RE:STATUS

PreStatusorOPDStatusbeinOPD,eitherSickBabyorWell
baby.7AM5PMweekdays,7AM12PMweekends.
DutyStatusbeintheER,wearSCRUBS.7AM7AMthe
nextday,unlessthereisacon,thenitis7AM8AM(waitfor
youralternates)
FromStatusdayafteryourDUTY.Mayleaveonlywhenthe
alternatesarrive.Endorseproperly.

RE:POSTS
B/NeurologygotoNeuroPsychOPD(nearsurgeryand
derma)
H/OHemaOncgotoBCI
DNeuroDevtthisisinWBC
PICUgotoPAYDivision,2PM4PMweekdays,8AM
12PMsaturdays.
WellBabyClinicSched(WBC)
o July18:TavernerTorno,B+GeraldSy
o July916:SorianoTan,J
o July1723:TornoUrgel+ChristopherGarces
o July2431:Tan,KTarectecan
o Pleasedivideyoursubgroupinto3.Andassignwhowill
reportonM/W/F.(Seenextcolumn).

NOTE:Bydefault,yourpostisSICKBABYCLINIC.
(Example:PICUorNeuro24PM,but8AM12PMyoushouldbeinSBC)
Ifyoudontknowwheretogo,whatyourpostis
gotoSBC.

RE:CONFERENCES
EveryMondayERConc/oJIs,mustgetcasefromER35
daysprior.
EveryTuesdayAdConc/oJIs,mustgetcasefromtheOPD3
5daysprior.
EveryWednesdayAuditc/oresidents,unlesstheymakeit
intoaCaseConferencethenc/oJIs
EveryThursdayGrandRoundsc/owho?
EveryFridayNeuroConc/oJIsmustgetcasefromtheOPD
35daysprior

ATTENDANCEISAMUSTforallcons,audits,rounds(allPREandDUTY
statusforthegivendate.OnlyJIswhoareFROMstatusareexempted
theyhavetostayintheERuntiltheiralternatesarrive.)
MustsignattendanceinCONby7AM.SigninAGAINinOPDat
8AM.

RE:WELLBABYCLINIC(WBC)REPORTS
EveryMondayHPIandPEduringinitialvisitafterdelivery.
Thefirstfollowupvisitofanewborn.Whatarethe
physiologicalchanges?
EveryWednesdayCasepresentationofanAdolescentCase
fromOPDMPPRCstyle,preventivepediatricsfor
adolescents(adamstest,immunizations,routinelabsetc)
EveryFridayImmunization:route,types,schedule,ADR

USTPEDIAOPD:OVERVIEWOFTHINGSTOKNOW

JIMonitorConsultant:Bernal
JIMonitorResident:Dizon
ERResidentIC:Wong
WBCResidentIC:David
SBCResidentIC:Dizon

ATTENDANCE
Calltime:7AM;Break:12pm1pm;Off:5PM
SignattendanceTWICE:at7AMduringCONandat8AMintheOPD.
o ThosewhoareFROMstatusneednotgototheCON;hence,neednotsigntheattendanceforthegivendaythathe/sheisFROM
STATUS.
Important
Donotleaveabruptly.Donotleavewithoutgettingpermissionornotifyinganyone.Donotleavewithoutproperendorsements.
Donotbelateforcons.DonotbelatefordutyPLEASE!

OPD
Schedule:
o Weekdays:8am12pm;2pm4pm
o Saturdays:8am12pm
Rules/Guidelines:
o Donotbenoisy,donotloiter.
o Maintainorder.
o Donotbringvaluables.Donotexaminepatientsintheroomwhereweplaceourstuff.
o Implement1companionperpatient.
Whatyouneed:
o MedBag:Sphygmomanometer,stethoscope,thermometer,pulseox,calculator
o Tonguedepressor,cottonballs,alcohol,tissue
o KYjelly,gloves(forDRE:mustbedonewithresident)
o PediaBlueandRedBook;MIMs
Whatyouneedtodo:
o Step1:Getpatientfromdecker.(doublecheckforms:ifinitialvisit,subsequentvisit,orfollowup)
o Step2:GetHeightandweight(inspectifindistress)ZSCORES
o Step3:GetVSTPR+BP(referimmediatelyifindistress)
o Step4(SSubjective):Getgeneralinfo,chiefcomplaintandhistory;getdiagnosticsdone
DoROS
DoHEADSSSFIRST>10years
Feedinghistory:breastfedornot
DoTannerstaging
KnowwhentogettheMaternal,Newborn,andGestationalhistory
Forinfantsdevelopmentalmilestones
SpecificallytakenotatWHATMONTHthechildachievedit.
PutanXifthemilestonehasnotyetbeenachieved.
Ifsubsequentvisitorfollowupvisitupdateaccordingly.
Immunizationsupdateaccordingly.
o Step5(OObjective):HeadtotoePE,NeuroExam
o Step6:Present.Bereadytogiveddxandtreatment,justincase.
Forms
o InitialVisitfirsttimeeverinthePediatricward.Forinfants,getdevelopmentalmilestonesform.
o Subsequentvisithasnotbeeninthewardformorethan3months.Updateimmunizationsanddevelopmentalmilestones.
o Followupvisitupdateimmunizationsanddevelopmentalmilestones.SOAP.
Assessforcomplianceandeffectofmedications.
Intervalhistoryprogressionvsimprovementofsymptoms
Getdiagnostics.
Entrycompetencies:
1. PediatricEmergenciesfoundintheEmergenciesbookfrom
USTFMS.
2. BLSforPediatricPatients

TherewillbeaquizBEFORETHESTARTOFTHESHIFT.

TopicsthatyouSHOULDknowaboutpriortostartingyourduty:
(Reference/Sourcesarealreadyindicated):
1. AsthmaGINA
2. PneumoniaPhilippinePediatricSociety
3. AcuteGastroenteritisWHO
4. AcuteOtitisMedia
5. UrinaryTractInfection

Herrulesandregulationsonprotocols:
Dontdischargeanypatientsiftheyarenotseenby
residents.
o Whenindoubt,askiftheyarethepatientorifthey
arejustthecompanionofthepatient.
o Eveniftheyinquireonly,dontletthemgo.Makesure
theyareseenbyaresident.
Lettheresident/sknowwhateveryouaregoingtodo.
Neverdoanythingwithoutnotifyingtheresidents.
o Beforemanagingorintervening,lettheresident
know.Notreatmentswithoutthem.
o Beforedoinganythingelse,lettheresidentknow.
Beforegoingonbreakorwhengoingtoaccompanya
patient.
o BOTTOMLINE:LETTHERESIDENTKNOW!InTagalog,
MAGPAALAM!
Ifthepatientrefusetreatments,WAIVERFORMalways.
ALLDOCUMENTSMUSTBESIGNEDBYTHERESIDENTIN
CHARGE.
o Thisincludes(laboratoryrequestforms).Nosignature,
nogo.
PatientsMUSTbeaccompanied24/7.ALWAYSaccompany
patients.AvoidABSCONDcases.
Vitalsignsaredoneeveryhour(q1)
JIsjobiscompletionofcharts.
o Whentheresident/fellow/consultantisalready
interviewingthepatients,goandlistentosavetime
andalsotolearnthestylesofinterviewing.Thisis
moreefficientthanhavingtodothehistorytakingall
overagain.Makesuretodocompletehistories.
BEEFFICIENTandANTICIPATE:Whenthefellow/residentis
there,makesuretolistenandbepreparedwiththe
materialsthatmaybeusedforthevariousprocedures.
o Example:IVinsertion:Preparesyringeforflushing,IV,
Gauze,tapeandetc.
o Alsobetheretoassisttheresident/fellow/consultant
whenexaminingthepatient.
Pagnakitamonanganghirapangresidentor
fellowsapagexaminengpasyente,tulunganmo
na.
IntheER,thePEismorefocused,expecttobeableto
practicethatthere.
Knowwhattodoincertaincases.Whenyouseethatthe
patienthasARDS,checktheRRatonce,haveenough
objectiveevidenceandanticipatetheinterventionsthat
needtobedone.
LABS:Checkthereceiptifitisalreadypaid.Followupwithin
30minutesiftheMedTechisntaroundyet.Theturnover
ofpatientsisusuallywithin4hours.(disposepatients
daw)?
Fordirectadmissions(usuallycancerpatientsorchronic
cases),makesurethattheERresidentsalreadyknowabout
itfirst.Samahanangparentsandagain,endorseyourVSto
othersbeforeyougo.
KnowhowtoREFER.

Herrulesandregulationsregardingdemeanors:
NOGADGETS!Ayawkomakakitangnaglalarongkung
anuanodyan.AyawkomakakitangnaglalarongiPad.
Whentherearelull/idlemoments,studyorreadyour
books!
o BAWALmagchikahanchikahandiyan.Whenyou
donthaveanythingtodo,readandstudy!
BAWALmatulogngsabaysabay.Therewillbedecking.
Whenyouareonabreak,ENDORSE!
Nocertaintimeofbreak.Whenyouhavefreetime,paalam
langtheneat.Minsandawkasinalilimutannila.
READthecaseswhenyougethome.

FinalReminders:
Her3requirements:
o Attitude
o Knowledge
o NOPLAYINGGAMES!
Sabingiba,pababanarawangUST.Hindi!Hinditayo
papayag.Dipwedeyun.USTisstillontop.Ibelievethe
residentsplayafactorbecausetheyhavebecamelenient.
So,akongayon.Dinaakomagiginglenient.

*AllQuotationsarefromDra.Wong.

EMERGENCYROOM
IfyouhaveapreceptorialteachingbutyouareassignedintheER,
askpermissiontoleaveERfirstandtelltheresidentorSIthatyou
haveanassignedpreceptorialteaching.GobacktoyourERpost
onceyouaredonewiththeteaching(moreonthepreceptorial
thinglater).

SomeERRules
Alwaysgettheheight,weightandVS.
Don'tforgettoremindtheparents/patientsthatUSTisasemi
privatehospitalmeaningitisnottotallyforfree
o First 2 hours 300php, succeeding hour
100php/hour
o Cashbasisalllabsandmedications
o Agree OR not, once they get the ER FORM,
CONSIDEREDALREADYTHATTHEYHAVEAGREED
THATTHEYWILLHAVETOPAY.ERFormisinthe
nursesstation
If the patient needs to be admitted, call the JIIC in the pedia
ward
Ifneednottobeadmitted,continuethemanagementstill.
CompletetheERform.

LEGEND
H=Hema;K=Nephro;F=From

B=NeuroinNeuroPsychOPD
D=DutyinER
P=PICUinPayDivision:weekdays24pm,Saturday8am12pm
C=CPU:pending.Dunnoyet

Allwhiteboxes=youshouldbeinSBClinic
AllyellowBoxes=youshouldbeinWellBabyClinic(dontforgetyouhavereportstodo)

Legend
Red=Duty
Blue=PICU
Green=Neuro
Violet=Nephro
Salmon=Hema
Yello=WellBaby
Gray=CPU

Preceptorship