P e d i a t r i c s |1
P e d i a t r i c s |2
ADMITTING ORDERS
Neonatology
NICU
Please admit under RI, LI, PD or AP
TPR q4H
May breastfeed if NSD; NPO x 2hrs if CS
Labs:
NBS at 24 hrs old, secure consent
CBC, BT (if w/ maternal illness, PROM or UTI
HGT now then 1, 3, 6, 12, 24, 48 hrs old (GDM)
HGT now (SGA or LGA)
Medications:
Erythromycin eye ointment both eyes
Vit K 1 mg IM (term); 0.5 mg (PT)
Hep B vaccine 0.5 ml IM, secure consent
BCG 0.05 ml ID (PT); 0.1 ml (term), secure onsent
SO
Routine NB care
Monitor VS q30 mins until stable
Thermoregulate at 36.5 to 37.5C
Place under droplight (NSD); isolette (CS)
ADMITTING ORDERS
Suction secretion prn
Will infrom AP /AP attended delivery
P e d i a t r i c s |3
Neurology
FEBRILE SEIZURE
Please admit under the service of Dr.
TPR q4H and record
DAT once fully awake
Labs:
CBC
U/A (MSCC)
IVF:
D5 0.3 NaCl 1P (50cc/kg in 8 h if <2 yo)
D5 0.3 NaCl 1L (30cc/kg in 8 h if >2 yo)
D5LR 1L at 30cc/kg in 8hif >40 kg
Medications:
Paracetamol prn q4h for T > 37.8C
SO:
MIO q shift and record
Monitor VS q2h and record
Monitor neurovital signs q4h and record
Continue TSB for fever
Seizure precaution at bedside as ff:
Suction machine at bedside
O2 with functional gauge; if with active sz give O2
at 2lpm via NC
ADMITTING ORDERS
Diazepam IVTT (0.3 mkd max of 5 mg IV) prn for sze
Will inform AP
Pls inform Dr _____ of this admission
Thank you.
P e d i a t r i c s |4
Pre Lumbar Tap
NPO
RBS by gluco prior to lumbar tap
Prepare lumbar tap set
2% Lidocaine # 1
G 23 spinal needle
Mannitol 250 cc 1 bottle - do not open
Solvent
Diazepam 1 amp
3cc syringe #2
2 manometers
sterile bottles # 3
sterile gloves # 2
Sterile gauze # 1
Sterile gauze w/ Betadine #1
Sterile towel w/ hole #1
Sterile clamp #1
3-way stopcock #1
Post Lumbar Tap
NPO x 4H
Flat on bed
Monitor NVS to include BP q 30mins x 4H, then qH
CSF exams
Bottle # 1 Gm stain, AFB, India ink, KOH
ADMITTING ORDERS
Bottle # 2 Cell count, CHON, Sugar
Bottle # 3 C/S, save remaining specimen
Watch out for vomiting, HA and hypotension
P e d i a t r i c s |5
Pulmonology
BRONCHIAL ASTHMA
Please admit under the service of Dr. _________
TPR q4H and record
NPO if dyspneic
Labs:
CBC CXR APL*
ABG* U/A (MSCC)
IVF:
D5 0.3 NaCl 1P (50cc/kg in 8 h if <2 yo)
D5 0.3 NaCl 1L (30cc/kg in 8 h if >2 yo)
D5LR 1L at 30cc/kg in 8hif >40 kg
Medications:
Paracetamol prn q4h for T > 37.8C (10 15 mkdose)
USN with Salbutamol or Salbu+Ipratropium neb; 1 neb x
3 doses
Incorporate Budesonide 10 mkd LD (max 200mg IV);
then 5mkd q6h IV (max of 100 mg IV)
Ranitidine IVTT at 1mkdose (if on NPO)
SO:
MIO q shift and record
Monitor VS q2h and record
Refer for persistence of tachypnea, alar flaring and
retractions
O2 at 2 lpm via NC, refer for desaturations <95%
ADMITTING ORDERS
Will inform AP
Pls inform Dr _____ of this admission
Thank you.
P e d i a t r i c s |6
BPN
Please admit under the service of Dr. ____________
TPR q4H and record
NPO if dyspneic
Labs:
CBC
U/A (MSCC)
ABG* CXR APL*
IVF:
D5 0.3 NaCl 1P (50cc/kg in 8 h if <2 yo) OR
D5 IMB/D5 NM at MR if with NO losses
D5 0.3 NaCl 1L (30cc/kg in 8 h if >2 yo)
D5LR 1L at 30cc/kg in 8hif >40 kg
Medications:
Paracetamol prn q4h for T > 37.8C (10 15 mkdose)
USN with Salbutamol or Salbu+Ipratropium neb; 1 neb x 3
doses then refer
NaCl (Muconase) nasal spray, 2 sprays per nostrils, then
suction using bulb QID
Ranitidine IVTT at 1mkdose (if on NPO)
SO:
MIO q shift and record
Monitor VS q2h and record
Continue TSB for fever
Refer for persistence of tachypnea, alar flaring and
retractions
O2 at 2 lpm via NC, or 6 lpm via facemask
Attach to pulse oximeter, refer for desaturations <95%
ADMITTING ORDERS
Will inform AP
Pls inform Dr _____ of this admission
Thank you.
P e d i a t r i c s |7
Gastroenterology
AGE
Please admit under the service of Dr.
TPR q4H and record
DAT once fully awake; NPO x 2hrs if with vomiting
Labs:
CBC
U/A (MSCC)
F/A (Concentration Method)
IVF:
D5 0.3 NaCl 1P (50cc/kg in 8 h if <2 yo)
D5 0.3 NaCl 1L (30cc/kg in 8 h if >2 yo)
D5LR 1L at 30cc/kg in 8hif >40 kg
Medications:
Paracetamol prn q4h for T > 37.8C
Zinc (E Zinc)
Drops 10mg/ml 1ml OD (<6 mos)
1ml BID (6 mos 2 yo)
Syrup 20 mg/5ml (>2 yo) 5ml OD
Ranitidine IVTT at 1mkdose (if with abdominal pain)
SO:
MIO q shift and record
Monitor VS q2h and record
Continue TSB for fever
Chart character, frequency and amount of GI losses
ADMITTING ORDERS
and replace w/ PLR 1L/1P vol/vol
Will inform AP
Pls inform Dr _____ of this admission
Thank you.
P e d i a t r i c s |8
Immunology
HYPERSENSITIVITY REACTION
Please admit under the service of Dr.
TPR q4H and record
Hypoallergenic diet
Labs:
CBC
U/A (MSCC)
IVF:
D5 0.3 NaCl 1P (50cc/kg in 8 h if <2 yo)
D5 0.3 NaCl 1L (30cc/kg in 8 h if >2 yo)
D5LR 1L at 30cc/kg in 8hif >40 kg
Medications:
*Epinephrine (1:1000) 0.1mg/kg/dose IM anterolateral thigh
(max of 0.3 mg)
*Salbutamol neb x 3 doses q 20 mins
Diphenhydramine 10 mkdose LD (max of 200mg IV); thenmg
IV)
5mkdose q6h IV (max of 100
Ranitidine IVTT at 1mkdose q 12h
SO:
MIO q shift and record
Monitor VS q2h and record to include BP
Continue TSB for fever
O2 at 2 lpm via NC, or 6 lpm via facemask
Attach to pulse oximeter, refer for desaturations <95%
Will inform AP
ADMITTING ORDERS
Pls inform Dr _____ of this admission
Thank you.
P e d i a t r i c s |9
Infectious Diseases
DENGUE FEVER
Please admit under the service of Dr.
TPR q4H and record
DAT ( No dark colored foods)
Labs:
CBC, Plt (optional APTT and PT)
Blood typing
U/A (MSCC)
IVF:
D5 0.3 NaCl 1P/1L (<40 kg) at 3 5 cc/kg
D5LR 1L (>40 kg) at 3 5 cc/kg
Medications:
Paracetamol prn q4h for T > 37.8C
Omeprazole 1mkdose max 40 mg IVTT OD
SO:
MIO q shift and record
Monitor VS q2h and record, to include BP
Continue TSB for fever
Refer for Hypotension, narrow pulse pressure
(<20mmHg)
Refer for signs of active bleeding like epistaxis, gum
bleeding, melena, coffee ground vomitus
ADMITTING ORDERS
Will inform AP
Pls inform Dr _____ of this admission
Thank you.
P e d i a t r i c s | 10
MEDICATIONS
ANTIBACTERIALS
CELL WALL ACTIVE ANTIBIOTICS
PENICILLINS
Amoxicillin (30 50 mkday) TID
Pediamox Susp : 250mg/5ml
Drops : 100mg/ml
Himox Cap : 250mg 500mg
Moxicillin Susp : 125mg/5ml 250mg/5ml
Harvimox Drops : 100mg/ml
Novamox
Amoxil Susp : 125mg/5ml 250mg/5ml
Cap : 250mg 500mg
Glamox Drops : 100mg/ml
Globapen
MEDICATIONS
