Oratio Imperata against COVID-19

Merciful and compassionate Father,

we confess our sins
and we humbly come to you
to find forgiveness and life.
We come to you in our need
to seek your protection
against the COVID-19 virus
that has disturbed and claimed many lives.
Oratio Imperata against COVID-19
We ask you now to look upon us with love
and by your healing hand,
dispel the fear of sickness and death,
restore our hope, and strengthen our faith.
We pray that you guide the people
tasked to find cures for this disease
and to stem its transmission.
Oratio Imperata against COVID-19
Bless our efforts
to use the medicines developed
to end the pandemic in our country.
We pray for our health workers
that they may minister to the sick
with competence and compassion.
Grant them health in mind and body,
strength in their commitment,
protection from the disease.
Oratio Imperata against COVID-19
Grant all these
through our Lord Jesus Christ your Son
who lives and reigns with you,
in the unity of the Holy Spirit,
God forever and ever. Amen.
We fly to Your protection, oh Holy Mother of God.
Do not despise our petition in our necessities,
but deliver us always from all dangers,
oh glorious and blessed Virgin.
Amen.
Oratio Imperata against COVID-19

Our Lady, health of the sick, pray for us.

St. Joseph, pray for us.
St. Raphael the Archangel, pray for us.
San Roque, pray for us.
San Lorenzo Ruiz, pray for us.
San Pedro Calungsod, pray for us.
Aggressive
Fluid
Resuscitation
Indications, Contraindications, and Complications of
Intravenous Fast Drip in Fluid Resuscitation

PGI Latras, Nico

 CONTENTS
01 02
Definition of Indications of Fast
Terms Drip

03 04
Contraindications
Complications
of Fast Drip
Fluid Resuscitation
Cornerstone of critical care practice that aims to
maintain organ perfusion and substrate delivery
through the administration of fluid and
electrolytes.
 Fast Drip
Aggressive fluid resuscitation with increased
fluid rate addressing critical stages of diseases
 Indications of Fluid
Resuscitation
Fluid Resuscitation should be started on the basis
of the ABCDE approach of assessment.

National Institute for Health and Care Excellence. (2013). IV Fluid Therapy in Adults.
 Indications for Aggressive Fluid
Resuscitation
1. Systolic BP of <100 mm Hg
2. Heart rate of >100 bpm
3. Capillary refill of >2 seconds, or cold-to-touch peripheral
extremities
4. Respiratory rate of > 20 cpm

PSMID. CPG on the Management of Acute Infectious Diarrhea in Children and Adults.
 Indications for Aggressive Fluid
Resuscitation

PSMID. CPG on the Management of Acute Infectious Diarrhea in Children and Adults.
 Indications for Aggressive Fluid
Resuscitation

PSMID. CPG on the Management of Acute Infectious Diarrhea in Children and Adults.
 Indications for Aggressive Fluid
Resuscitation
Moderate Dehydration
500 to 1,000 ml of plain Lactated Ringer’s solution in the first 2
hours is recommended.

Severe Dehydration
1,000 to 2,000 ml of plain Lactated Ringer’s solution within the
first 1 hour is recommended.

PSMID. CPG on the Management of Acute Infectious Diarrhea in Children and Adults.
 Contraindications of Fast Drip

1. Mild to No Dehydration
2. Renal, hepatic, or cardiac impairments
3. Pediatric population

Wallace HA, Regunath H. Fluid Resuscitation. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island
(FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534791/
 Complications of Fast Drip

1. Pulmonary edema
2. Acute respiratory distress syndrome
3. Compartment syndrome

Wallace HA, Regunath H. Fluid Resuscitation. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island
(FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534791/
 Conclusion
● Fluid resuscitation is an important cornerstone of critical
care practice.
● Use of increased fluid rate should be correlated clinically
to every patient in order to achieve greater benefits and
decrease risks and complications.
● Proper assessment of patients is a vital key that critically
dictates how fluid resuscitation should be given.
● Clinical observation dictates when to start, continue, and
stop aggressive fluid resuscitation.
THANK
YOU
DAILY ENDORSEMENT
August 8-9, 2022

COD: Dr. Verendia

ROD: Dr. Acero / Dr. Redoble
PGI: Rojo/Pautong/Baguio/Dimal
SC: Caras / Mocadi
OPD CENSUS
TOTAL PATIENTS LOGGED
TOTAL OPD 108

• TOTAL PATIENTS SEEN AND

99
DISCHARGED
• REFERRED 9

ANIMAL BITE 26

• New 6
• Follow - Up 20
• Referral 0
TELECONSULTATION CENSUS
TOTAL CLIENT REQUEST RECEIVED 0
TOTAL ABORTED REQUESTS 0
TOTAL PATIENT INQUIRIES 0
TOTAL ELECTRONIC PRESCRIPTION 0
GIVEN
PATIENTS WITHIN CDO 0
PATIENTS OUTSIDE CDO 0
PATIENTS REFERRED 0
EMPLOYEES CLINIC

EMPLOYEE CONSULT 14
Risk Assessment 0
Consult -
Post Quarantine Clearance -
Prescription refill 0
NMMC-CDO-CEREID CENSUS

LAST TOTAL 17 WARDS

No. of
Vacancies
patients
ADMISSION 4
WARD A (Male) 10 8
DISCHARGE 4 0 19
WARD B (Female)
TRANS OUT 0 WARD C (Male) 0 22
DEATH 0 WARD D (Male) 0 20 (+1 crib)
TOTAL 16 WARD E 6 16 (+1 crib)
NMMC-CDO-CEREID CENSUS

Employees 12

Non Employees 4
FOR CEREID ADMISSION TODAY
LAST TOTAL 3
ADMISSION 5
DISCHARGE 1
TRANS OUT 0
DEATH 0
TOTAL
Swabbed at Function Hall
SWABBED 14
POSITIVE 2
• EMPLOYEE 1
• DEPENDENTS 0
• PGIs 1
● CLERKS 0
● PATIENTS 0

NEGATIVE 12
FOR SWABBING TODAY
TOTAL 90
AMBULATORY CENSUS

TOTAL 15
AMBU - ER 14
TOXICOLOGY 1
HOSPICE 0
DISPOSITIONS
DISCHARGED 12
REFERRED TO OTHER DEPARTMENT 1
REFERRAL FROM OTHER DEPARTMENT 1
ADMITTED 0
HAMA 1
ABSCONDED 0
Still at the ER 0
Isolation 0
WARD CENSUS
TOTAL BEDS
6
(GEN. WARD)

OCCUPIED 2

BORROWED IM 1

AVAILABLE 3
PATIENTS IN THE
WARD:
2
 MANAGED AT THE WARD
PATIENT S O A P REMARKS
DATA
Agocoy, (+) abdominal Awake, coherent, NIRD Acute CBG (5AM) = 118mg/dL For UTZ-WA
Cristine Jean pain (PS 5/10) BP: 110/70 mmHg
24/F (-) nausea PR: 110 bpm
Cholecystitis NPO temporarily
& CXR-PA
(-) vomiting Temp: 37.3 C IVFTF: D5NSS 1L at 30gtts/min today
Salay, Misamis (-) jaundice RR: 20 cpm Continue current medications:
Oriental (-) fever O2 Sat: 98% at RA 1. Omeprazole 40mg IV
Follow-up
UO: 1.02cc/kg/hr q24h
CC: epigastric 2. Ketorolac 30mg IV q8h blood
pain Skin: warm, good turgor, pale 3. Piperacillin+Tazobactam GS/CS
HEENT: anicteric sclerae, pale 4.5g IV q6h ANST D0
Wt: 55kg PC, moist lips and oral mucosa 4. Paracetamol 600mg IV
C/L: Equal chest expansion, PRN for fever
DOA: 08/07/22 clear breath sounds, no 5. Hyoscine-N-butylbromid
retractions e 10mg IV q8h PRN for
HD: 2 CVS: distinct heart sounds, abdominal pain
NRRR, no murmur 6. Tramadol 50mg IV q8h
CIC: Dr. Red Abd: flat, NABS, soft, (+) for pain
RIC: Dr. tenderness in all quadrants Refer to GS for evaluation
Augustero Ext: full pulses, CRT <2 secs, no For UTZ-WA & CXR-PA
edema
MANAGED AT THE WARD
 MANAGED AT THE WARD
PATIENT S O A P REMARKS
DATA
Dela Peña, (-)vomiting Awake, coherent, NIRD 1. Urosepsis 08/08/22 3PM Follow up
Perfecto Jr. (-) flank pain BP: 110/70 mmHg
PR: 61 bpm 2. Acute Kidney Serum K 2.98 (L) urine GS/CS
19/M (-) abdominal
Temp: 36.5 C result
pain
RR: 18 cpm
Injury sec to #1 CXR-PA (08/08/22 at
Macabalan, (-) SOB 3. Electrolyte
O2 Sat: 97% at RA 4:26AM)
CDO UO:1.36 cc/kg/hr Imbalance: There are no active
CC: vomiting Skin: warm, good turgor Hypokalemia parenchymal densities.
HEENT: anicteric secondary to GI Heart is not enlarged.
Wt: 55kg sclerae, pink PC, moist
Loss Aorta is unremarkable.
lips and oral mucosa
DOA: C/L: Equal chest The diaphragm and
08/07/22 expansion, clear breath costophrenic sulci are
sounds, no retractions intact.
CVS: distinct heart
HD: 2 The visualized osseous
sounds, NRRR, no
murmur structures are
CIC: Dr. Red Abd: flat, NABS, soft,
RIC: Dr.
unremarkable.
non-tender, (-) kidney
Augustero punch sign
Ext: full pulses, CRT <2 Impression: No significant
secs, no edema chest findings.
 MANAGED AT THE WARD
PATIENT S O A P REMARKS
DATA
Dela Peña, (-)vomiting Awake, coherent, NIRD 1. Urosepsis Soft diet Follow up
Perfecto Jr. (-) flank pain BP: 110/70 mmHg 1 banana per meal
PR: 61 bpm 2. Acute Kidney urine GS/CS
19/M (-) abdominal Please start KCl drip: 40meqs
Temp: 36.5 C result
pain
RR: 18 cpm
Injury sec to #1 KCl in 1L PNSS to run for
Macabalan, (-) SOB 3. Electrolyte 8hrs x 2 cycles
O2 Sat: 97% at RA
CDO UO:1.36 cc/kg/hr
Current medications:
Imbalance: 1. KCl tablets, 2 tab TID
CC: vomiting Skin: warm, good turgor Hypokalemia PO
HEENT: anicteric 2. Metoclopramide 10mg
Wt: 55kg sclerae, pink PC, moist
secondary to GI IV q8h RTC
lips and oral mucosa Loss 3. ORS 1 sachet in 1L
DOA: C/L: Equal chest as tolerated
08/07/22 expansion, clear breath 4. Sodium bicarbonate
sounds, no retractions 650mg tab TID PO
CVS: distinct heart
HD: 2 Repeat serum crea today
sounds, NRRR, no
murmur
Repeat serum K 6hrs after
CIC: Dr. Red Abd: flat, NABS, soft, last cycle of KCl drip
RIC: Dr. non-tender, (-) kidney
Augustero punch sign
Ext: full pulses, CRT <2
secs, no edema
TOXICOLOGY
2
 TOXICOLOGY PATIENT AT THE WARD
PATIENT S O A P REMARKS
DATA
Alingay, Lenjie (+) salivation Awake, coherent, NIRD 1. Toxic Effects of NPO Atropine 1mg IV
23/F (-) cough BP: 120/80 mmHg IVF D5 NSS at 30 given for 6 doses
Pesticide: gtts/min already from
Carmen, CDO (-) BOV PR: 92 bpm
Wt: 52 kg (-) Hyperthermia Temp: 37.0 C Organophosph Therapeutics: 7AM of Aug 8,
1. Atropine 1mg IV 2022 to 6am of
(-) Flushed skin RR: 20 cpm ate q4H parameters is Aug 9, 2022.
CC: Chemical (-) restlessness O2 Sat: 96 % at RA
(Chlorpyrifos, achieved **Total of 19
Ingestion (-) bronchorrhea UO: 1.32cc/kg/hr 2. RESCUE DOSE: doses from
(-) lacrimation bpmc, xylene), Atropine 1 mg IV admission.
80 hrs post (-) diarrhea Skin: No rashes, no pallor, warm, severe, qhourly for wet
ingestion (-) sweating good turgor signs OR Atropine 1 Atropine 1mg
(-) bradycardia HEENT: Anicteric sclerae, pink PC,
non-accidental
mg neb qhourly for neb given for 4
DOA: Aug 5, (-) abdominal Pupils 4-5mm reactive to light, no 2. Adjustment bronchorrhea and doses already
2022 pain ptosis, slightly moist lips and oral Disorder salivation from 7AM of
mucosa 3. Ceftriaxone 2g IV Aug 8, 2022 to
3. Asymptomatic q24H ANST () 6AM of Aug 9,
HD: 4 C/L: Equal chest expansion, clear
Bacteriuria 4. Famotidine 20mg IV 2022.
breath sounds, no retractions
5. Metoclopramide **Total of 9
CIC: Dr. Simene CVS: Adynamic precordium, distinct
10mg IVTT q8h doses from
RIC: Dr. heart sounds, no murmur admission.
Watanabe Abd: flat, hypoactive bowel sounds,
soft, non-tender For psych
Ext: full pulses, CRT <2 secs, no referrral
edema
 TOXICOLOGY PATIENT AT THE WARD
PATIENT S O A P REMARKS
DATA
Alingay, Lenjie (+) salivation Awake, coherent, NIRD 1. Toxic Effects of CBG Monitoring Atropine 1mg IV
23/F (-) cough BP: 120/80 mmHg 9AM: 68mg/dL given for 6 doses
Pesticide: already from
Carmen, CDO (-) BOV PR: 92 bpm 11AM: 84mg/dL
Wt: 52 kg (-) Hyperthermia Temp: 37.0 C Organophosphate 7AM of Aug 8,
3PM: 79 mg/dL 2022 to 6am of
(-) Flushed skin RR: 20 cpm (Chlorpyrifos, bpmc,
9PM: 87 mg/dL Aug 9, 2022.
CC: Chemical (-) restlessness O2 Sat: 96 % at RA xylene), severe, 3AM: 81 mg/dL **Total of 19
Ingestion (-) bronchorrhea UO: 1.32cc/kg/hr non-accidental doses from
(-) lacrimation admission.
80 hrs post (-) diarrhea Skin: No rashes, no pallor, warm, 2. Adjustment Atropine neb given:
ingestion (-) sweating good turgor Disorder 7:40AM, 10:40AM, Atropine 1mg
(-) bradycardia HEENT: Anicteric sclerae, pink PC, 3. Asymptomatic 5:30PM and 9:30PM neb given for 4
DOA: Aug 5, (-) abdominal Pupils 4-5mm reactive to light, no doses already
pain ptosis, slightly moist lips and oral
Bacteriuria WOF: signs of atropine from 7AM of
2022
mucosa toxicity: blurring of Aug 8, 2022 to
C/L: Equal chest expansion, clear vision, hyperthermia, 6AM of Aug 9,
HD: 4 2022.
breath sounds, no retractions flushed skin,
**Total of 9
CIC: Dr. Simene CVS: Adynamic precordium, restlessness
doses from
RIC: Dr. distinct heart sounds, no murmur admission.
Watanabe Abd: flat, hypoactive bowel CBG monitoring q6h
sounds, soft, non-tender VS monitoring q hourly
Ext: full pulses, CRT <2 secs, no I&O monitoring q shift
edema
 TOXICOLOGY PATIENT AT THE WARD
PATIENT S O A P REMARKS
DATA
Paigalan, (-) odonophagia Awake, coherent, NIRD 1. Toxic Effects of Soft diet
Ronil (-) dysphagia BP: 110/70 mmHg IVFTF: D5NSS 1L at 30gtts/min
17/M (-) abdominal pain PR: 64 bpm Hypochlorite Continue current medications:
(-) melena Temp: 36.7 C Cleaning 1. Omeprazole 40mg IV
Lapasan, CDO RR: 17 cpm OD
O2 Sat: 96% at RA Solution, Mild, 2. Metoclopramide 10mg
CC: epigastric UO:1.20cc/kg/hr Non-accidental IV q8h PRN for vomiting
pain
Skin: warm, good turgor 2. Alcohol
36 hrs post HEENT: anicteric Intoxication,
ingestion sclerae, pink PC, moist
lips and oral mucosa Moderate (BAC
DOA: 08/07/22 C/L: Equal chest = 300mg/dL) -
expansion, clear breath
HD: 2 sounds, no retractions resolved
CVS: distinct heart 3. Adjustment
CIC: Dr. Red sounds, NRRR, no
RIC: Dr. murmur Disorder
Augustero Abd: flat, NABS, soft,
non-tender
Ext: full pulses, CRT <2
secs, no edema
TOXICOLOGY PATIENT AT THE WARD
SUMMARY CENSUS
16
 PATIENT DATA Chief Complaint DIAGNOSIS Disposition

ADMITTED
1 “Giubo, sipon, ug Admitted to
PMB COVID-19 - Mild
hilanat” CEREID
2 Admitted to
LW “Gihilanat ko” COVID-19 - Mild
CERIED
3 Transferred to
DC “Gihilanat ko” COVID-19 - Mild
Polymedic
4 For admission to
“Hilanat, ubo, ug
PMS COVID-19 - Mild TTMF ℅ City
sipon”
Isol.
5 1. Lumbar Disc Disease with
Referred to
Radiculopathy
AJ “Sakit akong likod” Orthopedics And
2. Diabetes Mellitus Type 2 -
Discharged
Uncontrolled
6 For admission to
DA “Labad akong ulo” COVID-19 - Mild
CEREID
 PATIENT DATA Chief Complaint DIAGNOSIS Disposition

AMBULATORY CARE

7 For Admission at
AF “Giubo ug sipon” COVID-19 Mild
CEREID today
8 “Ubo ug labad akong For Admission at
VD COVID-19 Mild
ulo” CEREID today
9 “Hilanat ug gisip-on
BR COVID-19 Suspect HAMA
ko”
10 1. Coronary Artery Disease,
Cardiomegaly, Sinus Rhythm, Treated and
VC “Nangluya ko”
Normal Axis, NYHA FC II-B Discharged
2. Diabetes Mellitus Type 2-suspect
11 “Nagsukaa ug Influenza-like Illness Treated and
DJ
hilanat” SARS-CoV-2, Negative Discharged
 PATIENT DATA Chief Complaint DIAGNOSIS Disposition

AMBULATORY CARE

12 “Ubo ug katol ang Influenza-like Illness Treated and

SM
tutunlan” SARS-CoV2, Negative Discharged
13 Hypertensive Cardiovascular Disease,
“Murag taas akong Cardiomegaly, LV form, Sinus Rhythm, Treated and
GL
dugo” Normal Axis, NYHA FC II, Malnutrition Discharged
Overweight
14
CC “Gasukaa ko” COVID-19 - Suspect Still at ER`

15
VB “Nagsukaha ko” COVID-19 - Suspect

16 Treated and
FL “Sakit akong tiyan” Acid Peptic Disease
Discharged
 PATIENT DATA Chief Complaint DIAGNOSIS Disposition

TOXICOLOGY
1 Baygon Chalk Alleged Ingestion of Insecticide Admitted by
TA
Ingestion (Deltamethrin, Baygon Chalk), Accidental PEDIATRICS
ADMITTED: 0
AMBULATORY
CARE:
14
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
AF “Giubo ug COVID-19 - Labs: Treated and
26/F sipon” RT-PCR
Suspect Discharged
Santa Elena, Iligan City

SINOVAC
Primary series x2
BOOSTERS:
ASTRAZENECA x1
MODERNA x1

8/8/22
6:53 AM- 7:45 AM

Vital Signs:
Temp: 36.1 ºC
BP: 120/80 mmHg
PR: 80 bpm
RR: 20 cpm
O2 sat: 99% RA
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
DJ “Nagsukaa ug Influenza-like Labs: Treated and
27/M Hilanat” >CBC with Platelet, Na, K
Illness > Urinalysis Discharged
Abellanosa, Brgy. 18,
CDO >GeneXpert
Hypokalemia >Dengue Duo
SINOVAC >S.typhi
Primary dose x2
secondary to GI
losses Medication:
8/8/22 1. Paracetamol 300mg
7:49 AM
SARS-CoV-2, IVTT via heplock
Home Medications:
Vital Signs: Negative 1. Paracetamol 500 mg 1
Temp: 38.3 ºC
BP: 120/80 mmHg tab q4h, PRN for fever
PR: 120 bpm 2. Metoclopramide 10
RR: 24 cpm
O2 sat: 99% RA mg 1 tab TID, PRN for
vomiting
3. KCl tab 2 tabs TID x 3
days
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
PMB “Gihilanat COVID-19 - Mild Labs: Admitted at
43/F ko” CBC with Platelet CEREID
Fatima, Lapasan, CDO Chest x-ray
ASTRAZENECA
Primary dose x2 Medications:
PFIZER 1. Cetirizine 10 mg tab
Booster x1 OD
2. Paracetamol 500 mg 1
8/8/22 tablet q4h, PRN for
9:56 AM - 12:01 PM fever
3. Ascorbic Acid 500 mg
Vital Signs: tab OD
Temp: 37.3 ºC 4. NAC 600 mg tab, 1 tab
BP: 110/60 mmHg
PR: 82 bpm + ½ glass water OD for
RR: 17 cpm 7 days
O2 sat: 99% RA 5. Zinc sulfate Syrup 10
ml OD
AMBULATORY ER
Chest x-ray
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
LW “Gihilantan COVID-19 - Mild Labs: Admitted to
23/M ko” CBC with Platelet CEREID
Taboc, Opol, Misamis Chest x-ray
Oriental

SINOVAC Medications:
Primary series x2 1. Paracetamol 500 mg 1
Boosters: tablet q4h, PRN for
ASTRAZENECA x1 fever
PFIZER x1 2. Ascorbic Acid 500 mg
tab OD
8/8/22 3. NAC 600 mg tab, 1 tab
9:55 AM - 11:58 AM + ½ glass water OD for
7 days
Vital Signs:
Temp: 37.5 ºC
BP: 110/60 mmHg
PR: 79 bpm
RR: 17 cpm
O2 sat: 98% RA
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
DC “Gihilantan COVID-19 - Mild Labs: Transferred to
30/F ko” CBC with Platelet (no Polymedic
#10 Narra St., Iligan result yet)
City
Chest x-ray
PFIZER
Primary series x2 Medications:
MODERNA 1. Paracetamol 500 mg 1
Booster x1 tablet q4h, PRN for
fever
8/8/22 2. NAC 600 mg tab, 1 tab
9:49 AM - 11:51 AM
+ ½ glass water OD for
7 days
Vital Signs:
Temp: 36.3 ºC
BP: 110/60 mmHg
PR: 80 bpm
RR: 16 cpm
O2 sat: 99% RA
Chest x-ray
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
SM “Ubo ug katol Influenza-like Illness Labs: Treated and
30/F ang tutunlan” >GeneXpert
SARS-CoV2, Negative
Discharged
Camaman-an, CDO

SINOVAC
Medications:
Primary series x2 1. Paracetamol 500
PFIZER mg tab, 1 tab
Booster x2 q4h, PRN for
8/8/22
11:28 AM - 12:30 PM
fever
2. Hexetidine Oral
Vital Signs: Gargle Solution
Temp: 36.1 ºC 15ml BID
BP: 120/80 mmHg
PR: 80 bpm 3. Vitamin C 500
RR: 20 cpm mg, 1 tablet OD
O2 sat: 98% RA
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
PMS “Hilanat, ubo, COVID-19 - Mild Labs: For admission to
30/F ug sipon” >GeneXpert
Camaman-an, CDO
TTMF ℅ City Isol.

SINOVAC
Medications:
Primary series x2 1. Paracetamol 500 mg 1
PFIZER tablet q4h, PRN for
Booster x1 fever
MODERNA 2. NAC 600 mg tab, 1 tab
Booster x1 + ½ glass water OD for
7 days
8/8/22
11:28 AM - 12:30 PM

Vital Signs:
Temp: 36.0 ºC
BP: 120/80 mmHg
PR: 84 bpm
RR: 20 cpm
O2 sat: 98% RA
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
GL “Murag taas Hypertensive Labs: Treated and
53/F akong dugo” Cardiovascular >CBC with Platelet Discharged
Bonbon, Opol, >SGPT, BUN, Crea
Misamis Oriental
Disease,
Cardiomegaly, LV >12L ECG
ASTRAZENECA form, Sinus >Chest x-ray
Primary series x2
Rhythm, Normal
Medications:
8/8/22 Axis, NYHA FC II,
Losartan 50 + HCTZ 12.5
9:45 AM Malnutrition
mg 1 Tab OD
Overweight
Vital Signs: Trimetazidine 35 mg I
Temp: 36.1 ºC Tab BID
BP: 120/90 mmHg
PR: 112 bpm Atorvastatin 40 mg 1 Tab
RR: 20 cpm Malnutrition OD
O2 sat: 98% RA
Overweight Carvedilol 6.25mg 1 Tab
BID
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
AJ “Sakit akong Lumbar Disc Labs: Referred to
50/F likod” Disease with >Urinalysis Orthopedics And
San Juan 1, Lapasan, Radiculopathy >Na, K, BUA
CDO
Discharged
>Glucose, RBS
SINOVAC Diabetes Mellitus
Primary series x2 Type 2 - Medication:
Uncontrolled Continue
8/8/22
9:24 AM
1. Tramadol 50mg
PRN OD
Vital Signs: 2. Ketorolac 30mg
Temp: 36 ºC IVTT
BP: 130/90 mmHg
PR: 111 bpm
RR: 24 cpm
O2 sat: 99% RA
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
DA “Labad COVID-19, Mild Labs: For admission to
22/M akong ulo” >CBC with Platelet
Consolacion, CDO
CEREID
>Urinalysis
JANSSEN
>Dengue Duo
Primary series x1 >Crea, SGPT, SGOT
>GeneXpert
8/8/22
11:15 AM
Medications:
1. Paracetamol 500 mg 1
Vital Signs:
Temp: 37.3 ºC tablet q4h, PRN for
BP: 120/80 mmHg fever
PR: 108 bpm 2. NAC 600 mg tab, 1 tab
RR: 20 cpm
O2 sat: 98% RA + ½ glass water OD for
7 days
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
VD “Ubo ug COVID-19 Mild Labs: For Admission at
32/M labad akong >Chest x-ray CEREID today
Macasandig, CDO ulo” >GeneXpert
SPUTNIK
PFIZER Medications:
1. Paracetamol 500
8/8/22 mg tablet, 1 tab
10:41 AM - 11:45 PM
q6h
Vital Signs: 2. Phenylephrine + C.
Temp: 36.7 ºC maleate +
BP: 120/80 mmHg
PR: 93 bpm Paracetamol, 1
RR: 20 cpm tablet TID
O2 sat: 99% RA
3. N-acetylcysteine
600 mg tablet, 1
tab + ½ glass water
x 7 days
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
BR “Hilanat ug COVID-19 Labs: HAMA
33/M gisip-on ko” >GeneXpert (not done)
Suspect
Carmen, CDO

PFIZER
Medications:
Primary dose x2 1. Phenylephrine +
Paracetamol
8/8/22 10mg/500mg, 1 tab
1:17 PM
q8h
Vital Signs: 2. Vitamin C + Zinc 1
Temp: 36.3 ºC tab OD
BP: 110/70 mmHg
PR: 75 bpm
RR: 20 cpm
O2 sat: 98% RA
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
VC “Nangluya Coronary Artery Labs: TREATED AND
50/F ko” Disease, Cardiomegaly, > 12 Leads ECG
Sinus Rhythm, Normal > Chest Xray DISCHARGED
Carmen, CDO
Axis, NYHA FC II-B > Na, K, Crea, BUN
PFIZER
Primary series x2 To consider Diabetes Home Medications:
PFIZER 1. ISMN 30 mg tab, 1 tab
Mellitus Type 2
Booster x1 once a day
2. ISDN 5 mg tab, 1 tab
sublingual as needed
8/8/22
for chest pain
7:19 PM 3. Carvedilol 6.25 mg tab,
1 tab twice a day
Vital Signs: 4. Celecoxib 200 mg tab,
Temp: 35 ºC 1 tab twice a day as
BP: 120/70 mmHg needed for pain
PR: 95 bpm
RR: 24 cpm 5. Aspirin 80 mg tab, 1
O2 sat: 99% RA tab once a day
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
CC “Nagsuka Acid Peptic Disease Labs: Admitted
>Chest X-ray
32/F ko”
>GeneXpert (NEGATIVE)
Opol, Misamis Oriental Multiple Electrolyte
>CBC with Platelet, Na, K
Imbalance >Urinalysis
JANSSEN
Primary series x1 Hypokalemia, Medications:
Hyponatremia 1. Metoclopramide 10mg
8/8/22 IV q8h, PRN for
10:38 PM COVID-19 - Suspect vomiting
2. Omeprazole 40 mg IV
Vital Signs: then OD
Temp: 36.5 ºC
BP: 110/80 mmHg
PR: 88 bpm
RR: 18 cpm
O2 sat: 96% RA
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
VB “Nagsukaha COVID-19 - Suspect Labs:
>GeneXpert
41/F ko”
>CBC with Platelet, Na, K
Lapasan, CdO, Mis.Or

SINOVAC
Medications:
Primary series x2
Metoclopramide 10mg IVTT
8/9/22
2:35 AM

Vital Signs:
Temp: 36.8 ºC
BP: 110/80 mmHg
PR: 88 bpm
RR: 20 cpm
O2 sat: 98% RA
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
 AMBULATORY ER
CHIEF
PATIENT DATA COMPLAINT
DIAGNOSIS INTERVENTION REMARKS
FL “Sakit akong Acid Peptic Disease Labs:
>GeneXpert
45/M tiyan”
>CBC with Platelet, Na, K
Consolacion, CdO, > ECG
Mis.Or > Amylase

SINOVAC
Primary series x2 Medications:

8/9/22 Metoclopramide 10mg IVTT

2:43 AM Sodium Alginate + NaHCO3 +
CaCO3 (Gaviscon) 1 sachet
Vital Signs: HNBB 10 mg IVTT
Temp: 36.0 ºC
BP: 140/90 mmHg
PR: 98 bpm
RR: 20 cpm
O2 sat: 98% RA
AMBULATORY ER
AMBULATORY ER
AMBULATORY ER
TOXICOLOGY
REFERRAL:
1
 PATIENT S O A P REMARKS
DATA
Tamargo, Vital signs 1. Alleged Baygon Chalk Referred to FAMED Admitted by
Athena BP 90/60 mmHg
PR 92 bpm
Ingestion NPO Temporarily PEDIATRICS
T 36.2 C (Deltamethrin),
4/F RR 28 cpm Accidental
O2 Sat 96 % at RA
Medications:
CC: Baygon 1. Omeprazole
Chalk Awake, alert, not in 15mg IVTT OD
respiratory distress
Ingestion Anicteric sclerae, pinkish
palpebral conjunctivae, no
Admission alar flaring, pale lips
Date: August C/L: CBS, ECE, no
8, 2022 retractions
CVS: AP, DHS, no murmurs
Abdomen: (+) Tenderness
HD: 1 Extremities: Warm, Full
pulses, CRT <2s, No edema
CIC: Dr.
Simene
RIC: Dr. Acero
MANAGED AT THE WARD
MANAGED AT THE WARD
 PEDIA CO-MANAGED AT THE WARD
PATIENT S O A P REMARKS
DATA
YUANA, (-)LBM Awake, comfortable, 1. Toxic Effect of Continue observance WOF:
Krizen (-)sweating NIRD Carbamate (Sevin) bronchorrhea,
(-)salivation BP: 80/50 mmHg Ingestion: mild, diarrhea,
1/M (-)rashes HR: 120 bpm accidental rashes,
(-)SOB RR: 38 cpm 2. Benign Febrile sweating, SOB
Temp: 37.3C
Patag, Opol, Seizure vs CNS
O2 sat: 95% at RA
Mis Or infection
warm, good turgor
Hosp #: AS, pink palpebral
01488631 conjunctivae
ECE, CBS, no
DOA: retractions
08/02/22 AP, DHS, NRRR, no
murmurs
CC: chemical flat, non-distended,
ingestion NABS, soft,
non-tender
SPP, CRT <2 secs, no
edema
-END-