ULTIMATE GUIDE IN PEDIA

I hope this helps

C 2015
Types of Rotations
Pre 7:00am 5:00pm
Duty 7:00am 7:00am (the next day) or 8:00am if my
con
Post your day off
No duty on Sundays except sa mga duty and Saturdays half day for Pre
people
FABELLA wear Uniform (bring White Scrubs) and go
straight to Fabella coz dun na attendance nio (7/8:00am
5:00pm everyday kahit Sunday)

C 2015
C 2015
 DISCLAIMER ->the ultimate guide to everyday pedia life but ung time hnd
constant sa lhat except sa conference schedules

GRANDROUNDS to be presented by the Jis of the ward and/or the

residents ultimate prepare -> give the protocol 3days before to the CIC
meaning you need to ask the RIC check it before 3days

CASE CONFERENCE/AUDIT discussion of the admitted

patients
1. AUDIT done only by residents
-sometimes consultant ask JIs opinions or something. Just be read if
your name is called
2. Case Conference JIs discuss the cases

ER CONFERENCE for ER people only (the OPD people na duty sa

ER)
C 2015
Ward people do nothing here but listen and be prompt
 ADMISSION CON all NEW admissions are to be
discussed. No need for powerpoint. Person incharged = JI IC (they
said its 9am-9pm admissions but we also ask the JIs with all admission
the day before to prepare pra hnd cla mabigla or something once
called all from MGH if they dont have admissions)

NUTRI CON is like GI lecture. The group of reporters will

be chosen or assigned -> be creative

Dr. Ongs ward prepare all those who has doc remedios ongs
patients -> if you dont have an ong patient, you may still listen
as long as you are not doing something more important (same
goes to other consultants -> be polite)

C 2015
 POWEPOINT TO BE PRESENTED USING THE TEMPLATE GIVEN:
Major: (the cases to be assigned to some may be or may NOT be their own
patients)
1. HEMA CON case to be chosen by the residents (dapat maganda journal)
2. CARDIO CON case to be chosen by the residents, if no patient with
cardio case then, the resident shall give you a theoretical case
3. NEPHRO CON - case to be chosen by the residents or the fellows
Minor: ( but treat as major coz they basically have the same weight)
1. CLINICO-RADIO same format and the radiographs will be discussed
by the radio resident (more often that not) -> ask help from radiology
department and invite them 3 days before (give them a protocol as well)
2. PHARMA CON random so everyone should be prepared (kung ano dw
feel ni doc Llamas) -> focus on the drugs given to the patient [why that
drug was given? Mechanism of action? Side effects? Drug interactions? ->
leader must prepare a list (3-5copies every time) C 2015
Who will attend
EVERYONE must attend the GRANDROUNDS and AUDIT
-> EVERYONE MEANS EVERYONE

All other cons, those who are involved only or when asked to attend
for those nicu or outside rotators or from

C 2015
SAMPLE

C 2015
C 2015
SAME EXAM SCHEDULE

C 2015
Bedside Rounds learning opportunities or sometimes, residents
will give you a random quiz

LECTURES:
Dr. DeeChan Nephro (listen coz its useful)
Dr. Benito Neuro (it didnt happen to us -> 3months ng hnd, but
still try coz it was said to be awesome -> as the neuro-psych
residents)

ROOM COMMONLY IN THE CONFERENCE ROOM 2C ung

daan nsa my CD Chapel

C 2015
ER Admission Process
All ER stuffs done by the ER Duty People (always have their
number or my isang taong assigned na itetext nla sa group
who will notify the ward on deck pra bumaba sa ER)

DISCLAIMER:
This is just a guide but it might confuse you one way or the
other.You might not get it right away because you will really
understand it once we do it ourselves. Nonetheless, ganito:

C 2015
 How to Admit a Patient 101

New form will be given

Go to the ER desk and to you to be filled out by
proceed to the desk near the patients family (PS:
Get the POS from the
the ATM machines in the assist the px)
ER
CD (near the OPD and you will also need to fill
canteen) out the medical abstract
part (kahit partially)

C 2015
 How to Admit a Patient 101

Go to the Social The receptionist will

Give the form from
Service Office with furnish a printed file
the Social Services to
the Patients Family to and ask the family to
the reception (near
let them sign the validate and certify
the ATM machines,
form (across the Pedia that the data are
OPD and canteen)
OPD ) correct

C 2015
 How to Admit a Patient 101

Accompany the The admissions will

relative to the Show the receipt to give you papers and
cashier to pay a the admissions the patient band ->
deposit (P1,000.00) then back to the ER

C 2015
 How to Admit a Patient 101

Patient is now ready to If not stable, stay in the

be admitted (admit the ER with the patient to
patient to the ward if do history, PE and
stable.) accomplish paper works

C 2015
Admitting a patient
is not a uniform thing and something may arise deviate of the
norm or something -> just be ready and always have
presence of mind

For direct admissions -> they will still pass the ER but there
will be no ER form so they will no pay anymore. But they
will be there for the POS (if not done in the OPD for OPD-
>admission) and/or IV line insertion

C 2015
 Paper Works:
1. JI Worksheet -> to be signed by the ER doctor (as early as you
can)
2. White Notes -> to be placed in the patients chart and
dropped at the cabinet thing inside the resident quarters within
24hours (w/ or w/o residents signature)
Medical Abstract -> part of the group of papers to be given to
you once you are admitting a patient -> fill up the first page only
(the continuation actually is the printed file w/c you update)
Discharge Summary or Medical Abstract update as often as
possible para ready ka na once the patient is off for discharge
(includes the course in the ward, lab results, meds everything)

AKA THE TOXIC STUFFS C 2015

Medj Irrita and Swerte Moments
Patient has DAMA (Discharged against medical advice wla
ka ng gagawin since hnd ngpa-admit) -> sad part, they may
not be accepted again
-> if admitted and ngDAMA -> you will not provide them
with their papers but still complete them for the record

Patient already got up to the ward or naka-admit na then:

Nagdecide na magpadischarge -> kelangan mo matapos lahat ng
papers nia until the medical abstract
Nagdecide na magpatransfer sa PAY -> finish all din

C 2015
JI Worksheet

C 2015
Pediatric Health Form
To be accomplished within 24hours
Looks like an initial pediatric form of the OPD but more
tedious
7 pages

C 2015
C 2015
C 2015
C 2015
Monitoring Sheet
Get a copy from the nurse station once the patient goes to
the ward

C 2015
C 2015
POS (Physicians Order Sheet)
To be filled out by doctors only
Ito ung colored red

C 2015
Medical Abstract

C 2015
Request Forms
Laboratory forms
Radiological Procedures
ECG etc

C 2015
Once the patients admitted
Get the monitoring sheet and supply it with normal values:
BP percentiles
Respiratory Rate
Cardiac / Pulse Rate
Prepare the index card of the patient (use the color indicated
for the CIC)
Write down the details of the patient in the white broad and
make sure to include the endorsement like prebreakfast
weight, vital sign schedule etc

C 2015
DISCHARGE
Ask the relative to buy 2 SHORT BROWN ENVELOPES

With envelope:
-Patient file
1. Cover for the envelope
2. Medical Abstract
3. Clinical Abstract (if they ask for it for PCSO or financial concerns -
> notify your resident once they ask for it)
4. Laboratory Worksheet

C 2015
DISCHARGE
Ask the relative to buy 2 SHORT BROWN ENVELOPES

With envelope:
-Resident-in-Charge
1. Cover for the envelope
2. Medical Abstract
3. Clinical Abstract (if they ask for it for PCSO or financial concerns -
> notify your resident once they ask for it)
4. Laboratory Worksheet
5. White Notes

Without envelope:
-Chart same as RIC copy C 2015
Reminders
Email all files of discharged patients to the RIC -> ASAP so you
wont forget
Ask the RIC to check the papers first before you print them or
print in a scratch first or let them borrow your laptop -> as the
case may be
Please maintain cleanliness in the quarters

C 2015
What to bring
Medicine bag
Preferably with OTOSCOPE (1-2per group is okay)
PEDIA CUFF and ADULT CUFF -> preferably
individual as well

C 2015
 Fabella Rotation
Rotation starts at 8:00am and ends at 5:00PM -> wear complete
uniform
You dont need to do courtesy call every time but that would be nice
If you will be absent or will attend a con or have an exam, prepare to
submit the letter before hand if you cannot as early as you can -> its
courtesy and mabait nmn cla, let us not abuse that.
What to bring:
WHITE SCRUBS
OR SLIPPERS -> may not be white
Cap and mask (girls, tie your hair)
Stetoscope
Correction Tape and Black Ballpen +/- clipboard
No jewelry as much as possible -> watch & valuables = pocket for safety
C 2015
 Fabella Rotation
WHAT MUST I KNOW:
Locate the NICU Conference Room (this is their quarters and it aint a
conference room but named as so)
There is a log book for you to sign in and out everyday before you proceed
to your post
Either in the ward to do PE (babies delivered in WARD 2 or 3) -> do this fast coz the
fellows are fast -> check for good cry, suck, jaudice, murmur, abdomen, and ask for
urination or bowel movement etc -> THIS ROTATION IS FOR AM ONLY AND
AFTER,YOU NEED TO GO TO THE DELIVERY ROOM
YOU WILL ALSO BE THE RUNNER TO FOLLOW-UP LAB RESULTS (there is a
folder in the NICU)
NICU -> super fun here. Do history to the mother even while in labor -> seems weird
but yes, you need to coz minsan q10mins ung NSD and simultaneous with CS (just do
decking)
C 2015
 Fabella Rotation
WHAT MUST I KNOW:
NICU
History:
NSD you just ask the mother
CS copy the ones in the chart but be polite to ask for it or borrow it from the nurse
in the OR or the Anes -> if it aint complete, ask the mother once she is in the
recovery room na -> assess naman is she is stable na and ready to answer your
questions
PREPARE THE CHARTS ARE PROMPT AS YOU CAN COZ EVERYONE WILL
NEED THAT
After delivery
Do APGAR
Then check the log book of anthropometrics and copy it in the chart ones meron na
and supply all the pages which the fellows will tell you to supply -> medyo mahirap
iexplain but youll learn it once you see it
C 2015
 Fabella Rotation
WHAT MUST I KNOW:
NICU
After delivery
Once you are done, check for the babies in the NICU -> if your baby is
there na, do Ballards (for the first-timers, they will show you and then
the next one you will do it together or they will allow you to do it
yourself and they will teach you->depende)
Then plot and complete the other blanks and give the chart to the
fellow
*For NICU Admissions, NICU Transient, etc -> you need to log them in
the respective logbooks update this coz sometimes others dont and I
had an experience of writing almost everything for more than a month
plus toxic dn talga.
C 2015
 Fabella Rotation
WHAT MUST I KNOW:
NICU
FOR CS
One JI must go with the fellow in the OR and ALWAYS BRING THE
TACKLE BOX (the one with ET tube in it) and prepare the suction
thing

ALWAYS BE AWARE OF THE BABY OUT TIME

Notify the fellow as well if the mom is Hep B positive or something for
precautions

PS: you will also learn a lot and its a whole new world. Hahaha
Observe the procedures coz ET tube insertion is just occurring left and
right
Observe the patients. Have initiative. C 2015
 NICU Rotation
WHAT MUST I KNOW:
1 or 2 per day
DUTY change into your WHITE SCRUBS, mask, cap and
slippers -> you cannot leave the ward as much as possible
PRE RUNNERS or change to scrubs and IRON the linens
-> thermoregulation of the baby

NO CATCH -> REPEAT ROTATION

C 2015
 NICU Rotation
History
do history to the mother before CS delivery or while she is still in labor
or you may ask the OB JI. Please do this fast coz some OB-Gyne residents
dont want you to be there coz medyo abala daw or the mom cannot focus
-> this is a more tedious history than the fabella thing
After delivery -> do EINC
Thoroughly dry the baby and assess -> do APGAR -> if no cry, stimulate
Put the baby in the mother and the linen in his or her back
The baby is q15 for the first hour and then q30
Do Ballards after and all the newborn care stuff

C 2015
 NICU Rotation
PAPERS
Medical Abstract all patients for discharge (update)
Milk Abstract if asked
White Notes only if the baby will be referred
Laboratory sheet if there are labs

* You have a different schedule in the NICU as well as different

set of conferences

C 2015
 Good Luck and Enjoy