
- IVF D5 Normal saline at rate of 33ml/hr + KCL 20
Meq/L
-feeding 10ml q3hrs with 5ml increment q8hr till
reaching full feeds 100ml q3hrs (with IVF
Adjusement accordingly)
-Omeprazole 8mg IV OD
-Clacium Globulonate 6MMOL PO BID
-1 Alpha drops 6 drops PO OD

ID:-
- Ceftazidim 400mg IV Q8hrs
- Clindamycin 40mg IV Q8hrs
MRSA : negative

Page 8 of 10
Bed NO. Patient Data Diagnosis / Active Problems Management Follow Up

NAME :
Mada CNS:-
Mohammed - precedex 0.2ml+19.8 ml normal slaine rate: 1.6
Rabie ml/hr ( 0.2mic/kg/hr)

786287 CVS:-
- keep on cardiorespiratory monitring
Age :
2 y -2m Resp:-
Mada is 2 years and 2 month old, saudi - Keep SpO2 > 94
girl. K/C of Myasthenia gravis diagnosed - Suction and CPT Q4H
by WES on 23/12/2022 - HFNC flow 14 L/min, FiO2: 60%
F/U with several hospitals and - Space salbutamol 0.5 ml+3 ml normal slaine neb
multispecialties. q4h
9 presented to our ER with hx of cough - ipratrobium promide 250 mcg neb q4h
and SOB for 1 day - normal slaine nasal dropsm q4h
- 3% sodium chloride 3 ml neb Q4H
Admitted as a case of Pnumonia - methylpredinsolone 4 mg IV q 6 hr

D2 Post admission GI/GU

- feeding 5 ml q 3 hr
-Omeprazole 10mg IV OD
-IVF D5 Normal saline at rate of 33ml/hr + KCL 20
Meq/L

ID:-
- vancomycin 120 mg IV q 6 hr
- Cefepime 400mg IV Q12hr (100mg/kg/day)

5 yrs old palestinian girl mediacally free Out of DKA

Name: came to er Started feeding 12 am -check BG pre meals ,4
Aseel hx of ltered level of counsclousness for 1 As per endocirne dr areej hours post meal ,bed time
Abdulrahman day TDD: 0.5 UNITS/KG/DAy and 3 am
Mohammed tacypnea Kg: 16 kg -send lab for TFT,vit
Alyamane hx of fever ISF:250
Page 9 of 10 D ,celiac profile ,
ICR:15 g chemistry tomorrow at 8
10
intial : Glargine : 4 units sc OD am
rbs 478 Novorapid To be given pre meals Diabetic diet
vbg ph 6.8 Diabetic educator
Page 10 of 10