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COURSE IN THE WARD. 1 ST Hospital Day. IVF: D5 IMB 500mL to run at 12-13 gtts /min Request for: CBC with platelet Gram stain of wound discharge Culture and sensitivity of wound discharge Medications:
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1ST Hospital Day • IVF: D5 IMB 500mL to run at 12-13 gtts/min • Request for: • CBC with platelet • Gram stain of wound discharge • Culture and sensitivity of wound discharge • Medications: • Clindamycin 150mg/slow IV infusion (32.1mg/kg/day) over 30 mins. now then every 8 hrs. ANST • Amikacin 100mg/slow IV push over (21.4mg/kg/day) 30 mins. every 8 hrs. • Paracetamol 250mg/5mL, 4 mL every 4 hours for Temp. > 38.5°C or for pain (14 mg/kg/dose ) • Refer to Pediatric Surgery for further evaluation and management
1st Hospital Day • Incision and Drainage of Abscess • 20cc purulent discharge • Specimen sent for GS/CS • For daily COD
2nd Hospital Day • D1-2 • Clindamycin150mg/slow IV infusion (32.1mg/kg/day) over 30 mins. now then every 8 hrs. ANST • Amikacin 100mg/slow IV push over (21.4mg/kg/day) 30 mins. every 8 hrs. • Decreased to D5 IMB 500mL to run at 9-10 gtts/min • Patient was transferred to malward • IVF to consume • Increase oral fluid intake
5th Hospital Day • D5-6 • Clindamycin 150mg/slow IV infusion (32.1mg/kg/day) over 30 mins. now then every 8 hrs. ANST • Amikacin 100mg/slow IV push over (21.4mg/kg/day) 30 mins. every 8 hrs. • 0.65% NaCl Nasal drops 2-3 gtts/nostril then suction Q6
14th Hospital Day • Day 14 • Clindamycin 150mg/slow IV infusion (32.1mg/kg/day) over 30 mins. now then every 8 hrs. ANST • Amikacin 100mg/slow IV push over (21.4mg/kg/day) 30 mins. every 8 hrs. • Disharged • Final Diagnosis: Abscess secondary to MRSA • Take Home Medications: • Co-trimoxazole 400mg 180mg/5mL, 4mL Q12 to complete for 2 weeks • Mupirocin ointment, apply on affected area TID • Anticipatory Guidance • Immunization update • For follow up at OPD on Oct 10, 2010