Definition • Severe hypertension = persistent elevated SBP >180 mmHg and/or DBP >110 mmHg • Hypertensive crises — Hypertensive urgency / Hypertensive emergency• Hypertensive urgency = Severe HTN + grade III or IV retinal changes; without acute target organ damage • Hypertensive emergency = + acute • Resistant hypertension = Uncontrolled HTN (>140/90 mmHg) with […]
Housekeeping • HO attempt for branula insertion / blood taking maximum is only 2. If unsuccessful, get help from MO (not another senior HO) Some Differences between Paediatric VS Adult Patients
STEP 1: Comorbidities • Ask about underlying medical illness(es) and the follow up. Which clinic, which hospital, government or private? • Previous history of admission(s) and why• Any recent admission? • List down all current medications correctly • How is the patient before this current illness sets in?• Social history • Is patient still working? […]
Original Logbook (i) Major Postings • Medical• O&G• Orthopaedics• Paediatrics• Surgical (ii) Elective Postings • Anaesthesiology• Primary Care• Psychiatry• Emergency Medicine Pandemic Logbook (i) Major Postings • Medical• O&G• Orthopaedics• Paediatrics• Surgical (ii) Elective Postings • Anaesthesiology• Primary Care• Psychiatry• Emergency Medicine Source: https://www.moh.gov.my/index.php/pages/view/2927?mid=1329
Growth charts for boys Growth charts for girls
“Knowing how to insert branula is not enough. A doctor should also master chest tube insertion, as good as branula insertion” Introduction 2 methods• Open method • Closed method (do not use this method) Important parts of a chest tube • Radio-opaque tip and a marker strip along the edge• Fenestrated end (with holes for […]
Warning signs • Lethargy, restlessness• Abdominal pain — abdominal tenderness & pain • Clinical fluid accumulation — pleural effusion / ascites • Liver enlargement >2 cm • • • Laboratory findings: Severity of shock CPG CPG Management of Dengue in Children (2nd ed, 2020) Take Home Message 1. Child must be touch touched, or else […]
Evaluation of background of newly diagnosed asthma Asthma control Severity of AEBA How to write diagnosis? Severity of AEBA + underlying for current AEBA ± background of asthma ± control of asthma Example 1Severe AEBA secondary to bronchopneumonia with underlying mild persistent asthma (poorly controlled) Example 2Moderate AEBA secondary to URTI with underlying newly diagnosed […]
Clerking a new case Admission ClerkingName + Gender Any underlying medical illness Any food / drug allergy Date of admission: ____Day __ of illness ===== Underlying Medical Illness1. ____2. ____ ===== Previous Hospitalizations1. ___2. ___ ===== History of Presenting Illness (HOPI) Any ? Any closed contact with COVID 19? Any recent traveling? – History of […]
Components of Neonatal Review in General ===== AgeGravidity + Parity + Gestational week HIV statusVDRL status ANC =====(Summary of) Birth History =====PROGRESS – Any fever / temperature instability?– Tolerating feeding? – Any vomiting? – – Other relevant questions to ask / check Examination findings =====PLANVentilation Feeding / Fluids Medications: Investigations: Other: Your Name & MMC […]