1) CAP:
CURB Score:
https://www.mdcalc.com/curb-65-score-pneumonia-severity
Plans:
Strict I/O
Reflo QID
IV Drips
Oxygen therapy
Watchout for worsening respiratory distress
Medications:
IV Augmentin 1.2g stat and TDS
Tab Azithromycin 500mg stat and OD x 3/7
Investigations:
Chest Xray
ECG
FBC, RP, LFT, AST, CRP, ESR
ABG
Continue Old Meds:
2) Cellulitis
Well Score:
https://www.mdcalc.com/wells-criteria-dvt
Plans:
Reflo QID
Strict I/O Charting
Medications:
IV Cloxacillin 2g stat and QID
or IV Tazocin 4.5g stat and QID
Investigations:
Xray
Ultrasound
ECG
D-Dimer
FBC, RP, LFT, AST, CRP
Viral Screening (Hep B, Hep C, HIV)
HBA1C
FLP
Continue Old Meds:
3) Stroke
NIHSS Score:
https://www.mdcalc.com/nih-stroke-scale-score-nihss
Plans:
Reflo QID
Strict I/O Charting
For swallowing test, if pass, allow orally, if fail, to insert RTF
If on RTF, to refer dietitians
To refer physiotherapy, rehab and occupational therapist
To educate family members on stroke care
If BP > 220/120 mmHg, KIV to start anti-hypertensive
Medications:
Tab Aspirin 100mg stat and OD
Tab Simvastatin 40mg ON
Investigations:
CT Brain
ECG
FLP, FBS
HBA1C
FBC, RP, LFT, AST
4) UGIB
Rockall Score: https://www.mdcalc.com/rockall-score-upper-gi-bleeding-complete
Chronic Liver Disease:
APRI Score: https://www.mdcalc.com/ast-platelet-ratio-index-apri
Child Pughs score: https://www.mdcalc.com/child-pugh-score-cirrhosis-mortality
Plans:
Reflo QID
Strict I/O Charting
Watchout for evidence of active bleed, if presence, to call Bleeder Call for urgent scope
IV Drips
To plan for OGDS
Medications:
IV Pantoprazole 80 mg stat and 8mg per hourly for 3/7
Withold all anti-platelet and anticoagulants
Investigations:
ECG
Daily FBC
RP, LFT, AST
Abdomen Xray
Sunday, July 14, 2019
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