| 1 |
5c8b4a426 |
2139-07-01 |
ruptured liver abcess /right empyema |
None |
consultant: **Name**
jrs: **Name**
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
resp support: psimv
inotrope: none
antihypertensives: nil
sedation: 24ml
inj fentanyl 100mcg/12ml ns @0.5(@1mcg/kg/hr)
inj midazolam 11mg/24ml ns @0.5ml/hr(@1mcg/kg/min)
antiepileptic: nil
antimicrobials: 10ml
inj ceftriaxone 150mg/5ml ns iv q12hrly.
steroid/ hormone: nil
feeds:npo
ivf:
n/2 with 10d (1:100kcl) @11ml/hr (gir@6)
miscellaneous:
inj vitamin k 2mg iv every monday
inj paracetamol 40 mg iv sos
inj calcium gluconate 5ml/5ml of 5%d iv over 30min q12hrly.
nursing and supportive care:
input/ output charting,
temperature, vitals monitoring q2h,
rbs q8h
strict asepsis to be maintained
oral care: swipe with chlorhexidine mouth wash soaked gauge piece twice a day.
weight
3.8 kg
length
cm
tfr
80%
tfv
300 ml
ivm
35ml
feeds
0ml
ivf
265
na
feeds
k
feeds
glucose
26g
aminoven
-
gir
6
blood products
-
sign/jr sign/sr |
| 2 |
5c8b4a426 |
2144-01-21 |
jacobsen syndrome : gdd/age/severe dehydration/septic shock/ lrti/hypernatremia |
room air |
consultant: **Name**
jrs: **Name**
srs: **Name**
wt (adm)
6.8 kg
length
65 cm
bsa
0.35 m2
tfr
120 %
tfv
820 ml
medications
35 ml
ivf
nil
feeds
780 ml
respiratory support: room air
sedation/analgesia/neuromuscular blockade:-nil
inotropes/ antihypertensives-nil
antimicrobials: 30 ml
inj piptaz 700 mg/ 10 ml ns q 8 hrly (100 mg/kg/dose) d4 30 ml
feed- ng feeds 65 ml q 2 hourly 780 ml
others : -5 ml
syp zinc (20mg/5ml) 5 ml od via ng for 14 days (d6/14)
nasoclear drops, 2 drops b/l nostrils q2h
inj pantop stop
tab lanzol jr 15 mg dissolve in 5 ml ns to give 2 ml od bbf
supportive care
vitals monitoring q2h
temperature monitoring q2h
input output monitoring q2h
rbs q12h |
| 3 |
5c8b4a426 |
2139-06-30 |
ruptured liver abcess /right empyema |
None |
consultant: **Name**
jrs: **Name**
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
resp support: servo control mode radiant warmer
inotrope: none
antihypertensives: nil
sedation: 24ml
inj fentanyl 100mcg/12ml ns @0.5(@1mcg/kg/hr)
inj midazolam 11mg/24ml ns @0.5ml/hr(@1mcg/kg/min)
antiepileptic: nil
antimicrobials: 10ml
inj ceftriaxone 150mg/5ml ns iv q12hrly.
steroid/ hormone: nil
feeds:npo
ivf:
n/2 with 10d (1:100kcl) @11ml/hr (gir@6)
miscellaneous:
inj vitamin k 2mg iv every monday
inj paracetamol 40 mg iv sos
inj calcium gluconate 5ml/5ml of 5%d iv over 30min q12hrly.
nursing and supportive care:
input/ output charting,
temperature, vitals monitoring q2h,
rbs q8h
strict asepsis to be maintained
oral care: swipe with chlorhexidine mouth wash soaked gauge piece twice a day.
weight
3.8 kg
length
cm
tfr
80%
tfv
300 ml
ivm
35ml
feeds
0ml
ivf
265
na
feeds
k
feeds
glucose
26g
aminoven
-
gir
6
blood products
-
sign/jr sign/sr |
| 4 |
5c8b4a426 |
2141-03-28 |
laryngomalacia/? congenital tb/ mother hbsag +ve |
None |
consultant: **Name**
jrs: **Name**
srs: **Name**
weight
11.9 kg
length
106 cm
gfr
53
tfr
174%
tfv
1920ml
ivm
300 ml
feeds
nil
ivf
as chemo
chemo
1620ml
na
1 meq/kg/day
k
0.5 meq/kg/day
glucose
90 g
aminoven
nil
gir
5 mg/kg/min
blood products
nil
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
resp support: niv
inotrope: nil
sedation: nil
antimicrobials:nil
feeds: npo till further orders
aed: nil
ivf (192): n/2 5%d with 1:100 kcl @8 ml/hr
miscellaneous: nil
inj pcm 24 mg sos
nursing and supportive care:
warmer care
input/ output charting,
temperature, vitals monitoring q 2 hr
rbs q 6 hrly
abdominal girth monitoring q 6 hrly
weight
2.4 kg
tfr
80%
tfv
192
ivm
-
feeds
-
ivf
192
na
6.1 meq/kg/d
k
1.6 meq/kg/d
gir
2.8 mg/kg/min
blood products
-
sign/jr sign/sr |
| 5 |
bfccdfd03 |
2171-12-14 |
rasmussen encephalitits/ status epilepticus |
None |
consultant: **Name**
jrs: **Name**
weight
13.4kg
tfr
80%
tfv
936 ml
ivf
552 ml
ivm
264 ml
feeds
120 ml
glucose
27.6 g +feeds
gir
1.4 mg/kg/min
k
0.8 meq/kg/day
feeds: ng feeds 10 ml 2 hrly via ng tube (120 ml)
ivf: n/2+ 5%d with 1:100 kcl @ 23 ml/hr (552 ml)
inotropes: nil
antimicrobials:
tab isoniazid 100 mg 1 and ½ tab od (10 mg/kg/day)
inj augmentin 500 mg iv 12 hrly (d2)
miscellaneous: (264 ml)
injection ivig @ 10 ml/h (total of 500 ml) (24 ml)
inj methylprednisolone 400 mg iv in 100 ml ns over 4 hours q24hr for 3 days (to check bp and sugar 2 hourly before, during and after infusion)
stop inj phenytoin
syp phenytoin (5 ml=30 mg) 7 ml- 6 ml (5.8 mg/kg/day)
inj valproate 400 mg in 30 ml ns over 20 min q12 hr (@60 mg/kg/d) (60 ml)
stop inj lacosamide
tab lacosamide 50 mg 1 tab od
inj lorazepam 1.5 mg iv q8hr
t. oxcarbamazapine 300 mg tds (@45 mg/kg/d)
t. topiramate 25 mg ¼ tab bd(@0.9 mg/kg/d)
inj pantop 15 mg iv q24hr
inj calcium gluconate 10 ml in 10 ml 5d over 30 min q6 hrly (80 ml)
nursing and supportive care:
intake output monitoring
temperature monitoring q2h
rbs monitoring q 6 hourly
clustering of procedures, asepsis to be maintained
oral suction 2 hrly |
| 6 |
bfccdfd03 |
2171-12-13 |
rasmussen encephalitits/ status epilepticus |
None |
consultant: **Name**
jrs: **Name**
weight
13.4kg
tfr
80%
tfv
936 ml
ivf
500 ml
ivm
440 ml
glucose
feeds
gir
feeds
k
2 meq/kg/day
feeds: nil
ivf: n/2 5%d @ 20 ml/hr
inotropes:
antimicrobials:
tab isoniazid 100 mg 1 and ½ tab od
miscellaneous: (48 ml)
injection ivig @ 1 ml/hr for 20 minutes f/b 2ml/hr for 20 minutes f/b 4 ml/hr for 20 minutes followed by 10ml/hr (total 500ml)
inj methylprednisolone 40 mg iv in 100 ml ns over 4 hours q24hr for 3 days (to check bp and sugar 2 hourly before, during and after infusion)
inj phenytoin 40 mg in 10 ml ns over 10 min q12 hr(@6 mg/kg/d)
inj valproate 400 mg in 30 ml ns over 20 min q12 hr (@60 mg/kg/d)
inj lacosamide 50 mg in 20 ml ns over 20 min q24 hr(@3.7 mg/kg/d)
inj lorazepam 1.5 mg iv q8hr
t. carbamazapine 300 mg tds (@45 mg/kg/d)
t. topiramate 25 mg ½ tab bd(@2 mg/kg/d)
inj pantop 14 mg iv q12hr
nursing and supportive care:
intake output monitoring
temperature monitoring q2h
rbs monitoring q 6 hourly
clustering of procedures, asepsis to be maintained |
| 31 |
0c3f1d566 |
2144-10-31 |
srns( ir/fsgs ) with aki with septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
31 kg
bsa
1sq m
tfr
1036 ml/sqm
tfv
1036 ml
ivf
288 ml
ivm
748ml
glucose
144
gir
3.2
tpn
a1l1
feeds
npo
k
0.9meq/kg/day
feeds: npo
ivf: inj ivf 50% dextrose (5: 100 ml kcl) @ 12 per hour (288ml)
inj. aminoven 310 ml @ 12.9 ml /hr
inj . intralipid 155 ml @ 6.5 ml /hr
antimicrobials: (renal modified doses)(40 ml)
inj. teicoplanin 155 mg in 10 ml ns over 1 hour 24 hourly (day 7)
inj. zosyn 2.1 gm iv q 8 hrly (day 7) (30 ml)
ionotropes: nil
miscellaneous: (243ml)
inj heparin via arterial line at 2ml/hr (48ml)
inj 3% nacl 2.5ml/hr (60ml)
inj. labetalol 180 mg in 12 ml ns @ 1 ml /hour (24ml )
inj hydrocortisone 15 mg iv q 6 hrly
inj midazolam (1ml=1 mg) @ 4 ml/hr (2.1mcg/kg/min) (96 ml)
inj fentanyl (1ml= 50 mcg) @0.6 ml/hr (1 mcg/kg/min) (14.4 ml)
inj vecuronium infusion stop
inj pantoprazole 30mg iv od
inj midazolam 3mg and inj xylocord 30mg before suction
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 2 hourly
clustering of procedures, asepsis to be maintained
eye care. moisol eye drop q 2 hourly, lacrigel ointment locally q 12 hourly, eye padding
et suctioning sos |
| 7 |
eb727bf19 |
2200-04-02 |
single/early term/37weeks (ballad score) /nvd/respiratory distess//eons/?ttnb |
None |
consultant: **Name**
jrs: **Name**
srs: **Name**
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
26.04.2019
weight
15kg
length
91 cm
tfr
50 %
tfv
609 ml
ivm
161 ml
feeds
160 ml
ivf
ml
na
1.5 meq/kg/day
k
nil
glucose
31 g
gir
1.4
blood products
nil
resp support: o2 by h3fnc @6l/min
inotrope: nil
antihypertensives/diuretic: nil
sedation: nil
antiepileptic:nil
antimicrobials: 40ml
inj cefotaxime 140mg/10ml ns iv over 30min q 8 hourly-d1 (30ml)
inj amikacin 30mg/10ml ns iv over 1hour q24 hourly (@15mg/kg/dose)-d1 (10ml)
steroid/ hormone: nil
feeds: 300ml
dexolac feeds (1scoop in 30ml)/ebm- 11 ml q2hourly via ng tube
ivf: nil
miscellaneous:
inj pcm 20 mg iv sos
nasoclear drops 2 drops in each nostril 4 hourly
nursing and supportive care:
input/ output charting- 2hrly
temperature, vitals monitoring q2h
rbs monitoring q4 hourly
strict asepsis to be maintained
abdominal girth monitoring q 6 hourly
positional change every q2 hourly (rightup—leftup---supine)
weight
2172gm
tfr
80 %
tfv
173 ml
ivm
40ml
feeds
133 ml
ivf
nil
glucose
feeds
gir
feeds
na
feeds
k
feeds
sign/jr sign/sr |
| 8 |
6a5a970cb |
2212-07-07 |
not found |
None |
diagnosis : thalassemia intermedia with meningoencephalitis with hydrocephalus with raised ict with hydrocephalus
consultant: **Name**
jrs: **Name**
weight
11 kg
tfv
100 %
tfv
1050 ml
ivm
218 ml
ivf
672 ml
prbc
165 ml
feed
60 ml
gir
2.43 mg/kg/min
k
1.4 meq/kg/day
na
16. 7 meq/kg/d
feeds : ng feed 5 ml q 2 hrly (60 ml)
ivf: ivf 5% dns @ 28 ml/hr with kcl 1 ml/100 ml ivf (672 ml)
antibiotics :
inj ceftriaxone 550 mg iv 12 hourly (day 2)
miscellaneous: (150 ml)
inj hepsaline via arterial line @ 2 ml/hr (48 ml)
inj. perfalgan 110 mg iv sos
inj. vit. k 3 mg iv weekly
inj. fentanyl @0.2 ml/hr (@1 mcg/kg/min)(4.8 ml)
inj. midazolam @ 1.4 ml/hr (@ 2 mcg/kg/min)(33.6 ml)
inj 3% nacl @ 2.8 ml/hour (67.2 ml)
tab acetazolamide 250 mg 1 tab 8 hourly
inj pantop 10 mg iv q 12 hourly
inj dexamethasone 1.6 mg iv 6 hourly
drain csf @ 6 ml /hour
inj prbc 165 ml over 4 hours iv
nursing and supportive care:
head end elevation, miniumal stimulation
inj midazolam 1.1 mg + xylocard 11 mg 15 min before each suction/ stimulation
input output monitoring q 2 hourly (inform if u/o <22 ml /2 hour)
temperature monitoring q 2 hourly
rbs monitoring q 6 hourly
asepsis to be maintained
abdominal girth monitoring 4 hrly
eye care moisel eyedrop q 2 hrly, lacrigel ointment q 12 hrly |
| 9 |
028a27f4b |
None |
esophageal atresia- tracheosophageal fistula/post right posterolateral repair with primary anastmosis/post feeding gastrostomy/anastmotic site stricture/post retrograde dilatation of stricture/acute febrile illness/?lrti- ?cap/?gastrostomy site infection |
None |
aiims picu – pis
address: agra
father’s occupation: labourer
beneficiary of : jssk
weight
3.8 kg
length
56 cm
bsa
0.24 m2
et size
4 mm
fixed at
-
bp centiles
centiles
sbp
dbp
map
5th
75
42
50th
85
40
55
90th
99
52
68
95th
102
54
70
95th +12
114
66
82 |
| 10 |
808ec541b |
2186-04-24 |
acute febrile illness/lower respiratory tract infection disseminated staphylococcal infection |
o by nasal prongs @ 5 l/min |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: o by nasal prongs @ 5 l/min
sedation, analgesia, neuromuscular blockade: nil
inotropes/ antihypertensives: 48ml
inj adrenaline 7.6mg in 24 ml ns @ 2ml/hr(0.2mcg/kg/min)
antimicrobials/antifungals: 80ml
inj ceftriaxone 2g in 20ml ns iv over 30 min q12h day 2
inj teicoplanin 540mg in 20 ml ns iv over 30 min q24h day 2
inj clindamycin 500 mg iv q 6 hourly day 1
ivf : 720 ml
ivf dns with 2:100 kcl free @ 30 ml/hr
feeds: orally allowed
miscellaneous : 50 ml
inj hepsaline @ 2ml/hr (48ml)
inj pcm 550 mg iv sos
inj pantoprazole 40 mg iv od
inj vitamin k 5mg in 20 ml ns iv over 30 min every monday
tab clobazam 10 mg po hs
tab levera 500 mg - 750mg po q12h
nursing and supportive care:
input/output charting q 2 hrly
vital monitoring q2 hrly
ag monitoring q 8 hrly
rbs monitoring q 4 hourly
tbw (adm)
54 kg
length
172
bsa
1.6 m2
tfr
40% + feeds
tfv
820 ml
medications
100 ml
ivf
720 ml
feeds
orally allowed
k
0.5 meq/kg/d
jr sign sr sign |
| 11 |
808ec541b |
2186-04-25 |
acute febrile illness/lower respiratory tract infection/? disseminated staphylococcal infection/septic shock(resolved) |
o by nasal prongs @ 2 l/min |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: o by nasal prongs @ 2 l/min
sedation, analgesia, neuromuscular blockade: nil
inotropes/ antihypertensives:
inj adrenaline -stop
antimicrobials/antifungals: 140ml
inj ceftriaxone 2g in 20ml ns iv over 30 min q12h day 3
inj teicoplanin 540mg in 20 ml ns iv over 30 min q24h day 3
inj clindamycin 500 mg in 20ml ns iv over 30 minutes iv q 6 hourly day 2
ivf : 720 ml
ivf dns with 1:100 kcl @ 30 ml/hr
feeds: orally allowed
miscellaneous : 50 ml
inj hepsaline @ 2ml/hr (48ml)
inj pcm 550 mg iv sos
inj pantoprazole 40 mg iv od
inj vitamin k 5mg in 20 ml ns iv over 30 min every monday
tab clobazam 10 mg po hs
tab levera 500 mg - 750mg po q12h (@23mg/kg/day)
nursing and supportive care:
input/output charting q 2 hrly
vital monitoring q2 hrly
ag monitoring q 8 hrly
rbs monitoring q 4 hourly
tbw (adm)
54 kg
length
172
bsa
1.6 m2
tfr
42% + feeds
tfv
910 ml
medications
190 ml
ivf
720 ml
feeds
orally allowed
k
0.3meq/kg/d
jr sign sr sign |
| 12 |
d76276d5e |
2159-02-19 |
b/l chemo resistant retinoblastoma / apml ?tss ? clostridium perfringes sepsis |
None |
consultant: **Name**
jrs: **Name**
weight
15 kg
tfr
80%
tfv
960 ml
ivf
576 ml
ivm
160 m l
feeds
npo
tpn
nil
glucose
40 grams
gir
2 mg/kg/min
k
1.14 meq/kg/day
feeds:
npo
ivf: (576 ml)
10% dns (1:100 kcl) @ 25 ml/hour
inotropes:
inj. nor adrenaline 2.2mg/12ml 5%d @ 5ml/hr (0.5mcg/kg/min)
inj. milrinone 5.4mg/12ml 5% d @ 0.5 ml/hr (0.25mcg/kg/min)
antimicrobials: (100 ml)
inj ceftriaxone 700 mg iv q12h-day 3
inj vancomycin 140 mg in 25 ml ns iv over 1 hour q6h-day 3
miscellaneous: (60 ml)
inj perfalgan 140 mg iv sos.
inj calcium gluconate 10 ml in 10 ml 5% dextrose iv over 30 min q8h
nursing and supportive care:
input output monitoring q 2 hrly
temperature monitoring q 2 hrly
asepsis to be maintained.
rbs monitoring q8h |
| 13 |
ce5ba5a31 |
2150-03-06 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
psimv |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: psimv
sedation, analgesia, neuromuscular blockade: 12 ml
inj fentanyl (1ml=50mcg) @ 0.5 ml/hr (@ 0.5 mcg/kg/min)
inotropes/ antihypertensives : nil
antimicrobials: (50 ml) renal modified
inj. meropenem 1 g in 20 ml ns iv over 30 minutes q 12 hrly (40 ml) d5 (@ 50 mg/kg/dose)
inj teicoplanin 250 mg in 10 ml ns iv over 1 hr q 24 hrly d8 (@5mg/kg/dose) (10 ml)
iv fluid: 2400 ml
ivf n/2 saline +5% d (2:100 kcl) @ 100 ml/hr
feeds : npo
miscellaneous : 108 ml
inj insulin (1ml=1u) @ 2.5 ml/hr (@ 0.05 u/kg/hr) (60 ml)
tab pangraf (tacrolimus) 3 mg bd
tab cellcept (mmf) 180 mg bd
inj. hydrocort 25 mg q 6 hrly (0.5mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
inj hepsaline @ 2 ml/hr via arterial line (48 ml)
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 2 hourly
ag monitoring q 2 hrly
ng on continuous drainage
moisol eye drops 1 drop ne q 4 hrly
lacrigel ointment q 4hrly
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfr
122 %
tfv
2570 ml
blood products
-
medications
170 ml
ivf
2400 ml
feeds
-
gir
1.6 mg/kg/min + feeds
e gfr
38.8 ml/min/1.73m2
jr sign sr sign |
| 11845 |
4b7de8cbc |
None |
achd (vsd) ftt with pneumonia with chf (lv volume overload) |
None |
aiims picu – pis
doa: 23.11.22
address - weight - 9.6kg length: 55 cm bsa:
father’s occupation: driver
bp :
sbp
dbp
5th
72
50th
84
40
90th
98
52
95th
102
54
95th+12
114
66 |
| 14 |
ce5ba5a31 |
2150-03-04 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
psimv |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: psimv
sedation, analgesia, neuromuscular blockade: 125 ml
inj midazolam (1ml=1mg) @ 4 ml/hr (@ 1.3 mcg/kg/min)
inj fentanyl (1ml=50 mcg) @ 1.2 ml/hr (@ 1.2 mcg/kg/hr)
inotropes/ antihypertensives : (10 ml)
inj noradrenaline 15 mg in 50 ml d5 @ 0.4 ml/hr (@ 0.04 mcg/kg/min)
antimicrobials: (50 ml) renal modified
inj. meropenem 1 g in 20 ml ns iv over 30 minutes q 12 hrly (40 ml) d3 (@ 50 mg/kg/dose)
inj teicoplanin 250 mg in 10 ml ns iv over 1 hr q 24 hrly d6 (@5mg/kg/dose) (10 ml)
iv fluid: 2400 ml
ivf dns (1:100 kcl) @ 100 ml/hr
feeds : ng feeds (toned milk) 25 ml q 2hrly x 6 feeds f/b 30 ml q 2hrly x 6 feeds (150 ml)
miscellaneous : 77 ml
inj lasix 40 mg in 5 ml ns iv over 4 hours (1 mg/kg)
inj insulin (1ml=1u) @ 1 ml/hr (@ 0.02 u/kg/hr)
tab pangraf (tacrolimus) 3 mg bd
tab cellcept (mmf) 180 mg ) od
inj. hydrocort 25 mg q 6 hrly (0.5mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
inj hepsaline @ 2 ml/hr via arterial line (48 ml)
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 1 hourly
ag monitoring q 2 hrly
ng on continous drainage
moisol eye drops 1 drop ne q 4 hrly
lacrigel ointment q 4hrly
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfr
141%
tfv
2992 ml
blood products
-
medications
262 ml
ivf
2400 ml
feeds
330 ml
gir
1.6 mg/kg/min
e gfr
36.7 ml/min/1.73m2
jr sign sr sign |
| 15 |
ce5ba5a31 |
2150-03-09 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
o2 by prongs |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: o2 by prongs
sedation, analgesia, neuromuscular blockade: nil
inotropes/ antihypertensives :
tab amlodipine 5 mg bd
antimicrobials: (50 ml) renal modified
inj. meropenem 1 g in 20 ml ns iv over 30 minutes q 12 hrly (40 ml) d8 (@ 50 mg/kg/dose)
inj teicoplanin 250 mg in 10 ml ns iv over 1 hr q 24 hrly d 11 (@5mg/kg/dose) (10 ml)
iv fluid: 960 ml
ivf dns with 2:100 kcl @ 40 ml/hr
feeds :
oral feeds ad lib, liquids to quantify
syp. potklor (15ml/20meq) 10ml q6h (1 meq/kg/d)
miscellaneous : 60 ml
inj insulin- stop
inj lispro 8u-8u-8u (before meals)
tab cellcept (mmf) 180 mg bd
inj. hydrocort 25 mg q 6 hrly (0.5 mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 1 hourly
ag monitoring q 2 hrly
oral intake chart in detail
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfv target
2.5 - 3 l/day
blood products
-
medication
151 ml
ivf
960 ml
feeds
ad lib
oral liq
2 l/day
gir
1.4 mg/kg/min + feeds
k
ivf- 0.7 meq/kg
oral- 1 meq/kg
jr sign sr sign |
| 16 |
ce5ba5a31 |
2150-03-05 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
psimv |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: psimv
sedation, analgesia, neuromuscular blockade: 96 ml
inj midazolam (1ml=1mg) @ 4 ml/hr (@ 1.3 mcg/kg/min)
inotropes/ antihypertensives : nil
antimicrobials: (50 ml) renal modified
inj. meropenem 1 g in 20 ml ns iv over 30 minutes q 12 hrly (40 ml) d4 (@ 50 mg/kg/dose)
inj teicoplanin 250 mg in 10 ml ns iv over 1 hr q 24 hrly d7 (@5mg/kg/dose) (10 ml)
iv fluid: 2160 ml
ivf dns (1:100 kcl) @ 90 ml/hr
feeds : ng feeds (toned milk) 50 ml q 2hrly l (600 ml)
miscellaneous : 88 ml
inj insulin (1ml=1u) @ 1.7 ml/hr (@ 0.03 u/kg/hr) (40ml)
tab pangraf (tacrolimus) 3 mg bd
tab cellcept (mmf) 180 mg ) bd
inj. hydrocort 25 mg q 6 hrly (0.5mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
inj hepsaline @ 2 ml/hr via arterial line (48 ml)
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 2 hourly
ag monitoring q 2 hrly
ng on continuous drainage
moisol eye drops 1 drop ne q 4 hrly
lacrigel ointment q 4hrly
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfr
142%
tfv
2994 ml
blood products
-
medications
234 ml
ivf
2160 ml
feeds
600 ml
gir
1.5 mg/kg/min + feeds
e gfr
36.7 ml/min/1.73m2
jr sign sr sign |
| 17 |
ce5ba5a31 |
2150-03-07 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
psimv |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: psimv
sedation, analgesia, neuromuscular blockade: 10 ml
inj fentanyl (1ml=50mcg) @ 0.4 ml/hr (@ 0.4 mcg/kg/min)
inotropes/ antihypertensives :
tab amlodipine 5 mg bd
antimicrobials: (50 ml) renal modified
inj. meropenem 1 g in 20 ml ns iv over 30 minutes q 12 hrly (40 ml) d6 (@ 50 mg/kg/dose)
inj teicoplanin 250 mg in 10 ml ns iv over 1 hr q 24 hrly d9 (@5mg/kg/dose) (10 ml)
iv fluid: 2040 ml
ivf n/2 saline +5% d with 6:100 kcl @ 85 ml/hr
feeds : (600 ml)
ng feeds (toned milk) 50 ml q 2 hrly
syp. potklor 3 ml in each feed (36 ml)
oral sips of water allowed (to be quantified)
miscellaneous : 156 ml
inj insulin (1ml=1u) @ 1.5 ml/hr (@ 0.05 u/kg/hr) (36 ml)
inj magnesium sulphate 2g (4ml) in 40 ml ns iv over 4 hours x 3 doses q 6 hourly (120 ml)
tab pangraf (tacrolimus) 3 mg bd
tab cellcept (mmf) 180 mg bd
inj. hydrocort 25 mg q 6 hrly (0.5mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
inj hepsaline stop
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 1 hourly
ag monitoring q 2 hrly
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfr
137 %
tfv
2892 ml
blood products
-
ivm
216 ml
oral med
36 ml
ivf
2040 ml
feeds
600 ml
gir
1.4 mg/kg/min + feeds
k
ivf- 5 meq/kg/d
oral- 1 meq/kg/d
e gfr
50.83 ml/min/1.73m2
jr sign sr sign |
| 18 |
ce5ba5a31 |
2150-03-08 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
o2 by prongs |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: o2 by prongs
sedation, analgesia, neuromuscular blockade: 5 ml
inj fentanyl (1ml=50 mcg) @ 0.2 ml/hr (@ 0.2 mcg/kg/min)
inotropes/ antihypertensives :
tab amlodipine 5 mg bd
antimicrobials: (50 ml) renal modified
inj. meropenem 1 g in 20 ml ns iv over 30 minutes q 12 hrly (40 ml) d7 (@ 50 mg/kg/dose)
inj teicoplanin 250 mg in 10 ml ns iv over 1 hr q 24 hrly d 10 (@5mg/kg/dose) (10 ml)
iv fluid: 960 ml
ivf n/2 saline +5% d with 2:100 kcl @ 40 ml/hr
feeds :
oral feeds ad lib, liquids to quantify
syp. potklor 3 ml in each feed (36 ml)
miscellaneous : 60 ml
inj insulin (1ml=1u) @ 2.5 ml/hr (@ 0.05 u/kg/hr) (60 ml)
tab cellcept (mmf) 180 mg bd
inj. hydrocort 25 mg q 6 hrly (0.5 mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 1 hourly
ag monitoring q 2 hrly
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfv target
2.5 - 3 l/day
blood products
-
medication
151 ml
ivf
960 ml
feeds
ad lib
oral liq
2 l/day
gir
1.4 mg/kg/min + feeds
k
ivf- 0.7 meq/kg
oral- 1 meq/kg
jr sign sr sign |
| 19 |
ce5ba5a31 |
2150-02-28 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
hfnc |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: hfnc
sedation, analgesia, neuromuscular blockade: nil
inotropes/ antihypertensives : 36 ml
inj adr 15 mg in 50 ml ns @ 1.5 ml/hr (0.15mcg/kg/min)
antimicrobials: (70 ml)renal modified
inj. zosyn 4gm in 20 ml ns iv over 1 hr q 8 hrly
inj teicoplanin 400 mg in 8 ml ns iv over 1 hr q 24 hrly
iv fluid: 350 ml
ivf ns @ 350 ml/hr (@ 7ml/kg/hr)
feeds :nil
miscellaneous : 96 ml
inj insulin (1ml/mg) @ 2ml/hr (0.04ml/kg/h)
tab pangraf 3 mg bd
tab cellcept 180 mg od
inj. hydrocort 25 mg q 6 hrly
inj. pantop 40 mg iv od
inj. emset 4mg iv sos
inj hepsaline @ 2ml/hr via arterial line (48ml)
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 2hourly
ag monitoring q 2 hrly
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfr
%
tfv
ml
blood products
-
medications
202 ml
ivf
350 ml/h
feeds
nil
gir
egfr
47.2 ml/min/1.73m2
jr sign sr sign |
| 20 |
ce5ba5a31 |
2150-03-02 |
srns/ post lrrt/ckd 5t-2d/dengue with shock |
psimv |
name: **Name**
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support: psimv
sedation, analgesia, neuromuscular blockade: 96ml
inj midazolam (1ml=1mg) @3ml/hr (@1mcg/kg/min)
inj fentanyl (1ml=50 mcg) @1ml/hr (@1mcg/kg/hr)
inotropes/ antihypertensives : (120 ml)
inj adrenaline 15 mg in 50ml ns @ 2ml/hr (@0.2mcg/kg/min)
inj noradrenaline 15 mg in 50ml ns @3 ml/hr (@0.35mcg/kg/min)
antimicrobials: (70 ml) renal modified
inj. piperacillin-tazobactam 2.5 gm of piperacillin in 20 ml ns iv over 1 hr q 8 hrly -d4 (@50mg/kg/dose)
inj teicoplanin 250 mg in 8 ml ns iv over 1 hr q 24 hrly- d4 (@5mg/kg/dose)
iv fluid: 1704 ml
ivf dns (1:100 kcl) @ 71ml/hr
feeds : npo
miscellaneous : 96 ml
inj insulin (1ml=1u) @2ml/hr (@0.04 u/kg/hr)
w/h tab pangraf (tacrolimus) 3 mg bd
w/h tab cellcept (mmf) 180 mg bd
inj. hydrocort 25 mg q 6 hrly (0.5mg/kg/dose)
inj. pantop 40 mg iv od
inj. emeset 4mg iv sos
inj hepsaline @ 2ml/hr via arterial line (48ml)
nursing and supportive care:
input/output charting q 2h
vital monitoring q 2h
rbs monitoring q 1hourly
ag monitoring q 2 hrly
ng on continous drainage
wt (adm)
50.9 kg
length
160 cm
bsa
1.4 m2
tfr
100%
tfv
2086 ml
blood products
-
medications
382 ml
ivf
1920 ml
feeds
npo
gir
1.2 mg/kg/min
egfr
36.6 ml/min/1.73m2
jr sign sr sign |
| 21 |
5153d49b5 |
2137-10-17 |
cystic fibrosis with pulmonary exacerbation/ ? abpa |
None |
consultant: **Name**
jrs: **Name**
currentweight
14kg
height
110 cm
tfr
96%
tfv
1152ml
feeds
240ml
ivm
312ml
ivf
600ml
k+
nil
na
3.2 meq/kg/day
gir
1.8 mg/kg/min
feeds: ng feed 30 ml q 3 hourly ( 240ml)
ivf n/5 in 5% dextrose @ 25 ml/hr
antimicrobials: (220.5ml)
inj vancomycin stop
inj colistin 3.5 lakh unit/30ml ns q8hrly(d4) (90ml)
inj tigecycline 14 mg/15 ml ns over 1 hr q12hrly(d3)( 30ml)
inj voriconazole 125 mg/20 ml ns over 2 hr q12hrly(d3)(40ml)
inj. azithromycin 140mg/20ml ns iv over 60min give 2 more days (20ml)
inj septran 100 mg/10 ml ns iv q8hrly ( d2) @ 21mg/kg/day(30ml)
ionotropes: (7.2ml)
inj noradrenaline 4 mg/24 ml ns @ 0.3 ml/hr( @ 0.05mcg/kg/min)
sedation: (60ml)
inj midazolam (1 mg/ml) @ 2ml/hr ( @ 2.3 mcg/kg/min)(48ml)
inj fentanyl(50 mcg/ml) @ o.5ml/hr ( @ 1.7 mcg/kg/hr)(12ml)
miscellaneous:
inj vitamin k 5 mg iv every monday
inj hydrocortisone 30 mg iv q 6hrly
c creon – withheld
inj. hepsaline 1ml/hr(24ml)
sequential chest physiotherapy:
nebulisation with salbutamol 2.5 mg/3 ml ns q2hrly f/b 3% nacl 3 ml neb 4 hrly
f/b 3 ml n-acetylcysteine neb 4 hrly f/b chest physiotherapy 4 hrly f/b mdi ipravent 250 mcg 4 hrly f/b mdi foracort 200 mcg 2 puff bd f/b colistin nebulisation 5 lakh unit /4 ml ns bd
cf supplements:
t shelcal 500 mg 1 tab po od
c evion 200 iu 1 cap po od
visyneral drops 1.5 ml po od
syp vit d3 (1 ml – 400 iu) 1 ml po bd
inj paracetamol 150 mg iv sos.
inj pantoprazole 15 mg iv q 24 hourly
nursing and supportive care:
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs monitoring 4 hourly
abdominal girth monitoring q6h
skin and hair care
eye care
change position q2h
inform if uo <30 ml/2hourly or >120 ml/2 hourly.
attach positioning and physiotherapy chart |
| 22 |
5153d49b5 |
2137-10-16 |
cystic fibrosis with pulmonary exacerbation/ ? abpa |
None |
consultant: **Name**
jrs: **Name**
currentweight
14
height
110 cm
tfr
100%
tfv
1200 ml
feeds
npo
ivm
387
ivf
813
k+
2.3 meq/kg/day
na
2.9 meq/kg/day
gir
1.98 mg/kg/min
feeds: npo
ivf n/3 in 5% dextrose with kcl 2ml/100 ml @ 34 ml/hr
antimicrobials: (255 ml)
inj vancomycin 225 mg/10 ml ns over 1 hr q6hrly(d13)
inj colistin 3.5 lakh unit q8hrly(d3)
inj tigecycline 14 mg/15 ml ns over 1 hr q12hrly(d2)
inj voriconazole 125 mg/20 ml ns over 2 hr q12hrly(d2)
syp azithromycin(100 mg/5 ml) 4 ml od
inj septran 100 mg/5 ml ns iv q8hrly ( d1) @ 21mg/kg/day
ionotropes:
inj noradrenaline 4 mg/24 ml ns @ 0.5 ml/hr( @ 0.1 mcg/kg/min)
sedation:
inj midazolam (1 mg/ml) @ 4.5 ml/hr ( @ 5.5 mcg/kg/min)
inj fentanyl(50 mcg/ml) @ 1 ml/hr ( @ 3.7 mcg/kg/hr)
miscellaneous:
inj vitamin k 5 mg iv every monday
inj hydrocortisone 30 mg iv q 6hrly
c creon – withheld
sequential chest physiotherapy:
nebulisation with salbutamol 2.5 mg/3 ml ns q2hrly f/b 3% nacl 3 ml neb 4 hrly
f/b 3 ml n-acetylcysteine neb 4 hrly f/b chest physiotherapy 4 hrly f/b mdi ipravent 250 mcg 4 hrly f/b mdi foracort 200 mcg 2 puff bd f/b colistin nebulisation 5 lakh unit /4 ml ns bd
cf supplements:
t shelcal 500 mg 1 tab po od
c evion 200 iu 1 cap po od
visyneral drops 1.5 ml po od
syp vit d3 (1 ml – 400 iu) 1 ml po bd
inj paracetamol 150 mg iv sos.
inj pantoprazole 15 mg iv q 24 hourly
nursing and supportive care:
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs monitoring 4 hourly
abdominal girth monitoring q6h
skin and hair care
eye care
change position q2h
inform if uo <30 ml/2hourly or >120 ml/2 hourly.
attach positioning and physiotherapy chart |
| 23 |
5c9b97343 |
2123-06-09 |
tuberous sclerosis/ ards/ septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
22 kg
bsa
0.84
gfr
32
tfr
600 ml/m2
tfv
462 ml
ivf
120 ml
feeds
npo
ivm
342 ml
na
nil
gir
2.2
glucose
64
feeds
npo;ng on continuous drainage.
ivf:
inj 50 % dextrose @ 5 ml/hr (120 ml)
inotropes: ( ml)
inj noradrenaline 3.2 mg in 12 ml 5% dextrose @ 1 ml/hr (0.2 mcg/kg/min) stop
antimicrobials: (100 ml)
inj. septran 60 mg of trimethoprim in 10 ml 5% dextrose q12 hrly -20 ml
inj. fungisome 50 mg/50 ml pre chilled ns over 3 hrs 24hrly -50 ml day 11
inj. vancomycin 220mg/30ml 10 % dextrose q24hrly- 30ml day 12
inj. zosyn 2.2 gm of piperacillin iv q8hrly day 11
miscellaneous: (242 ml)
t. lamotrigine 25mg 1tab bd (2mg/kg/day)stop
inj. levera 170mg/20ml ns iv bd ( 15 mg/kg/day)-40 ml
inj. fentanyl ( 1ml =50mcg) 0.9ml/hr (2 mcg/kg/hr)-22 ml
inj. midazolam ( 1mg=1ml) 4 ml/hr (3 mcg/kg/min)-96 ml
syr. carnisure 7.5 ml 8 hrly stop
inj. pantocid 20mg iv od
inj. vit k 5mg iv every day
inj. methyl prednisolone 40mg/25ml ns iv q24h -25 ml
stop amlodipine
inj. hepsaline @ 2ml /hr
inj. ntp 10mg/12ml ns @ 0.5ml/hr (3 mcg/kg/min)
nursing and supportive care:
input output monitoring q2hrly, temperature monitoring q2hrly
asepsis to be maintained
rbs monitoring 4 hrly
mouth care 8 hrly with chlorhexidine
head in midline and elevation by 300
moisel e/d 2hrly |
| 24 |
5c9b97343 |
2123-06-10 |
tuberous sclerosis/ ards/ septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
22 kg
bsa
0.84
gfr
17
tfr
450 ml/m2
tfv
378 ml
ivf
113 ml
feeds
npo
ivm
265 ml
na
nil
gir
2.2
glucose
64
feeds
npo;ng on continuous drainage.
ivf:
inj 50 % dextrose @ 5 ml/hr (120 ml)
inotropes: (7 ml)
inj noradrenaline 3.2 mg in 12 ml 5% dextrose @ 0.3 ml/hr (0.06 mcg/kg/min)
antimicrobials: (100 ml)
inj. septran 60 mg of trimethoprim in 10 ml 5% dextrose q12 hrly -20 ml
inj. fungisome 50 mg/50 ml pre chilled ns over 3 hrs 24hrly -50 ml day 13
inj. vancomycin 220mg/30ml 10 % dextrose q24hrly- 30ml day 14
inj. zosyn 1.5 gm of piperacillin iv q6hrly day 13
miscellaneous: (158 ml)
t. lamotrigine 25mg 1tab bd (2mg/kg/day)stop
inj. levera 170mg/15ml ns iv bd ( 15 mg/kg/day)-30 ml
inj. fentanyl ( 1ml =50mcg) 0.9ml/hr (2 mcg/kg/hr)-22 ml
inj. midazolam ( 1mg=1ml) 2 ml/hr (2.4 mcg/kg/min)-48 ml
syr. carnisure 7.5 ml 8 hrly stop
inj. pantocid 20mg iv bd
inj. vit k 5mg iv every day
inj. methyl prednisolone 40mg/10ml ns iv q24h -10 ml
stop amlodipine
inj. hepsaline @ 1 ml /hr ---24 ml
inj vecuronium 50 mg + 24 ml ns @ 1 ml/hr (0.1 mg/kg/hr)
stop nahc03
nursing and supportive care:
input output monitoring q2hrly, temperature monitoring q2hrly
asepsis to be maintained
rbs monitoring 4 hrly
mouth care 8 hrly with chlorhexidine
head in midline and elevation by 300
moisel e/d 2hrly |
| 25 |
5c9b97343 |
2123-06-05 |
tuberous sclerosis/ ards/ septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
22 kg
bsa
0.84
gfr
26
tfr
60%(as per ideal body weight)
tfv
791 ml
ivf
120 ml
feeds
120 ml
ivm
551 ml
k
0.45 meq/kg/day+ feed
na
feed
gir
feed
glucose
feed
feeds
ng feeds 10 ml ( 1/3rd scoop in 10ml) 2 hourly -120 ml
syp potklor 1.2 ml per feed. stop
ivf:
ivf n/2 10% d 5ml/hr with 4ml kcl in 100ml ivf -120ml
inotropes: nil
antimicrobials: (100 ml)
inj. septran 60 mg of trimethoprim in 10 ml 5% dextrose q12 hrly -20 ml
inj. fungisome 50 mg/50 ml pre chilled ns over 3 hrs 24hrly -50 ml day 9
inj. vancomycin 220mg/30ml 10 % dextrose q24hrly- 30ml day 10
inj. zosyn 2.2 gm of piperacillin iv q8hrly day 9
miscellaneous: (451 ml)
t. lamotrigin 25mg 1tab bd (2mg/kg/day)
inj. levera 170mg/20ml ns iv bd ( 15 mg/kg/day)-40ml
inj. fentanyl ( 1ml =50mcg) 0.9ml/hr (2 mcg/kg/hr)-22ml
inj. midaz ( 1mg=1ml) 4 ml/hr (3 mcg/kg/min)-96 ml
inj. lasix 50mg/24 ml ns @ 2 ml/hr (0.2mg/kg/hr)-48ml
syr. carnisure 7.5 ml 8 hrly
inj. pantocid 20mg iv od
inj. vit k 5mg iv every day
inj. methyl prednisolone 40mg/25ml ns iv q24h -25 ml
inj aminoven 220 ml @ 9.1 ml/hour-----220 ml
nursing and supportive care:
input output monitoring q2hrly, temperature monitoring q2hrly
asepsis to be maintained
rbs monitoring 4 hrly
mouth care 8 hrly with chlorhexidine
head in midline and elevation by 300
minimal stimulation
before painful procedure (use lignocain 22mg i.v;midazolam 2.2mg; fentanyl 22mcg)
moisel e/d 2hrly
stop otrivin nasal drops |
| 26 |
5c9b97343 |
2123-06-07 |
tuberous sclerosis/ ards/ septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
22 kg
bsa
0.84
gfr
23
tfr
60%(as per ideal body weight)
tfv
790 ml
ivf
stop
feeds
240 ml
ivm
551 ml
k
feed
na
feed
gir
4 grams +feed
glucose
feeds
aminoven
1 g/kg/day
feeds
ng feeds 20 ml 2 hourly -240 ml
ivf: stop
inotropes: nil
antimicrobials: (100 ml)
inj. septran 60 mg of trimethoprim in 10 ml 5% dextrose q12 hrly -20 ml
inj. fungisome 50 mg/50 ml pre chilled ns over 3 hrs 24hrly -50 ml day 10
inj. vancomycin 220mg/30ml 10 % dextrose q24hrly- 30ml day 11
inj. zosyn 2.2 gm of piperacillin iv q8hrly day 10
miscellaneous: (451 ml)
t. lamotrigin 25mg 1tab bd (2mg/kg/day)
inj. levera 170mg/20ml ns iv bd ( 15 mg/kg/day)-40 ml
inj. fentanyl ( 1ml =50mcg) 0.9ml/hr (2 mcg/kg/hr)-22 ml
inj. midaz ( 1mg=1ml) 4 ml/hr (3 mcg/kg/min)-96 ml
inj. lasix 50mg/24 ml ns @ 2 ml/hr (0.2mg/kg/hr)-48 ml
syr. carnisure 7.5 ml 8 hrly
inj. pantocid 20mg iv od
inj. vit k 5mg iv every day
inj. methyl prednisolone 40mg/25ml ns iv q24h -25 ml
inj aminoven 220 ml @ 9.1 ml/hour-----220 ml
t. amlodipine 2.5 mg bd (0.23 mg/kg/day)
nursing and supportive care:
input output monitoring q2hrly, temperature monitoring q2hrly
asepsis to be maintained
rbs monitoring 4 hrly
mouth care 8 hrly with chlorhexidine
head in midline and elevation by 300
moisel e/d 2hrly |
| 27 |
5c9b97343 |
2123-06-04 |
tuberous sclerosis/ ards/ septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
22 kg
bsa
0.84
gfr
26
tfr
60%(as per ideal body weight)
tfv
800 ml
ivf
69 ml
feeds
180 ml
ivm
551 ml
k
0.9 meq/kg/day
na
feed
gir
feed
glucose
feed
feeds
ng feeds 20 ml 2 hourly -480 ml
syp potklor 1.2 ml per feed.
ivf:
nil
inotropes: nil
antimicrobials: (100 ml)
inj. septran 60 mg of trimethoprim in 10 ml 5% dextrose q12 hrly -20 ml
inj. fungisome 50 mg/50 ml pre chilled ns over 3 hrs 24hrly -50 ml day 8
inj. vancomycin 220mg/30ml 10 % dextrose q24hrly- 30ml day 9
inj. zosyn 2.2 gm of piperacillin iv q8hrly day 8
miscellaneous: (527 ml)
t. lamotrigin 25mg 1tab bd (2mg/kg/day)
inj. levera 170mg/20ml ns iv bd ( 15 mg/kg/day)-40ml
inj. fentanyl ( 1ml =50mcg) 0.9ml/hr (2 mcg/kg/hr)-22ml
inj. midaz ( 1mg=1ml) 4 ml/hr (3 mcg/kg/min)-96 ml
inj. lasix 50mg/24 ml ns @ 2 ml/hr (0.2mg/kg/hr)-48ml
syr. carnisure 7.5 ml 8 hrly
inj. pantocid 20mg iv od
inj. vit k 5mg iv every day
inj. methyl prednisolone 40mg/25ml ns iv q24h -25 ml
inj aminoven 220 ml @ 9.1 ml/hour-----220 ml
nursing and supportive care:
input output monitoring q2hrly, temperature monitoring q2hrly
asepsis to be maintained
rbs monitoring 4 hrly
mouth care 8 hrly with chlorhexidine
head in midline and elevation by 300
minimal stimulation
before painful procedure (use lignocain 22mg i.v;midazolam 2.2mg; fentanyl 22mcg)
moisel e/d 2hrly
stop otrivin nasal drops |
| 28 |
5c9b97343 |
2123-06-03 |
tuberous sclerosis/ ards/ septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
22 kg
bsa
0.84
tfr
60%( as per ideal body weight)
tfv
800 ml
ivf
291 ml
feeds
npo
ivm
509 ml
k
1.6
na
2.8
gir
1 mg/kg/min
glucose
32.1 gm
feeds
keep npo
ivf: (291ml)
ivf n/3 in 10% d ( 6 : 100ml kcl) @ 12 ml/hr
inotropes: (12ml)
inj. milrinone 8mg/12ml ns @ 0.3ml /hr (0.15mcg/kg/min)
antimicrobials: (175 ml)
inj. septran 110mg of trimethoprime in 20ml of ns 6 hrly -80ml
inj. liposomal ampho b 65mg/65 ml 5% d iv over 3hrs 24hrly -65ml
inj. vancomycin 220mg/30ml ns 24hrly- 30ml
inj. zosyn 1.5gm iv 8hrly
miscellaneous: (322 ml)
t. lamotrigin 25mg 1tab bd (2mg/kg/day)
inj. levera 170mg/20ml ns iv bd ( 15mg/kg/day)-40ml
inj. fentanyl ( 1ml =50mcg) 1.6ml/hr (3.6mcg/kg/hr)-38ml
inj. midaz ( 1mg=1ml) 6.5ml/hr 95mcg/kg/min)-156ml
inj. lasix 50mg/24 ml ns @ 2 ml/hr (0.2mg/kg/hr)-48ml
syr. carnisure 7.5ml 8 hrly
syr. salbutamol stop
inj. pantocid 20mg iv od
inj. vit k 5mg iv every day
inj. methyl prednisolone 22mg/25ml ns iv bd -50ml
nursing and supportive care:
input output monitoring q2hrly, temperature monitoring q2hrly
asepsis to be maintained
rbs monitoring 4 hrly
mouth care 8 hrly with chlorhexidine
head in midline and elevation by 300
minimal stimulation
before painful procedure (use lignocain 22mg i.v;midazolam 2.2mg; fentanyl 22mcg)
moisel e/d 2hrly
otrivin nasal drops bd |
| 29 |
0c3f1d566 |
2144-11-03 |
srns( ir/fsgs ) with aki with septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
31 kg
bsa
1sq m
tfr
1258 ml/sqm
tfv
1315 ml
ivf
1074 ml
ivm
184 ml
glucose
72 gm
gir
1.6
tpn
a2l2
feeds
60
k
0.5 meq/kg/day
feeds: 5 ml toned milk q 2 hrly (60 ml)
ivf: inj ivf 50% dextrose (6 : 100 ml kcl) @ 6ml per hour (144 ml)
inj. aminoven 620 ml @ 25.8 ml /hr
inj . intralipid 310 ml @ 13 ml /hr
antimicrobials: (renal modified doses)(40 ml)
inj. teicoplanin 155 mg in 10 ml ns over 1 hour 24 hourly (day 9)
inj. zosyn 2.1 gm iv q 8 hrly (day 9) (30 ml)
miscellaneous: (144 ml)
inj heparin via arterial line at 2ml/hr (48ml)
inj pantoprazole 30mg iv od
inj sodium nitroprusside
adrenaline nebulization 5.0 mg/3 ml ns q 4 hrly
budecort nebulization 1 mg/3 ml ns q 12 hrly
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 4 hourly
clustering of procedures, asepsis to be maintained
eye care. moisol eye drop q 2 hourly, lacrigel ointment locally q 12 hourly, eye padding
et suctioning sos
abdominal girth monitoring 2 hrly |
| 30 |
0c3f1d566 |
2144-11-01 |
srns( ir/fsgs ) with aki with septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
31 kg
bsa
1sq m
tfr
1210 ml/sqm
tfv
1210 ml
ivf
1074 ml
ivm
136 ml
glucose
72 gm
gir
1.6
tpn
a2l2
feeds
npo
k
0.5 meq/kg/day
feeds: npo
ivf: inj ivf 50% dextrose (6 : 100 ml kcl) @ 6ml per hour (144 ml)
inj. aminoven 620 ml @ 25.8 ml /hr
inj . intralipid 310 ml @ 13 ml /hr
antimicrobials: (renal modified doses)(40 ml)
inj. teicoplanin 155 mg in 10 ml ns over 1 hour 24 hourly (day 8)
inj. zosyn 2.1 gm iv q 8 hrly (day 8) (30 ml)
miscellaneous: (96 ml)
inj heparin via arterial line at 2ml/hr (48ml)
inj hydrocortisone 15 mg iv q 6 hrly
stop midazolam and fentanyl
inj pantoprazole 30mg iv od
inj sodium nitroprusside 22 mg in 12 ml ns @ 2ml/hr (48ml) (2 mcg/kg/min)
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 4 hourly
clustering of procedures, asepsis to be maintained
eye care. moisol eye drop q 2 hourly, lacrigel ointment locally q 12 hourly, eye padding
et suctioning sos
abdominal girth monitoring 2 hrly |
| 32 |
0c3f1d566 |
2144-10-30 |
srns( ir/fsgs ) with aki with septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
31 kg
bsa
1sq m
tfr
604 ml/sqm
tfv
604 ml
ivf
300 ml
ivm
304 ml
feeds
npo
k
1meq/kg/day
feeds: npo
ivf: inj ivf 50% dextrose (5: 100 ml kcl) @ 12 per hour (300 ml)
antimicrobials: (renal modified doses)(40 ml)
inj teicoplanin 155 mg in 10 ml ns over 1 hour 24 hourly (day 6)
inj zosyn 2.1 gm iv q 8 hrly (day 6) (30 ml)
ionotropes: nil
miscellaneous: (266 ml)
inj heparin via arterial line at 2ml/hr (48ml)
inj 3% nacl 2.5ml/hr (60ml)
inj hydrocortisone 15 mg iv q 6 hrly
inj midazolam (1ml=1 mg) @ 3 ml/hr (1.6 mcg/kg/min) (72 ml)
inj fentanyl (1ml= 50 mcg) @0.6 ml/hr (1 mcg/kg/min) (14.4 ml)
inj vecuronium infusion (1ml=1mg) at 3ml/hr (72 ml)
inj pantoprazole 30mg iv od
inj midaz 3mg and inj xylocord 30mg before every painful procedure.
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 2 hourly
clustering of procedures, asepsis to be maintained
eye care. moisol eye drop q 2 hourly, lacrigel ointment locally q 12 hourly, eye padding
et suctioning sos |
| 33 |
0c3f1d566 |
2144-11-02 |
srns( ir/fsgs ) with aki with septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
31 kg
bsa
1sq m
tfr
1258 ml/sqm
tfv
1315 ml
ivf
1074 ml
ivm
184 ml
glucose
72 gm
gir
1.6
tpn
a2l2
feeds
60
k
0.5 meq/kg/day
feeds: 5 ml toned milk q 2 hrly (60 ml)
ivf: inj ivf 50% dextrose (6 : 100 ml kcl) @ 6ml per hour (144 ml)
inj. aminoven 620 ml @ 25.8 ml /hr
inj . intralipid 310 ml @ 13 ml /hr
antimicrobials: (renal modified doses)(40 ml)
inj. teicoplanin 155 mg in 10 ml ns over 1 hour 24 hourly (day 9)
inj. zosyn 2.1 gm iv q 8 hrly (day 9) (30 ml)
miscellaneous: (144 ml)
inj heparin via arterial line at 2ml/hr (48ml)
inj pantoprazole 30mg iv od
inj sodium nitroprusside 22 mg in 12 ml ns @ 4ml/hr (96 ml) (4 mcg/kg/min)
adrenaline nebulization 5.0 mg/3 ml ns q 4 hrly
budecort nebulization 1 mg/3 ml ns q 12 hrly
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 4 hourly
clustering of procedures, asepsis to be maintained
eye care. moisol eye drop q 2 hourly, lacrigel ointment locally q 12 hourly, eye padding
et suctioning sos
abdominal girth monitoring 2 hrly |
| 34 |
0c3f1d566 |
2144-10-29 |
srns( ir/fsgs ) with aki with septic shock |
None |
consultant: **Name**
jrs: **Name**
weight
31 kg
bsa
1sq m
tfr
694 ml/sqm
tfv
694 ml
ivf
360 ml
ivm
334 ml
feeds
npo
k
-
feeds: npo
ivf: inj ivf 50% dextrose @ 15 per hour (360 ml)
antimicrobials: (renal modified doses)(40 ml)
inj teicoplanin 155 mg in 10 ml ns over 1 hour 24 hourly (day 5)
inj zosyn 2.1 gm iv q 8 hrly (day 5) (30 ml)
ionotropes: (60 ml)
inj nor adrenaline 9mg/24 ml 5%d @ 1.5 ml/hr (@ 0.3mcg/kg/min)
inj dopamine 450 mg/12 ml ns @ 1 ml/hr ( @ 20mcg/kg/min)
miscellaneous: (234 ml)
inj heparin via arterial line at 2ml/hr (48ml)
inj hydrocortisone 15 mg iv q 6 hrly
inj midazolam (1ml=1 mg) @ 3 ml/hr (1.6 mcg/kg/min) (72 ml)
inj fentanyl (1ml= 50 mcg) @0.6 ml/hr (1 mcg/kg/min) (14.4 ml)
inj 20 % albumin 100ml over 4 hours.
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 2 hourly
clustering of procedures, asepsis to be maintained
eye care. moisol eye drop q 2 hourly, lacrigel ointment locally q 12 hourly, eye padding
et suctioning sos |
| 35 |
58b511a89 |
2152-09-27 |
?septic shock ?inborn error of metabolism |
None |
consultant: **Name**
jrs: **Name**
wt
6.8 kg
tfr
70%
total fluid
480 ml
feeds
npo
ivm
114 ml
ivf
360 ml
glucose
-
gir
3.6
na
4meq/kg/day
k
1meq/kg/day
feeds: npo
ivf: n/2 + 10%d @ 15 ml/hr
inotropes: (30ml)
inj nor-adrenaline 2 mg in 12ml 5% d @ 0.3 ml/hr(7ml)(0.1 mcg/kg/min)
inj dopamine 100 mg in 12 ml ns @ 0.5 ml/hr (12 ml) (10 mcg/kg/min)
inj dopamine 100 mg in 12 ml ns @ 0.5 ml/hr (12 ml) (10 mcg/kg/min)
antimicrobials (60 ml):
inj ceftriaxone 340 mg iv q 12 hourly(d1)
inj vancomycin 100 mg in 15 ml ns over 1 hr every 6 hourly(d1)
miscellaneous: (24ml)
inj vit k 2 mg in 2.5 ml ns iv stat followed by every monday
inj hepsaline @ 1ml/hr (24 ml)
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 4 hourly
clustering of procedures, asepsis to be maintained
moisol e/d 1 drop each eye q 4 hourly, lacrigel ointment both eyes bd |
| 36 |
58b511a89 |
2152-09-28 |
?septic shock ?inborn error of metabolism |
None |
consultant: **Name**
jrs: **Name**
wt
6.8 kg
tfr
70%
total fluid
480 ml
feeds
npo
ivm
149 ml
ivf
331 ml
glucose
58 g
gir
6 mg/kg/min
na
2meq/kg/day
k
2meq/kg/day
feeds: npo
ivf: 10%d 106 ml
25%d 190 ml
3% nacl 28 ml
15% kcl 7 ml
total 331 ml @ 14 ml/hr
inotropes: (48ml)
inj nor-adrenaline 2 mg in 12ml 5% d @ 0.3 ml/hr(7ml)(0.12 mcg/kg/min)
inj dobutamine 100 mg in 12 ml ns @ 1 ml/hr (12 ml) (20 mcg/kg/min)
inj dopamine 100 mg in 12 ml ns @ 0.8 ml/hr (12 ml) (16 mcg/kg/min)
inj adrenaline 2 mg in 12 ml ns @0.2 ml/h (4.8 ml) (0.07 mcg/kg/min)
inj milrinone 2.5 mg in 12 ml ns @0.5 ml/h (0.25 mcg/kg/min) (12 ml)
antimicrobials (60 ml):
inj ceftriaxone 350 mg iv q 12 hourly(d2)
inj vancomycin 100 mg in 15 ml ns over 1 hr every 6 hourly(d2) (60 ml)
miscellaneous: (41ml)
inj vit k 2 mg in 2.5 ml ns iv stat followed by every monday
inj hepsaline @ 1ml/hr (24 ml)
inj midazolam undiluted @ 0.5 ml/h (12 ml) (1.2 mcg/kg/min)
inj fentanyl (1 ml=50 mcg)@0.2 ml/h (4.8 ml) (1.5 mcg/kg/min)
nursing and supportive care:
input output monitoring q2h
temperature monitoring q2h
rbs monitoring q 4 hourly
clustering of procedures, asepsis to be maintained
moisol e/d 1 drop each eye q 4 hourly, lacrigel ointment both eyes bd |
| 37 |
8ca1c4dd4 |
2121-02-28 |
developmental delay with status epilepticus with shock |
None |
consultant: **Name**
jrs: **Name**
feeds – ad lib
iv fluids (nil)
inotropes (7.2 ml)
inj dopamine - stop
inj milrinone 4.3 mg in 12 ml ns @ 0.3 ml/hr (0.15 mcg/kg/minute) (7.2 ml)
antimicrobials (12 ml)
inj. ceftriaxone 600 mg iv q 12 hourly (day 4)
miscellaneous (56 ml)
inj. paracetamol – 120 mg – iv – sos
inj 3% nacl @ 1.5 ml/hr (36 ml) (0.125 ml/kg/hr)
inj valproate 180 mg in 10 ml ns over 1 hour q 12 hourly (20 ml) (30 mg/kg/min)
inj calcium gluconate- stop
syp shelcal 5 ml tds po
syp potklor 4 ml po tds
nursing and supportive care
input output monitoring q2h
temperature monitoring q2h
rbs monitoring – q 3 hourly
minimal stimulation, head in midline
inj fentanyl 10 mcg before painful procedure
asepsis to be maintained
weight
12 kg
tfv
75 ml plus feeds
tfr
6.2 ml/kg + feeds
ivf
nil
feeds
adlib
ivm
75 ml
k+
1.33 meq/kg/day
glucose
feeds
gir
- |
| 38 |
8ca1c4dd4 |
2121-02-26 |
developmental delay with status epilepticus with shock |
None |
consultant: **Name**
jrs: **Name**
feeds
npo
iv fluids (720ml)
dns ( 10% ) @ 30 ml/hr (720 ml); add 1 ml kcl per 100 ml fluid
inotropes (46 ml)
inj dopamine 90 mg in 12 ml ns @ 1.4 ml/hr (14 mcg/kg/min) (34 ml)
inj milrinone 4.3 mg in 12 ml ns @ 0.5 ml/hr (0.25 mcg/kg/minute) (12 ml)
antimicrobials (12 ml)
inj. ceftriaxone 600 mg iv q 12 hourly (day2)
miscellaneous (268 ml)
inj. paracetamol – 120 mg – iv – sos
inj 3% nacl @ 6 ml/hr (144 ml) (0.5 ml/kg/hr)
inj valproate 180 mg in 10 ml ns over 1 hour q 12 hourly (20 ml) (30 mg/kg/min)
inj hepsaline @ 1ml/hr (24 ml)
inj calcium gluconate 10 ml in 10 ml 5% dx over 30 min under cardiac monitoring q 6 hourly (80 ml)
nursing and supportive care
input output monitoring q2h
temperature monitoring q2h
rbs monitoring – q 3 hourly
minimal stimulation, head in midline
inj fentanyl 10 mcg before painful procedure
asepsis to be maintained
weight
12 kg
tfv
100%
tfr
1050 ml
ivf
720 ml
feeds
npo
ivm
326 ml
k+
1.2 meq/kg/day
glucose
72 gm
gir
4.1 mg/kg/min |
| 39 |
8ca1c4dd4 |
2121-02-27 |
developmental delay with status epilepticus with shock |
None |
consultant: **Name**
jrs: **Name**
feeds (720 ml)
orally allowed/ feeds atleast 60 ml q 2hourly
iv fluids (nil)
inotropes ( 36 ml)
inj dopamine 90 mg in 12 ml ns @ 0.8 ml/hr (8 mcg/kg/min) (19 ml)
inj milrinone 4.3 mg in 12 ml ns @ 0.5 ml/hr (0.25 mcg/kg/minute) (12 ml)
antimicrobials (12 ml)
inj. ceftriaxone 600 mg iv q 12 hourly (day 3)
miscellaneous (152 ml)
inj. paracetamol – 120 mg – iv – sos
inj 3% nacl @ 3 ml/hr (72 ml) (0.25 ml/kg/hr)
inj valproate 180 mg in 10 ml ns over 1 hour q 12 hourly (20 ml) (30 mg/kg/min)
inj hepsaline stop
inj calcium gluconate 10 ml in 10 ml 5% dx over 30 min under cardiac monitoring q 8 hourly (60 ml)
syp potklor 4 ml po tds
nursing and supportive care
input output monitoring q2h
temperature monitoring q2h
rbs monitoring – q 3 hourly
minimal stimulation, head in midline
inj fentanyl 10 mcg before painful procedure
asepsis to be maintained
weight
12 kg
tfv
200 ml plus feeds
tfr
16.6 ml/kg + feeds
ivf
nil
feeds
adlib
ivm
200 ml
k+
1.33 meq/kg/day
glucose
feeds
gir
- |
| 40 |
5d583ba32 |
2167-04-25 |
complicated pneumonia with empyema rt |
None |
consultant: **Name**
jrs: **Name**
weight
19 kg
tfr
60 %
tfv
870 ml
ivf
425ml
feeds
-
ivm
445 ml
k+
0.45 meq/kg/d
na
4.7 meq/kg/day
tpn
--
glucose
42g
gir
1.5mg/kg/min
feeds:
allow orally
ivf: (425 ml)
ivf 10 %dns @ 17 ml/hr (add 1 ml kcl/100 ml iv fluid)
antimicrobials: (445 ml)
inj meropenem 570 mg in 20 ml ns iv q 8 hrly (30mg/kg/dose) (d6)—60 ml
inj linezolid 190mg iv q8h (d6) (285 ml)
inj azithromycin 190 mg in 100 ml ns iv over 1 hour q 24 hrly (100 ml) (d5)
misc
sedation: nil
others:
inj perfalgan 190 mg i.v. sos
inj vit k 5 mg stat followed by every weekly (sat)
oral care with chlorhexidine mouth wash q12h
nursing care:
input output monitoring q2h
temperature monitoring q2h
asepsis to be maintained,
rbs monitoring – q 12 hour
keep head in midline, elevated by 30 degrees
inform if uo < 40 ml or >150 ml in 2 hours
care of chest tube. measure chest tube drain daily |
| 41 |
5d583ba32 |
2167-04-27 |
complicated pneumonia with empyema rt |
None |
consultant: **Name**
jrs: **Name**
weight
19 kg
tfr
60 %
tfv
870 ml
ivf
525 ml
feeds
-
ivm
345 ml
k+
feeds
na
2.27meq/kg/day
tpn
--
glucose
14g+feeds
gir
0.5+feeds
feeds:
allow orally
ivf: (525 ml)
ivf dns (no kcl) @22ml/hr
antimicrobials: (345 ml)
inj meropenem 570 mg in 20 ml ns iv q 8 hrly (30mg/kg/dose) (d8)—60 ml
inj linezolid 190mg iv q8h (d8) (285 ml)
inj azithromycin - stop
misc
sedation: nil
others:
inj perfalgan 190 mg i.v. sos
inj vit k 5 mg x 2days. followed by every weekly (sat)
oral care with chlorhexidine mouth wash q12h
nursing care:
input output monitoring q2h
temperature monitoring q2h
asepsis to be maintained,
rbs monitoring – q 12 hour
keep head in midline, elevated by 30 degrees
inform if uo < 40 ml or >150 ml in 2 hours
care of chest tube. measure chest tube drain daily |
| 42 |
5d583ba32 |
2167-04-26 |
complicated pneumonia with empyema rt |
None |
consultant: **Name**
jrs: **Name**
weight
19 kg
tfr
50 %
tfv
725 ml
ivf
280 ml
feeds
-
ivm
445 ml
k+
feeds
na
2.27meq/kg/day
tpn
--
glucose
14g+feeds
gir
0.5+feeds
feeds:
allow orally
ivf: (280 ml)
ivf dns (no kcl) @12ml/hr
antimicrobials: (445 ml)
inj meropenem 570 mg in 20 ml ns iv q 8 hrly (30mg/kg/dose) (d7)—60 ml
inj linezolid 190mg iv q8h (d7) (285 ml)
inj azithromycin 190 mg in 100 ml ns iv over 1 hour q 24 hrly (100 ml) (d6)
misc
sedation: nil
others:
inj perfalgan 190 mg i.v. sos
inj vit k 5 mg stat followed by every weekly (sat)
oral care with chlorhexidine mouth wash q12h
nursing care:
input output monitoring q2h
temperature monitoring q2h
asepsis to be maintained,
rbs monitoring – q 12 hour
keep head in midline, elevated by 30 degrees
inform if uo < 40 ml or >150 ml in 2 hours
care of chest tube. measure chest tube drain daily |
| 43 |
5d583ba32 |
2167-04-28 |
complicated pneumonia with empyema rt |
None |
consultant: **Name**
jrs: **Name**
weight
19 kg
tfv
feeds
ivf
525 ml
feeds
-
ivm
345 ml
k+
feeds
na
feeds
tpn
--
glucose
feeds
gir
feeds
feeds:
allow orally .
ivf: stop
antimicrobials: (345 ml)
inj meropenem 570 mg in 20 ml ns iv q 8 hrly (30mg/kg/dose) (d9)—60 ml
inj linezolid 190mg iv q8h (d9) (285 ml)
inj azithromycin - stop
misc
sedation: nil
others:
inj perfalgan 190 mg i.v. sos
inj vit k 5 mg today followed by every weekly (sat)
oral care with chlorhexidine mouth wash q12h
nursing care:
input output monitoring q2h
temperature monitoring q2h
asepsis to be maintained,
rbs monitoring – q 12 hour
keep head in midline, elevated by 30 degrees
inform if uo < 40 ml or >150 ml in 2 hours
care of chest tube. measure chest tube drain daily |
| 44 |
8cb85f5fb |
2161-06-04 |
congenital heart disease /coarctation of aorta/ ccf with pneumonia |
None |
consultant: **Name**
jrs: **Name**
1 /10/2018
weight
3.3kg
length
55 cm
bsa
0.22 m2
tfr
62 %
tfv
207 ml
ivf
nill
feeds
84ml
ivm
123 ml
k+
nill
na
4.3meq/kg/day
aminoven
-
lipid
-
glucose
feeds
gir
feeds
feeds: ng feeds 7ml q 2horly ( preferably ebm) (84ml)
fluids: stop
antimicrobials: (70 ml)
inj meropenem 130mg/10ml ns iv over 2 hrs q8h (d6) (30ml)
inj vancomycin 50mg/10ml ns iv over 60mins q6h (d6) (40ml)
aed: (20ml)
inj .phenytoin 10mg/10ml ns iv q 12hourly
sedation (4.8 ml)
inj fentanyl (1ml=10mcg) at 0.2ml/hr ( 0.5mcg/kg/min) (4.8 ml)
miscellaneous: (28 ml)
inj. calcium gluconate 3.5 ml /3.5ml 5% dextrose over 20min q6h (28ml)
inj. vit k 1mg every on monday
inj. lasix 1.6mg iv q 12hourly (1mg/kg/day)
mdi asthalin stop
syp vit d 1ml ng od
nebulization with asthalin 2mg/3ml ns q2h.
nursing and supportive care:
input/ output charting
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs q 4 hourly
ag charting q 2 hrly
moisol eye drops 1 drop every 2 hourly and lacrigel every 12 hourly
coconut oil application on dry skin |
| 45 |
8cb85f5fb |
2161-06-02 |
congenital heart disease ? coactation with ccf with pneumonia |
None |
consultant: **Name**
jrs: **Name**
29 /09/2018
weight
3.3kg
length
55 cm
bsa
0.22 m2
tfr
65 %
tfv
214 ml
ivf
80 ml
feeds
nil
ivm
130 ml
k+
1.8meq/kg/d
na
4.2 meq/kg/day
aminoven
-
lipid
-
glucose
19 g
gir
4 mg/kg/min
feeds: stop
fluids: (81 ml)
ivf: 50% dextrose: 28 ml
10% dextrose: 50 ml
15% kcl: 3 ml
-----------------------------------------
total 81 ml @ 3.4 ml/hr
antimicrobials: (70 ml)
inj meropenem 130mg/10ml ns iv over 2 hrs q8h (d4) (30ml)
inj vancomycin 50mg/10ml ns iv over 60mins q6h (d4) (40ml)
aed: (20ml)
inj .phenytoin 10mg/10ml ns iv q 12hourly
sedation (12ml)
inj midazolam – stop
inj fentanyl (1ml=10mcg) at 0.2ml/hr ( 0.5mcg/kg/min) (4.8 ml)
miscellaneous: (28 ml)
inj. calcium gluconate 3.5 ml /3.5ml 5% dextrose over 20min q6h (28ml)
inj. vit k 1mg every on monday
inj. lasix 1.6mg via ng q 12hourly (1mg/kg/day)
mdi asthalin 100mcg/puff 2 puffs q4h
syp vit d 1ml ng od
tab amlodipine – stop
stop adrenaline nebulization.
nebulization with asthalin 2mg/3ml ns q2h.
nursing and supportive care:
input/ output charting
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs q 4 hourly
ag charting q 2 hrly
moisol eye drops 1 drop every 2 hourly and lacrigel every 12 hourly
coconut oil application on dry skin |
| 451 |
65f996e70 |
2154-06-21 |
bronchial asthma - severe exacerbation |
: hfnc |
consultant: **Name**
jrs: **Name**
srs: **Name**
respiratory support:: hfnc
sedation, analgesia, neuromuscular blockade: nil
inotropes/ antihypertensives: nil
antimicrobials: nil
ivf - nil
feeds - orally allowed
miscellaneous : -
t. prednisolone 20mg po bd.
neb with asthalin (salbutamol ) 5mg +5 ml ns q6hrly
nebulization with budecort (0.5mg) q12hrly
neb ipratropium- discontinue
inj aminophylline- discontinue
nursing and supportive care:
input/output charting q 2 h
vital monitoring q 2 h
rbs monitoring q 2 hourly
40 kg
length
150 cm
bsa
1.2 m2
tfr
ivf
nil
ivm
nil
feeds
ad lib
jr/sign
sr/sign |
| 46 |
8cb85f5fb |
2161-06-01 |
congenital heart disease ? coactation with ccf with pneumonia |
None |
consultant: **Name**
jrs: **Name**
weight
3.3kg
length
55 cm
bsa
0.22 m2
tfr
68.4%
tfv
226ml
ivf
96ml
feeds
nil
ivm
130ml
k+
1.7meq/kg/d
na
7.3meq/kg/day
aminoven
-
lipid
-
glucose
5 g
gir
1mg/kg/min
feeds: stop
fluids: (48ml)
ivf: n/3 10% dextrose kcl (3:100) at 4ml/hr (96ml)
add mvi 2ml to ivf
antimicrobials: (70 ml)
inj meropenem 130mg/10ml ns iv over 2 hrs q8h (d3) (30ml)
inj vancomycin 50mg/10ml ns iv over 60mins q6h (d3) (40ml)
aed: (20ml)
inj .phenytoin 10mg/10ml ns iv q 12hourly
sedation (12ml)
inj midazolam – stop
inj fentanyl (1ml=10mcg) at 0.5ml/hr ( 1.5mcg/kg/min) (12ml)
miscellaneous: (28 ml)
inj. calcium gluconate 3.5 ml /3.5ml 5% dextrose over 20min q6h (28ml)
inj. vit k 1mg every on monday
inj. lasix 1.6mg via ng q 12hourly (1mg/kg/day)
mdi asthalin 100mcg/puff 2 puffs q4h
syp vit d 1ml ng od
tab amlodipine - stop
nursing and supportive care:
input/ output charting
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs q 4 hourly
ag charting q 2 hrly
moisol eye drops 1 drop every 2 hourly and lacrigel every 12 hourly
coconut oil application on dry skin |
| 47 |
8cb85f5fb |
2161-06-05 |
congenital heart disease /coarctation of aorta/ ccf with pneumonia |
None |
consultant: **Name**
jrs: **Name**
weight
3.3kg
length
55 cm
bsa
0.22 m2
tfr
81 %
tfv
266ml
ivf
nil
feeds
196ml
ivm
70 ml
k+
nil
na
4.3meq/kg/day
aminoven
-
lipid
-
glucose
feeds
gir
feeds
feeds: ng feeds 16ml q 2hrly (preferably ebm) (196ml), add 1ml mct oil to alternating feeds
fluids: nil
antimicrobials: (70 ml)
inj meropenem 130mg/10ml ns iv over 2 hrs q8h (d7) (30ml)
inj vancomycin 50mg/10ml ns iv over 60mins q6h (d7) (40ml)
aed
inj .phenytoin – stop
syp phenytoin (5ml=30mg) 1.8ml ng bd (6mg/kg/d)
sedation
inj fentanyl - stop
miscellaneous:
inj. calcium gluconate – stop
inj. vit k 1mg every on monday
inj. lasix 1.6mg iv q 8hourly (1mg/kg/day)
syp vit d (1ml=400u) 5ml ng od
syp osteocalcium (5ml= 82mg ca and 200iu vit d3) 5ml ng bd
nebulization with asthalin 2mg/3ml ns q6h
nursing and supportive care:
input/ output charting
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs q 6 hourly
ag charting q 6 hrly
eye care - stop
coconut oil application on dry skin |
| 48 |
8cb85f5fb |
2161-06-07 |
congenital heart disease /coarctation of aorta/ ccf with pneumonia |
None |
consultant: **Name**
jrs: **Name**
weight
3.3kg
length
55 cm
bsa
0.22 m2
tfr
92 %
tfv
306.6 ml
ivf
nil
feeds
240 ml
ivm
66.6ml
k+
nil
na
1.3 meq/kg/day
aminoven
-
lipid
-
glucose
feeds
gir
feeds
feeds: og feeds 20ml q 2hrly (preferably ebm) (240 ml), add 1ml mct oil to alternating feeds tried 4 ml ks feed remaining feeds through the og( try direct breast feeding)
fluids: nil
antimicrobials: (30 ml)
inj meropenem 130mg/10ml ns iv over 2 hrs q8h (d9) (30ml)
inj vancomycin stop
aed
syp phenytoin (5ml=30mg) 1.8ml ng bd (6mg/kg/d)( 3.6ml)
sedation
nil
miscellaneous: (33ml)
inj. vit k 1mg every on monday
inj. lasix 3 mg via ng q 8hourly (2.7 mg/kg/day)
syp vit d (1ml=400u) 4ml ng od
syp osteocalcium (5ml= 82mg ca and 200iu vit d3) 5ml ng bd
nebulization with asthalin 2mg/3ml ns q6h
ns iv 1ml/hr via picc line (24 ml)
nursing and supportive care:
input/ output charting
temperature monitoring q 2 hourly
strict asepsis to be maintained
rbs q 6 hourly
ag charting q 6 hrly
coconut oil application on dry skin
positioning q2h left up, right up alternatively with 30 degree head end
elevation |