MUST KNOWS FOR FEU-NRMF CLERKSHIP

Disclaimer: This document is shared to you for the intention of guiding you on your tasks as you rotate in each department.
Changes regarding duty schedules are subject to change; and are under the discretion of each department.
Expect that you will looked DOWN as the lowest form in the hospital. You might have misunderstandings with other medical
staff, but its best to always extend your patience. More often, nurses would get in your nerves. While some of them are really
nice, there are, unfortunately, a bunch who would boss you around to get you to do things for them. Always keep in mind that
youre only going to be an expensive monitoring machine for a year, so just bear with it. Always try to be polite, but know when
to stand up for yourself when you know that youre right. One year will pass by quickly, trust me.
Good luck, and enjoy clerkship! Make the most out of each experience, learn as much as you can, and perform procedures to
enhance your skills. Bring a little notebook with you, notes can come in handy anytime! If you are not sure of something, you
can always ask your PGIs before consulting your residents. Im sure my batch mates would gladly teach you what they know.

SCHEDULE:
The usual schedule is duty every THREE days. However, some rotations have duties every four or
five days, sometimes even every other day.
Pre-Duty: The day before you go on duty. You go to the hospital for 8-10 hours. The tasks for pre duty
status vary per rotation.
Duty: The day you spend >24 hours * (24 hour duty is subject to change) in an institution. Example, in the base
hospital (FEU) Duty starts at 7:00 am the present day, until 7:00 am the following day.
From-Duty: The remaining hours of the day after your 24-hour tour of duty. From duty status can be
once relieved (meaning once the duty people are in, you guys could leave),or sometimes until 12 noon,
if youre lucky, usually until 4-5 in the afternoon, and sometimes, when you are really, brimming with
luck, the latest is 6-8 in the evening. (Are you counting the hours already? )
For those areas with duties every 4 or 5 days, there are statuses such as Pre(3) or Pre(2) Duty. Hours are
basically the same as those on Pre-Duty.
THINGS TO BRING:
It depends on the rotation. If you can, always bring an extra uniform or scrub suit when you are on duty.
You never know when you might need one.
Whenever youre rotating OUTSIDE, please take care of your things, esp your cardio stethoscopes,
Welch Allyn bp apps Thieves have an eye for the expensive things. Never leave your valuables
unattended. Worst case scenario: whole bag gets stolen (This happened in JR). So avoid using your
expensive bags as well when rotating outside.
Its handy to have a belt bag or sling bag with you during outside rotations so you always have your
valuables and other paraphernalia with you.
TERMS TO FAMILIARIZE YOURSELF WITH:
Status whether you are pre, duty, or from, as explained above
Inside base hospital, a.k.a. FEU
Demerit a penalty; number of hours you get for a certain offense
Merit reward; number of hours you get for getting a job done; this can make-up for your lates and
demerits
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SHO Senior House Officer who checks the attendance whenever you are in duty. Whenever you are on
DUTY inside, dont forget to sign the logbook located at the information counter in the hospital lobby.
Attendance will be checked at night (be alert for the page, or have someone text you when they hear it),
however sometimes they check attendance twice, or even thrice, so be careful not to get out-of-post!
(NCH also has a SHO).
Out of Post not being at your post regardless of status (pre, duty) This is equivalent to 5 days or (40
hours) make-up
JIOD Junior Intern On Duty: The leader of the group. This only applies to the Inside departments of
Pedia, Surgery and IM. Roles will be discussed later on.
JIIC Junior Intern In Charge of a certain service patient/s.
Ka-back a.k.a. co-JIIC / Whenever youre rotation is Ward/Servce inside, you will always have a kaback or partner for each duty day who will be responsible to take care of your service patients when
you are not within the hospital premises anymore, and likewise, you are responsible for their patients as
well
Endorsement morning discussions of what happened during the 24-hour tour of duty with residents
and consultants; you are expected to know the cases that will be endorsed
Bedside when you have to monitor patients vital signs q15 (such as BT or Chemo)
De-bulking converting toxic monitoring (q2 to q4, q1 to q2) with your residents permission (or
sometimes your own judgment, just be 100% sure that your patient is stable)
Make up The number of hours you need to cover for your lates, absences, and demerits. They can be
started once you are on your 6th month of clerkship. However there are departments that only allow
three clerks at a time to do their make-up, so reserve your make-up slot early, on the day you plan to do
your make-up.
BASIC RULES:
1.
2.
3.
4.

DO NOT FALSIFY VITAL SIGNS MONITORING

AVOID SIGNING ATTENDANCE FOR GROUPMATES/FRIENDS
NEVER LEAVE YOUR POST WITHOUT ASKING FOR PERMISSION
ALWAYS KNOW WHEN TO REFER when a patients vital signs seem to be deranged,
double-check it, refer immediately to your resident!
1. ) 5. ATTEND THE REVIEW EVERY SATURDAY as much as you can (They usually tolerate up to
two absences, but never more than that)

THE GOLDEN RULE IN CLERKSHIP: Be fair to your prime mates

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WHAT YOU MUST KNOW FOR EACH ROTATION Lets get started!
ELECTIVES
(Psych, ENT-HNS, Ophthalmology)
Psych Inside:
>Things to bring: Stethoscope, BP app, laptop, ipad, whatever gadgets can get you through the night
> Attendance: The attendance sheet is inside the IM office.
> Duty Schedule: Every 3 days (not sure if they changed it to 4) for two weeks
> Posts: Blood Bank, OPD (sometimes when the IM department gets really toxic, I heard that they used
to pull-out Psych JIs.)
>This is the most benign rotation, ever. You get to enjoy the lounge, get complete bed rest as well.
Btw, its your duty to get the water containers used for drinking refilled (just split the expenses among
your prime mates), and your duty to answer the phone inside the female JI lounge
>From status: once relieved, except when theres reporting
>Be prepared to do a complete psychiatric history and mental status exam whenever theres a service
patient referral whos under the service of Dra. Yumul.
Consultants youll meet in the OPD: Dr. Atanacio, Dr. Tan Chio-Chiong , Dra. De Castro
Psych Outside: NCMH (National Center For Mental Health)
>Things to bring: BP apparatus and stethoscope, thermometer, penlight (other PE essentials), carbon
paper, lots of bond paper, clipboard, mosquito repellant lotion, alcohol
> Environment: Its hot and humid in NCH especially in summer. Bring a portable fan if you can, and
hydrate yourself! For car parking: Arrive at least before 7:30 and youd still have a good parking spot.
They do charge a FIXED parking fee, I just cant remember how much.
> Attendance: Time in: 8:00 am General attendance is in Pavilion 1, and your respective pavilions.
> Duty schedule: Every four days (not sure if this is still the rule)for two weeks
Pre duty: 8-5pm
From status: 5pm
> Posts: ER/ACIS, Pavilions
> Other reminders: Keep track of the requirements youve passed. They usually hand out a clearance
form, accomplish it, and make sure you take a picture of it before completing your rotation (just in case
you have questionable deficiencies). You also have to take an exit exam.
Ophthalmology
>Things to bring: OPHTHALMOSCOPE! BP apparatus and stethoscope, thermometer, penlight, scrub suit,
cap and masks (if on duty)
> Attendance: 7-7:30 am attendance at the OPD
> Duty schedule: Every four days (not sure if this is still the rule) for two weeks
> Posts: OPD, ward if duty, OR, RR (So bring scrub suits but youll only get to observe)
> Other reminders: Expect a lot of patients at the OPD! Assessing each patient can take a long time
because you have to thoroughly perform visual acuity tests. Prepare for reporting. When a patient is
scheduled for OR, be there at least 30mins-1hr before the procedure.
ENT-HNS
>Things to bring: BP apparatus and stethoscope, thermometer, penlight, scrub suits, cap and mask
> Attendance: 7-7:30 am at the OPD
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> Duty schedule: Every four days (not sure if this is still the rule) for two weeks
> Posts: OPD, ward, OR, RR
> Other reminders: There would be a designated Washer at the OPD, whose task is to clean the
tongue depressors, etc and other paraphernalia used in the OPD. Grab the chance to perform an aural
toilette if allowed by your residents! Also prepare for reports. You would usually observe surgeries
performed at the OR.
*ENT-HNS residents are really, really nice and super cool! Just dont abuse them and dont be
disrespectful. They are very considerate and they really get well along with JIs. Expect an ENT vs.
OPHTHA showdown at the end of your rotation

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PEDIATRICS
Pedia Inside
>Things to bring: BP apparatus and stethoscope (PEDIA CUFFS! For baby, toddlers, school age children),
thermometer (AXILLARY), penlight, TAPE MEASURE, otoscope, ophthalmoscope, laptop, THERAPEUTIC
INDEX, CALCULATOR, name STAMP
> Attendance: STRICTLY 7:00 am at the conference room
They are very strict about coming in early, so avoid getting late! And the departments clock is around
FIFTEEN minutes earlier than the rest of the hospital so be early!
> Duty schedule: Every three days
> Posts: OPD (7 days) weekdays from 7-4pm
SERVICE: (2 weeks)
Pre-duty: 7-4pm
From duty usually goes home in the afternoon, usually after reporting
NICU (7days)
Pre duty: 7-4pm
From duty: Once relieved status
> Other reminders:
SERVICE
Assign a JIOD for each duty. JIOD duty will only include studying the admissions, discharges
during the 24 hour tour of duty. STUDY THE CASES! *Pedia endorsement is the MOST TOXIC and
UNNERVING*. During endorsement, you are expected to know everything about the patient by
HEART, starting from the history, even the laboratory results, etc. You are not allowed to have a
copy of the history with you during endorsement. Memorize everything. Be prepared for the
bed side endorsement. During De Vega rounds, the JIIC must be prepared for the endorsement
as well. He can ask basically anything, even the discharges or admissions the previous days. So
just know your patient. The department is very strict with their monitoring, so never miss a
monitoring on a patient.
Always do your SOAPing and update your paperworks.
Prepare good reports for merits.
NICU
Coordinate with your OB co-JI when asking about the maternal history. You would need that for
the endorsement. Assign a JIOD for each duty, who will also possibly endorse the next day.
Whenever Dr. Becina is around, and he asks you to touch the baby, WASH YOUR HANDS first
before anything else!
OPD
Bring complete paraphernalias for assessing patients. Examine your patients in the examining
table. Be systematic with your PE, the department is strict with their OPD charts. Do not use
abbreviations. Have someone assigned as your logger so he/she could start logging patients as
early as 2pm, or even after lunch so you could avoid going home late.
Pedia Outside
JRRMMMC (Jose R. Reyes Memorial Medical Center)
>Things to bring: BP apparatus with PEDIA CUFFS and stethoscope, thermometer, penlight, tape
measure, scissors, tape (though you could get/hoard lots of micropore from the station or ER), mosquito
repellant lotion, alcohol, SCRUB SUIT (green), MASKS always wear them!
> Environment: Its hot and humid too!
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> Attendance: 7:00 am at the pedia office (If youre going to bring a car, go in early, before 7am so you
could get a parking spot. There is no parking fee)
> Duty schedule: Every three days for two weeks
> Posts: WARD/ER for one week, OPD/NICU for one week
> Other reminders:
NICU Bring your own caps and masks. Pre-duty tasks include monitoring, and running errands
(esp when you need to go outside and you have to change back to your uniforms. Smock gowns are not
allowed). Pre duty can also be assigned to the OPD. DUTY In charge of all deliveries, and making sure
the tackle box is always complete with the necessary paraphernalia. Your cue on an ongoing delivery is a
buzzer. You also have to take the maternal history and relay it to your residents. The census is
accomplished by your PGIs. From duties can go home after endorsement.
ER/WARD Expect this rotation to be toxic and exhausting. ER post is usually from 8am-5pm.
You can go to the ward once your PGI arrives, if there are no other pending tasks or if the ER is not toxic.
Ask permission from your resident first. In the ward, you do EVERYTHING -- Monitoring, weighing all
babies, history and PE, discharge summaries and clinical abstract, extractions, insertions, ambu-bagging,
CPR, obtaining initial readings from the radio department, send specimens to the lab, etc. Do as much
procedures as you can. Pre-duties are the ones usually assigned to do the paperwork and monitoring
before they go home, so that the from-duties can rest. From duty can go home 12noon, as long as there
are no afternoon conferences.
*Whenever youre in JR, go the DOH cafeteria. The food is good yet its cheap.
NCH (National Childrens Hospital)
> Things to bring: BP apparatus with PEDIA CUFFS and stethoscope, thermometer, penlight, tape
measure, scissors, tape, mosquito repellant lotion, alcohol, SCRUB SUIT (any color), MASKS always
wear them!
> Environment: Its hot and humid in NCH especially in summer. Bring a portable fan if you can, and
hydrate yourself!
> Attendance: STRICTLY 8:00 am in the neuro ward
Pre-duty: Until 4-5pm
From status: OPD in the afternoon (during nephro, cardio, hema award)
> Duty schedule: Every three days for two weeks
> Posts: WARD
> Other reminders:
Monitoring can be toxic and tiring. Always refer to your residents for any deranged values. Get the
opportunity to do lumbar tap while in the neuro ward. Be prepared for codes. Attend lectures and
conferences. Expect reporting, and always be with your residents during bedside rounds. Parking spots
are limited in the area. Always report for sho, and you can change your into your scrub suits after SHO.

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SURGERY
Surgery Inside
>Things to bring: BP apparatus and stethoscope, thermometer, penlight, scrub suit, cap and mask
> Attendance: Time in: 7:00 am (STRICTLY)
> Duty schedule: Every three days for one month
> Posts: Pre-duty: OPD
Duty: Ward, OR, RR, ICU
> Other reminders:
For OR patients, you are expected to be at the OR an hour before the scheduled procedure. The
department is not too strict about the monitoring. Closely monitor patients for the first 24 hours after
their OR. The from-duties may go home as long as there are no assigned reporting/lectures/conferences
for the day. Be careful from being marked as out-of-post, so always ask permission from your
residents if you are allowed to go home. Two JIs are required to scrub-in an OR for a service patient.
Surgery Outside
MMC
BP app, steth, smock
gown, scrub suit any
color), jacket, pillows,
blanket, food
7:00 am at the
residents office
DUTY-FROM for one
week (From status til 12
noon)

POC
BP app, steth, scrub suit
(any color)

JR
BP app, steth, scrub suit
(green), micropore,
scissors

7:00 am at the ER
complex
DUTY FROM for one
week (From status is
once relieved)

7:00 am the ER complex

Posts

OR, ER

Other reminders

-Dont forget to claim

your meal stubs (Food
from the caf are
expensive but you can
always buy outside)
- From duties are
expected to scrub in for
ORs occurring until 12
noon
-NO MONITORING IN
THIS HOSPITAL!!!! (This

ER, (Ward only to insert

NGTs, etc), ambulance
conductions
- Move quickly! Focus
on the pertinent
examination findings on
your patient. Patients
can pile up any time
and they may come in
waves.
- Focus on NOI, TOI,
POI, DOI (Nature, Time,
Place of Injury)
- NO MONITORING!

Things to bring

Attendance
Schedule

PRE paperworks and

procedures in the ward;
ambu-bagging in the
SICU; scrubbing in the
OR (which happens
rarely)
DUTY ER complex only
FROM discharge
summaries
ER, WARD

- This is one of the most

toxic rotations. During
duty, be prepared for all
procedures
extraction, insertion,
abg, follow up of initial
radiologic findings or
laboratory results. Be
prepared to deal with
VA and burn patients in
the ER, also brace
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is relatively a benign
post except for long
hours at the OR)
-Be sure to have your
infamous rooftop
photos and with the
Lap God, Dr. KST.
-Overnight parking in
the open area near the
hospital costs Php 100
and above. The parking
fee inside the hospital is
EXTREMELY expensive!
- You are expected to
help (CPR, ambu bag)
during CODES occurring
within the ER complex.
- Dont lock yourselves
in the lounge, go out
from time to time and
help your PGIs in the
ER.

- You dont have to

worry about the food, it
is always provided by
the respective team on
duty. JIs always eat
together with residents
- For ambucons: know
the case of the patient
- You can park our car if
you arrive early,
however, slots are
limited, and there is a
parking fee.

yourself for drunk,

demanding patients
who come in for
medico-legal purposes.

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OBSTRETRICS AND GYNECOLOGY

OB Inside
>Things to bring: BP apparatus and stethoscope, thermometer, penlight, scrub suit (green), cap and
mask, TAPE MEASURE, bond paper (lots), clipboard folder with margins (1 inch on all sidesas a guide
for your histories), scrub suits, cap and mask
> Attendance: Time in: 7:00 am (STRICTLY)
> Duty schedule: Every three days for one month
> Posts: Pre-duty: OPD
Duty: Ward, OR, RR, BEDSIDE (BT, Chemo), (ICU on rare cases)
> Other reminders:
You will learn a lot from this rotation. Prepare yourself for tons of handwritten paperwork. Be
patient with the labor watch, and closely monitor all patients endorsed. Never self de-bulk your patient
monitoring. Do your paperwork immediately so they can be checked by the residents asap for quick
revision. Be prepared for the reporting, oral and written revalida. Refer asap to your residents for any
deranged vital signs. Attend lectures and endorsement, they would often check the attendance. If you
are unsure about the fetal heart tones, refer to your resident immediately! Girls tie your hair during
grand rounds!
OB Outside
Things to bring

Attendance
Schedule

Posts
Other reminders

RMC
BP apparatus and stethoscope,
thermometer, penlight, scrub suit
(any color), smock gown, cap and
mask, TAPE MEASURE
7:00 am at the ER
DUTY FROM for two weeks
FROM status 12 noon

DR/WARD/OR/ER
-No sleeping allowed during duty
hours, during wee hours in the
morning. Keep yourself awake!
-Expect mass deliveries: be quick
and be ready to do successive
insertions, extractions, catheter
insertions, and deliveries. Avoid
baby-out (babies delivered in
the bed/stretcher), this
corresponds to a demerit. Update
your vital signs monitoring and do
your labor watch meticulously.
-Be prepared for an exit exam
-You may be called as a first assist

JRMMMC
BP apparatus and stethoscope,
thermometer, penlight, scrub suit
(green), cap and mask, TAPE MEASURE
7:00 am at the DR
PRE 7-5 at the OPD
DUTY FROM for two weeks
FROM status until 12 noon unless there
are conferences in the afternoon, and be
sure to endorse to the duty residents
before going home
OPD/ER/WARD/DR
OPD: designate a JI for vital signs taking,
for abdominal girth measurement, etc.
You are only allowed to leave at 5:00
pm.
WARD: monitoring, paperwork,
extractions, ALL errands, scrub in to CS
procedures and other OR procedures
DR: deliveries, labor watch
ER: this post is toxic! History/PE of the
patient, extraction, insertion

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during emergency CS cases

-Pre duty task: Monitoring,
insertion in the ward, extractions,
discharge summaries and clinical
abstracts
From: paper works (but the preduties would usually accomplish
everything so the from duties can
take their rest)

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COMMUNITY AND FAMILY MEDICINE

Things to bring

Attendance
Schedule

Posts

Other reminders

ER
BP app, steth,
thermometer, penlight

WARD
BP app, steth,
thermometer

7:00 am CFM office, ER

logbook
Every three days (20
days)
FROM: attend morning
endorsements and
lectures, then come
back in the afternoon
for lectures
ER
OPD Pre-Duty

7:00 am CFM office

Bring your own masks

which you can use for
ambu-bagging
Your task is to do q15
monitoring, ambubagging and CPR; it is
not your task to take
the vital signs in the
triage area

COMMUNITY
BP app, steth,
thermometer,
ophthalmoscope, TD,
umbrella
7:00 am CFM office

Every four or five days (20

days)
OFF on pre duty days that
fall on a week end
FROM: must attend
lectures

7:00-5:00 am weekdays
only (20 days)

Community Vital
Signs/Triage;
Immunization; Extraction
Take note of your
immunization/extractions.
Prepare for endorsements
with Dra. Samaniego
Monitor patients (usually
two or three only)
Accompany Dr. Joves
during rounds and youll
learn a lot!

Community Patient
history, assessment
and management
Take note of all the
patients you see in the
community

This is one of the benign rotations because you get to have weekends off, and youll experience
the classroom setting again. However, it gets busy during the second month as you prepare you
papers for the community and family presentation, so manage your time wisely. Always attend Dr.
Joves lectures! You will learn a lot of basics in this rotation. Avoid loitering outside the classroom, if
you get caught you will be given an out of post! Do not get left by the bus!

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INTERNAL MEDICINE
IM Inside
Service
>Things to bring: BP apparatus , Steth, penlight, thermometer (all PE essentials including neuro bag), > >
Attendance: Time in: 7:00 am in the IM office
> Duty schedule: Every three days for one month
> Posts: Ward
Pre-Duty: q4 monitoring of respective assigned station, history until 3:00 pm, discharge
summaries and clinical abstract; prepare for possible endorsement the following day. Dont
forget to get the history youve written before going to the morning endorsement
From duty: can go home after conferences
Be present during lectures, attendance is always checked.
> Other reminders:
JIOD: patient and chart rounds, in charge of keeping the nook clean (All demerits are group
demerits, times three to the JIOD)
Monitor your patients, relay all those vital signs that need to be relayed! Refer asap when
needed.
FLOATERS: BT, chemo, q15 and q30
FOR SERVICE PATIENTS: Always know your patient and your co-JIICs patient. Accomplish
referrals on time. Always check your charts for any updates. Dont forget to do your patients
and your co-JIIC patients SOAPing. Update your discharge summaries and clinical abstract daily.
Good reports are given merits, as well as good endorsement.
Tips: DO YOUR HISTORY and PE METICULOUSLY. They give demerits for crappy morning
endorsements.
ICU/CCU
>Things to bring: BP apparatus, Steth, penlight, thermometer (all PE essentials including neuro bag),
scrub suits ICU door codes: 1214# or 1213#
> Attendance: Time in: 7:00 am in the ICU
> Duty schedule: DUTY FROM for one week
FROM status: Once relieved after endorsement
> Other reminders: Bring a laptop for paperwork needed for service patients
Avoid Dra. Yumul during endorsement. Learn as much as you can from the residents Monitor patients
q15 and relay any deranged values immediately. Prepare for morning endorsement if you have service
patient admission
OPD
>Things to bring: BP app, Steth, penlight, thermometer (all PE essentials including neuro bag)
> Attendance: Time in: 7:00 am in the IM office and OPD logbook
> Duty schedule: 7-4pm everyday for one week
> Other reminders: Prepare for reporting, learn as much as you can from your residents. If there are too
many patients, start logging early
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IM outside

Things to bring
Attendance
Schedule
Posts
Other reminders

RMC
BP app, steth, mask, thermometer,
penlight, extra uniform
7:00 am at the IM ward
DUTY-FROM for one week (From status
til 12 noon)
ER, WARD
You will do ward work (extractions,
insertion, monitoring, mannitol drips,
CTT bottle change)
FROM status: 12 noon; in charge of
discharge summaries and clinical
abstracts
ER: history, PE, prescribe medications,
do ECG
Grab the opportunity for intubation
Parking: thirty pesos FIXED rate*

EAMC
BP app, steth, mask, thermometer,
penlight, extra uniform
7:00 am at the IM office
PRE DUTY FROM for one week
WARD, ambulance conduction
WARD
- Monitoring, extractions,
discharge summaries,
clinical abstract, carry out
orders of your respective
teams (prescribe
medications, fill out
laboratory request forms)
- From status: usually 5-6pm.
You can go home once your
team is done with their
rounds are you are finished
carrying out their orders
- PHILHEALTH/CF3 forms
require a DAY by DAY
course in the ward
Parking Fee: 100 pesos for
overnight parking
Grab the opportunity for intubation
and thoracentesis

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Comprehensive Examinations
- Most questions are lifted from the lectures so attend as much lectures as you can.
- You would find it impossible, or at times hard to find time to study for the comprehensive exams
while being on duty and having something else to study about. So dont feel bad when you fail
the first exam. Chances are, youd still pass the removals exam. Just avoid taking post-promo
removals.
SOAPING FORMAT
This is only a SAMPLE format

S> Patient seen and examined on his/her ____ hospital day, (__day of illness), ___
day afebrile, with the following subjective complaints:
No or with fever, etc (other signs and symptoms)
For pedia patients: ask about bowel movement, urine output, and activity

O>
General: conscious, coherent, afebrile, not in cardio respiratory distress with the
following vital signs: BP CR RR Temp
Pink palpebral conjunctiva, anicteric sclera, no nasoaural discharge, no
tonsillopharyngeal congestion (Pedia version: *use what only applies*: normocephalic, anterior and
posterior fontanel is open/closed and measures, pink palpebral conjunctiva, white sclera, ear canal is patent with
whitish material partly occluding the canal, intact tympanic membrane, moist/dry lips, pink buccal mucosa, nonhyperemic pharyngeal walls)

Neck is supple, no neck vein engorgement, no cervicolymphandenopathy

Chest: symmetrical chest expansion, no retractions, no lagging, clear breath
sounds (Pedia version: include air entry whether good, fair or poor; be specific about the location of
retractions, whether intercostals or subcostal)

Heart: Adynamic precordium, normal rate, regular rhythm, no murmurs

Abdomen: globular/flabby/flat, normoactive bowel sounds, soft, non-tender
Extremities: no gross deformities, full and equal pulses, no cyanosis, no edema,
CRT <2 secs
Skin: no active dermatoses
*Include laboratory findings in your O.
A> Working Diagnosis
P> Diet, Diagnostics, Drugs, Disposition

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