FDAR: ACTION

PEDIATRIC INTENSIVE CARE UNIT RECORD  Refer

FOCUS 1: BORN TO A 31YRS OLD G1P1(1001) 34 NECKS FOCUS 5: Updated result of CBC & BT
2 DAYS BY EUTZ W/SROM FOR 24HRS, CLEAR
 At 3pm, hook to oxygen support at 21pm via nasal
AMNIOTIC FLUID, CEPHALIC
occlusion
 Admit under service of Dr. Linayao
FOCUS 6: STAMPS(?) AND VITAL SIGNS
 Secure consent for admission and management
 At 9:30pm, decrease oxygen support at 1pm
FOCUS 2: LABOR WITH REGULAR PRENATAL CHECKUP
 Insert orogastric tube feeding
& INTAKE OF MULTIVITAMINS, MATERNAL AND
PATERNAL BLOOD TYPE  Start feeding at 5ml every 30mins then if tolerated
after 2 may increase to 10ml/feeding
 NPO, Hook to D10W
NEONATAL INTENSIVE CARE UNIT RECORD (WT 2770g)

FOCUS 1: CNS

 At 8AM, Decrease oxygen support at 0.51pm via NC

194 ml to run at 8mL/hr for 24 hrs (TFR 70 GIR 48)
 Hook to oxygen support at 51pm via funnel
 For complete blood count as platelet count to
include blood typing
 Order blood culture and sensitivity test
 Chest X-ray AP lateral
 Monitor CBG at birth (1st hr, 3 hrs, 6hrs and 12 hrs)
FOCUS 3: REPORT TO HEMATOLOGIST
 Start Ampicillin 140mg slow IV now q12 (TD 50.
54mg/kg/day)
 Start Gentamicin 11mg slow IV via IP over
30minutes now then q24 (TD 3.9mg/kg/dose)
 Maintain current tube feeding at 10ml/feed every 3
hours
FOCUS 2: RESPI: 44-54BPM O2 STAT: 99-100%
 Trans-out from isolation room
 At 10:45AM, follow up blood culture and sensitivity
test results
 Continue present management
FOCUS 4: GIT 0.6 cc/kg/hr
 For Na, K, Chloride & Iodized calcium now to
indicate total bilirubin, indirect and direct bilirubin
 Start continuous phototherapy
 At 11AM, revise IVF as follows:

FOCUS 4: EENC

 Administer Hepatitis B vaccine 0.5mL intramuscular

route right anterolateral thigh once with consent
 Administer BGC (bacille calmette Guerin) 0.5mL
intradermal route right deltoid once with consent
 Newborn screening at 24 hours of life once with 222ml to run at 9.2Ml/hr for 24 hours due 11AM (TFR
consent 80 GIR = 5.5)
 For OAE (otoacoustic emission test) at 48 hours of
life once with consent FOCUS 6: UPDATE & RELAYED ELECTROLYTES
 Place isolette and pulse oximeter  At 1:50pm, revise IVF as follows:
 Weigh patient daily and record
 Monitor input and output every shift record
 Monitor vital signs every 5 minutes (first 2hrs then
30mins, net 2 hrs then hourly there a??)
 Keep thermoregulate 36.5 to 37.4
222ml to run at 9.2ml/hr for 24 hours due 2AM (TFR 80  Refer to Dr. Sheila Masangkay, neonatologist
GIR 5.5)  At 8AM, follow-up official chest x-ray results and
blood culture and sensitivity results
 Repeat potassium tomorrow at 6AM
 Revise fluid to:
FOCUS 7: UPDATED BY DR. LINAYAO 41ML EVERY
OTHER TO REACH 15ML

 At 7pm, for capillary blood glucose now then q12

 For repeat potassium tomorrow at 6AM to include
sodium
 Increase feeding 1ml every other feeding to reach
15ml
 Discontinue oxygen support
FOCUS 8: INPEC(?): 8CS (-)24hrs
 At 5pm, repeat complete blood count with platelet
count tomorrow 6AM
 Repeat total bilirubin, indirect and direct bilirubin
tomorrow
 Repeast chest xray
 For 20 echo
 At 6pm, decrease CBG once a day
 Revise current IVF as follows:
249ml-120(PF) = 129ml/24 hours to run at 5.4ml/hr for
24 hours due 6pm tomorrow (TFR 90 GIR 6.2)
108ml to run at 4.5ml/hr for 24hours
 10AM, follow up blood culture and sensitivity
results
 Continue present management
 At 1:10pm, increase feeding 1ml every other
feeding to reach 20ml na OGT????
FOCUS 3: INCREASE 2ML Q6H TO REACH 30ML, D/C
CBG, D/C ABXD50, SUGGEST CRANIAL ULTRASOUND
 Increase feeding 2ml every other feeding to reach
30ml
 May discontinue antibiotics (Day 5 completion)
 Discontinue CBG monitoring
 Await 2D echo results
 Suggest to do cranial ultrasound
 Discontinue oxygen support
 At 2pm, carry out neonatology notes
 For cranial ultrasound
 Revise current IVF as follow:

NEONATAL INTENSIVE CARE UNIT RECORD (WT 2630g)

FOCUS 1: REMOVE FROM INCUBATOR, MAINTAIN

CURRENT FEEDING, PHOTOTHERAPY TO
INTERMITTENT PHOTOTHERAPY

 At 10:20am, wear out from isolette
 Maintain current feeding at 15ml q3h
 At 7:19pm, hook catheter(??) to oxygen support via
nasal cannula 0.51pm
 For scheduling of 2 DEcho
 With incremental feeding of 1ml every other, may
not continue increment if not tolerated
FOCUS 2: TROCOSTOMY
 Revise fluids to 10IMB (?) to run at same rate
103ml to run at 3ml/hr for 24 hours due 6pm (TFR-PF)
(90-PF) (GIR1.9)
NEONATAL INTENSIVE CARE UNIT RECORD (WT 2610)
FOCUS 1
 Continue present management
 Please follow-up blood culture and sensitivity
results
 Increase feeding to 15ml if tolerated, may try
dropper feeding
 FOCUS 2

 At 11 AM, revise IVF to as follows:

129ml/24hrs to run at 5.4ml/hr for 24 hours due

12pm tomorrow. (TFR 90 GIR 6.2)

FOCUS 3

 11:30AM, revise current IVF as follows

249ml to run at 10.4ml/hr for 24 hours due 12pm