THERAPEUTIC DOSAGES

DOSE = Wt (kg) x TD x Preparation (inverse) TD = dose x preparation x frequency

Frequency Wt (kg)
EMPIRICAL DOSING (not used for antibiotic and regulated drugs)
AGE DOSE AGE DOSE
0-3 months 0.3 mL 1-3 yrs old 2.5 mL
4-6 months 0.6 mL 4-6 yrs old 5 mL
7-9 months 0.9 mL 7-10 yrs old 7.5 mL
10-12 months 1.2 mL >10 yrs old 10 mL
NORMAL VALUES
LDL < 100 (optional) Sodium 135 – 145 mmol/L
Total Cholesterol <200 Potassium 3.5 – 5.3 mmol/L
HDL < 40 low; > 60 high Albumin 35 – 50 g/L
HbA1c <6% SGPT 0 – 55 U/L
3.0 – 9.2 mmol/L (male) 62 – 115 mmol/L (male)
BUN Creatinine
2.5 – 7.2 mmol/L (female) 53 – 97 mmol/L (female)
Celsius to Fahrenheit: ( C x 1.8 ) + 32 Fahrenheit to Celsius: ( F – 32) / 1.8
 THERAPEUTIC DOSE
DRUG DOSE PREPARATION

Drops: 60mg/0.6ml (Tempra)

100mg/mL (Calpol)
PARACETAMOL 10–20 mg/kg/dose q4 PO, IV Syrup: 120mg/mL (Afebrin, Calpol, Tempra)
Syrup: 250mg/5ml (Afebrin, Calpol 6 plus,
Tempra forte)

5-10 mg/kg/dose q6-8

IBUPROFEN 2-6 y/o: 5-10 mL Syrup: 100mg/5ml (Dolan FP)
7-10 y/o: 10 mL
Syrup: 50mg/mL
MEFENAMIC ACID 6.5 mg/kg/dose q6-8
Tab: 250mg, 500mg
AMINOPENICILLINS
Drops: 100mg/mL; 125mg/1.25ml
30-50 mg/kg/day q8 PO
AMOXICILLIN Syrup: 125mg/5ml, 250mg/5ml Amoxil, Glamox,
OM: 80 - 90 mg/kg/day q8
Himox, Sumoxil
Syrup: 125mg/5ml, 250mg/5ml
100 - 200 mg/kg/day q6 PO Cap: 250mg, 500mg
AMPICILLIN
Meningitic dose: 200-400mg/kg/day q4-q6 IV Vial: 100, 125, 500mg/vial
(Ampcillin, Ampedia, Pensyn)
WITH BETA-LACTAMASE INHIBTORS
375mg/vial (250mg Ampicillin)
AMPICILLIN-SULBACTAM 100 - 200 mg/kg/day q6 IV, IM (Based on Ampicillin)
750mg/vial (500mg Ampicillin)
Syrup: 156mg/5ml (125mg Amox)
312mg/5ml (250mg Amox)
Cap: 375mg/tab (250mg Amox)
AMOXICILLIN CLAVULANIC
30-50 mg/kg/day q8 IV, PO 625mg/tab (500mg Amox)
ACID or CO-AMOXICLAV
Vial: 300mg/vial (250mg Amox)
600mg/vial (500mg Amox)
1.2g/vial (1g Amox)
PENICILLINS
PENICILLIN V 125mg/5mL = 200,00 U/5mL
50,000-100,000 U/kg/day q6
PEHNOXYMETHYL 250mg/5mL = 400,00 U/5mL
High dose: 150,000-200,000 U/kg/day q6 PO
PENICILLIN (Pentacillin, Sumapen)
AQUEOUS PEN G 50,000-100,000 U/kg/day q6 1,000,000 U/vial
BENZYLPENICILLIN Meningitic dose: 200,000-400,000 U/kg/day q6 IV 5,000,000 U/vial
PENCILLINASE RESISTANT PENICILLINS Skin infection: 14 days duration of treatment
Syrup: 125mg.5ml
CLOXACILLIN 50-100 mg/kg/day q6 PO
Tab: 250mg, 500mg/tab

OXACILLIN 75-100 mg/kg/day q6 IV Vial: 250mg, 500 mg/vial

CEPHALOSPORINS
1ST GENERATION
Syrup: 125mg/5ml, 250mg/5ml
CEPHALEXIN 25-50 mg/kg/day q6 PO
Drops: 100mg/mL Keflex, Ceporex
CEPHALOTHIN 80-160 mg/kg/day q6 IV 1 g/vial Keflin
2ND GENERATION
125mg/5ml Zimacef, Zinnat
20-40 mg/kg/day q12 PO
250mg/5ml Zinnat
CEFUROXIME 75-150 mg/kg/day q8 IV, IM
250mg, 750mg, 1.5mg/vial
Tab: 125mg/mL, 250mg/5ml Ceclor
CEFACLOR 40 mg/kg/day q8 PO 125mg/mL, 250mg/5ml Ceclor
CEFOXITIN 20-40 mg/kg/day q6-12 IV 1 g/vial Mefoxin
3RD GENERATION
50-100 mg/kg/dayq12-24 IV
CEFTRIAXONE 250mg, 500mg, 1 g/vial Rocephin
Typhoid: 75-80 mg/kg/day for 7 days
CEFOTAXIME 100-200 mg/kg/day q6-8 IV 250mg, 500mg, 1 g/vial Claforan
CEFTAZIDIME 90-150 mg/kg/day q8 IV 250mg, 500mg, 1 g/vial Fortum
Drops: 20mg/mL
CEFIXIME 1.5-3mg/kg/day q12 PO Suspension: 100mg/5ml
Capsule: 100mg, 200mg Tergacef
ANTI-HISTAMINES
Syrup: 2mg/mL
HYDROXIZINE 1-2 mg/kg/day q12 PO
Tab: 10mg, 25mg (Iterax)

5 mg/kg/day q6 PO, IV Tab: 25mg, 50mg/cap

DIPHENHYDRAMINE
Anaphylaxis: 1-2 mg/kg/dose IM, IV Vial: 50mg /mL (Benadryl)

6-12 yr: 1 tab Drops: 10mg/mL

CETIRIZINE 10 mg or 20 drops OD Syrup: 5mg/5ml
2-6 yr: 5mg or 10 drops OD Tab: 10mg/tab Virlix
>12 yr: 1 tab or 2 tsp
6-12 yr: ½-1 tab or 1 ½ tsp Syrup: 0.5mg/5mL
CLEMASTINE 1-3 yr: ½ - 1 tab Tab: 1mg/tab
<1 yr: 1-2.5 mL (Tavageyl)
All taken BID
>12 yr: 1 tab OD Syrup: 5mg/5mL
LORATADINE 2-12 yr: >30kg: 2 tsp OD Tab: 10mg/tab
<30kg: 1 tsp OD (Claritin)
CORTICOSTEROIDS
>12 yr: 1-2 tab QID after meal Syrup: 0.25mg/2mg/5mL
BETAMETHASONE
6-12 yr: ½ tab or ½ tsp TID Tab: 0.25mg/2mg
DEXCHLORPHENAMINE MALEATE
2-6 yr: ¼ tsp TID (Celestamine)
ANTI-KOCH’S COMBINATION DRUGS: KIDZKIT , ; FIXCOM , ; QUADTAB; RIFZIN
Trisovit: 50mg/5ml
Nicetal: 100mg/5ml
ISONIAZID 5-10 mg/kg/day OD PO
Odinah: 150mg/5ml
Compilex: 200mg/5ml
100mg/5ml (Rimactane, Resimin, Rifesin)
200mg/5ml (Rifamax, Resimin, Rifasin,
RIFAMPICIN 10-15 mg/kg/day OD PO
Rimactane forte)
Rifamax drops: 100mg/5ml
PYRAZINAMIDE 15-30 mg/kg/day OD PO 200mg/5ml, 500mg/tab (PZA-CIBA)
STREPTOMYCIN 20-30 mg/kg/day OD IM 1 g/vial
ETHAMBUTOL 15-25 mg/kg/day OD 200mg, 400mg/cap
ANTI-ASTHMA
Syrup: 2mg/5ml
SALBUTAMOL 0.15-0.30 mg/kg/dose q6 PO Tab: 2mg/tab
Nebule: 2.5mg/5ml, 5mg/2.5ml
Syrup: 1.5mg/2ml
TERBUTALINE 0.075 mg/kg/dose q6 PO
Nebule: 5mg/2ml (Bricanyl)
LD: 10-20 mg/kg IV
HYDROCORTISONE 100mg/vial (Give H2 Blocker)
MD: 5-8 mg/kg/dose q6 IV
PREDNISONE (Taper!) 0.5-2 mg/kg/day PO x 3-5d Tab: 5mg, 20mg (Give H2 Blocker)
MUCOKINETIC/EXPECTORANTS
Pedia syrup: 15mg/5ml
1.2-1.6mg/kg/day
Syrup: 30mg/5ml
Infant drops: 7.5mg/mL
1-2 yr: ½ tsp BID
AMBROXOL <6 mos: 0.5ml BID
2-6 yr: ½ tsp TID
7-12 mos: 0.75 mL BID
6-12 yr: 1 tsp BID-TID
13-14 mos: 1ml BID
>12yr: 1 tab/ 1-2tsp BID
<2 yr: 1.2 mL TID
BROMHEXINE
2-6 yr: 2.5 mL TID or 4mg tab BID Elixir syrup: 4mg/5ml
(Bisolvon)
6-12 yr: 5 mL or 4mg tab TID Tab: 8mg/ tab
>12 yr: 10 mL or 8mg tab TID
1-3 mos: 0.5 mL TID Drops: 40mg/mL
4-7: 1 tsp TID
CARBOCISTEINE 3-6 mos: 0.75 mL Syrup: 200mg/5ml
8-12 yr: 1 ½ tsp
(Solmux) 6-12 mos: 1 mL TID Susp: 500mg/5ml
>12 yr: 1 cap or 1-2 tsp
2-3 yr: ½ tsp TID Cap: 500 mg
SALBUTAMOL + CARBOCISTEINE 2-6 yr: ½ tsp Susp: 2mg/500mg/5ml
>12 yr: 1 cap or 1-2 tsp TID
(Solmux Broncho) 7-12 yr: ½ - 1 cap Cap: 2mg/500 mg/cap
2-6 yr: 1 tsp Syrup: 50mg/1mg/5ml
SALBUTAMOL + GUAIFENESIN >12 yr: 1-2 cap BID-TID
7-12 yr: 2 tsp - 1 cap Cap: 100mg/2mg
ACETYLCYSTEINE (Fluimucil) 1 sachet in 200ml of water TID Sachet: 200mg
ERDOSTEINE (Ectrin) 1 cap TID Cap: 300mg
MACROLIDES
Erycin/Erythrocin
Drops: 100mg/2.5ml
Syrup: 200mg/5ml (also Macrocin)
ERYTHROMYCIN 30-50 mg/kg/day q6 PO Ilosone drops: 100mg/mL
Syrup: 125mg/5ml, 250mg/5ml
Erymax: 40mg/5ml
Tablet: 250mg, 500mg
CLARITHROMYCIN 7.5 mg/kg/dose q12 PO 125mg/5ml (Klaricid)
AZITHROMYCIN 10 mg/kg/day x 3 days PO 200mg/5ml (Zithromax)
Syrup: 40mg/200mg/5ml (Septin, Bactrim, Trimocon)
5-8 mg/kg/day q12 PO (based on TMP mg) Syrup: 80mg/400mg/5ml (Septin, Trizole, Bactile TS)
COTRIMOXAZOLE
TMPmg/SMXmg/mL Triglobe: 45mg/205mg
Cap: 160mg/800mg, 80mg/400ml
Syrup: 125mg/5ml
CHLORAMPHENICOL 50-100 mg/kg/day q6 IV, PO Vial: 1 g/vial
Cap: 250mg, 500mg
AMINOGLYCOSIDES
AMIKACIN 15-22 mg/kg/day q8 IV, IM 100mg, 250mg, 500mg/2ml vial
GENTAMICIN 5-8 mg/kg/day q8 IV, IM 80mg/2ml vial (Garamycin)
TOBRAMYCIN 6-7.5 mg/kg/day q8 IV, IM 80mg/2ml vial (Nebcin)
NETILMICIN 2.5 mg/kg/dose q8 IV, IM 100mg/2ml vial (Netomycin)
DECONGESTANTS

1-3 mos: ¼ mL 1-2 y/o: 1 mL

Drops: 6.26mg/mL
PHENYLPROPANOLAMINE 4-6 mos: ½ mL 2-6 y/o: ½ tsp QID
Syrup: 12.5 mg/5ml
7-12 mos: ¾ mL 7-12 y/o 1 tsp

BROMPHENIRAMINE MALEATE + 0.1 mg/kg/dose TID-QID Drops

PHENYLEPHRINE + 2-4 y/o: ¾ tsp TID-QID >12 y/o: 1-2 tsp TID-QID Pedia Syrup
PHENYLPROPANOLAMINE 4-12 y/o: 1 tsp TID-QID Syrup (Dimetapp)
CARBINOXAMINE RESINATE, 1-6 y/o: 1 tsp >12 y/o: 1 cap or 1 tsp Syrup: 1.3mg/16.6mg/5ml
PHENYLPROPANOLAMINE 6-12 y/o: 2 tsp BID Cap: 4mg/20mg (Rhinipront)
2-4 drops/nostril TID-QID Pedia Nasal drops: 0.65%
NaCl
Spray enough amount/nostril Spray: 0.65% (Salinase
ANTI-CONVULSANTS
LD: 10-20 mg/kg IV Grain 1 tab = 60mg
PHENOBARBITAL MD: 5-8 mg/kg/day q12 PO, IV Tab: 15,30,60,90 (PHILUSA)
Max: 1-2 g Vial: 130mg/mL vial
LD: 10-20 mg/kg IV Susp: 30mg/5ml, 124mg/5ml
PHENYTOIN MD: 5-8 mg/kg/day q12 PO, IV Vial: 100mg/2ml
Max: 1g Cap: 30mg, 100mg (Dilantin)
0.2-0.5 mg/kg/dose IV
Tab: 2mg, 5mg , 10mg
DIAZEPAM 0.3 mg/kg/dose Rectal
Vial 10mg/2ml (Valium)
Max: <5 y/o: 5mg; >5y/o: 10mg
ANTIPARASITIC

Amoebiasis: 30-50 mg/kg/day q8 for 10 days Syrup: 125mg/5mL

Anaerobic infection: Suppository: 1g if +Nystatin (Flagystatin)
METRONIDAZOLE
LD: 15mg/kg IV Tab: 250mg, 500mg
MD: 7.5mg/kg/dose q6 PO, IV Vial: 500mg/100mL

METRONIDAZOLE (Furamide) or Syrup: 125mg/5ml

20-40 mg/kg/day q8 PO x 10 days
with DILOXANIDE FUROATE Tab: 500mg Furamide
5-12 yr: ½ - 1 tab TID x 5 days
(Entamazole) Tab: 200mg/250mg
> 12 yrs: 2 tabs TID x 5 days
Entamazole
Ascariasis: 75 mg/kg/day OD x 2 days
PIPERAZINE CITRATE Syrup: 625mg/5mL
Entamoebiasis: 65 mg/kg/day OD x 7 days
Ascariasis/Entamoebiasis: 11 mg/kg PO OD HS, Drops: 20mg/mL
PYRANTEL EMBONATE
repeat after 2 weeks, max 1g Syrup: 125mg/5ml
500 mg or 10mL single dose at bedtime Syrup: 50mg or 20mg/mL
MEBENDAZOLE
100 mg or 5mL BID x 3 days Tab: 100mg, 500 mg
ALBENDAZOLE
>2 yr: 400 mg or 10mL single dose HS Susp: 4% x 10mL
Capillariasis: 10 days
<2 yr: 200 mg or 5mL single dose HS Tab 400mg
Giardiasis: 5 days
Hair: Rub vigorously on hairy parts for 10 mins
Shampoo
then rinse thoroughly
PERMETHRIN Lotion
Body: Apply from neck down leave for 8 hours
Kwell (Reformulated)
(overnight) then rinse
ANTIVIRAL
20mg/kg/dose QID x 5 days Susp: 200mg/5ml
<2yr: 200mg Tab: 200mg, 400mg, 800mg
ACYCLOVIR
2-6 yr: 400mg Vial 250mg
>6 yr: 800mg QID x 5 days
ANTACIDS
Pedia: 1 tsp taken 1 hr & 3 hrs after meal
HYDROCHLORIDE
& HS Suspension
DICYCLOVERINE SIMETHICONE
Peptic ulcer: 2 tabs Q4 Tablet
(Kremil-S)
Hyperacidity: 1-2 tabs after meals
Susp: 200mg/225mg/5ml
AlMg(OH)3 (Maalox) Pedia: 2-4 tsp Max: 16 tsp
Chewable Tab: 200mg/200mg
AlMg(OH)3 Dimethicone (Maalox Adult: 2-4 tabs, 30cc given at ER
Susp: 200mg/225mg/25mg/5ml
Plus) ALL: 20 mins – 1 hr after meal + HS QID
Chewable Tab: 200mg/200mg/25mg
ANTISPASMODIC CAUTION FOR CHILDREN <6YR, NOT USED OFTEN
Pedia: ½ - 1 tsp TID
2-12 yr: 1-2 tab 15 mins before feeding Syrup: 10mg/5ml
DICYCLOVERINE
TID-QID Tab: 10 mg
Adult: 1-2 tbsp or 2 tabs TID
Pedia: 5mg TID IV Vial: 20mg/mL
HYOSCINE-N-BUTYLBROMIDE
Adult: 10mg TID Tab: 10mg
 IDEAL BODY WEIGHT
Ave. wt. at birth 3000 grams
Infants: 0-6 mos: age(mos) x 600 + BW (3000gms) Children: 1-6 yrs: age(yrs) x 2 + 8
7-12 mos: age(mos) x 500 + BW (3000gms) 7-12yrs: age(yrs) x 7 - 5
Adults: Male: 106 lbs + 6lbs/inch over 5ft 2
Female: 100 lbs + 5lbs/inch over 5 ft
HEAD CIRCUMFERENCE
At birth: 35 ± 2 cm next 8 mos: ¼ inch/month 3-5 y/o: ½ inch/yr
1st 4 mos: ½ inch/month 2 y/o: 1 inch 6-20 y/o: ½ inch/5yrs
LENGTH
Ave birth length: 50cm or 20inches birth – 3 mos: 9 cm 6 – 9 mos: 5 cm
Ave gain in length during 1st yr: 25 cm 3 – 6 mos: 8 cm 9 – 12 mos: 3 cm
ROUTINE NEWBORN CARE
1. Vitamin K prophylaxis: 1 mg IM (if <1kg: 0.3mg) – prevents hemorrhagic disease of the NB
2. AgNO3/ Erythromycin 0.5% or 1% Tetracycline – for ophthalmia neonatorum
3. Labeling
4. Bathing
5. Cord care
CSF NORMAL VALUES
Neonate Infant Child
Total CHON 20 – 100 15 - 45 15 – 45
Glucose 32 – 119 40 – 80 40 - 80
RBC 0 0 0
WBC 0 - 30 0 – 10 0–3
 WHO MANAGEMENT OF DIARRHEA
A B C
CONDITION Well, alert Restless, Irritable* Lethargic, Unconscious*
EYES Normal Sunken Very sunken
TEARS Present Absent Absent
MOUTH/TONGUE Moist Dry Very dry
THRIST Drinks normally, not thristy Drinks eagerly, Thristy* Drinks poorly, unable to drink*
SKIN PINCH Goes back quickly Goes back slowly Goes back very slowly
Some dehydration, at least 1 Severe dehydration at least 1
DECIDE No signs of dehydration
major* major*
SOME DEHYDRATION: MILD: 1 major ± other signs MODERATE: 2 major ± other signs
Objective parameters of adequate hydration: WEIGHT GAIN and URINE OUTPUT
TREATMENT: PLAN A: Volume per volume replacement
Amount of ORS given after each loose
AGE Amount of ORS to provide for use at HOME
stool
<24 months 50 – 100 mL 500mL/day
2 – 20 years old 100 – 200 mL 1000mL/day
> 10 years old As much as wanted 2000mL/day
HYDRITE (90): 1 tab dissolved in 200 mL of water; give the amount stated above
ORS at Health Center: 1 sachet dissolved in 1 L water (prepare for PLAN B)
If 100mL is needed, get 100mL from the 1 L then dilute with equal amount of water (100mL)
Making it 200mL. Give 100mL from the 200mL after each loose stool.
TREATMENT: PLAN B: Amount needed x wt (gms) x 0.075 or wt (kg) x 75
The amount computed should be consumed equally in 4 hours
HYDRITE (90): 1 tab dissolved in 100mL water, give the amount computed equally within 4 hours
ORS of Health Centers: 1 sachet dissolve in 1 L water, give amount computed equally within 4 hours
ORS: Na=90, K=20, Cl=60, Glucose=111, Citrate=10 or HCO3=30
TREATMENT: PLAN C: (IV) LR/PNSS First Give 30ml/kg for Then Give 70ml/kg for
Infants < 12 mos 1 hr 5 hrs
Older 30 mins 2 ½ hrs
*Repeat once if with WEAK PULSE or PULSE NOT DETECTABLE. Reassess after 1 – 2 hrs. If DHN not improving, give more
rapid IV drips but watch out for PULMONARY CONGESTION. Give also ORS (5mL/kg/hr) as soon as Px can drink usually
after 3 – 4 hrs (Infants), after 1 – 2 hrs (older). After 6 hours (infants) or 3 hours (older), evaluate the px then choose
appropriate PLAN. IV not available: ORS via NGT (20mL/kg/hr x 6hrs). DHN not improving, shift to IV after 3 hours.
HOSPITAL BASED HYDRATION THERAPY cc/hr = uggts/min 4ugtts = 1gtt
DHN and FLUIDS < 2 y/o or < 10 kg > 2 y/o or > 10 kg
MILD (3-5% wt loss)
50 cc/kg 30 cc/kg
D5 0.3NaCl in 6-8hrs
MODERATE (6-10% wt loss) 0.25 PLR in
100 cc/kg 60 cc/kg
1-2hrs 0.75 D5 0.3 NaCl in 5-6 hrs
SEVERE (9-15% wt loss) 0.33 PLR in 1-2
150 cc/kg 90 cc/kg
hrs 0.66 D5 0.3 NaCl in 5-6hrs
Hydration takes 6-8 hrs Urine Output = Total output/24hrs/wt (kg) = cc/hr
e.g. 1 yr old, 10 kg in mod DHN: 10kg x 100cc/kg = 1000cc needed
¼ (250 cc PLR for 1 hr)/4 = 62gtts/min for 1 hr
¾ (750 cc D5 0.3 NaCl for 5 hrs) = 150 cc/hr/4 = 37gtts/min for 5 hrs

MAINTENANCE (Ludan’s Method) TFR: Actual wt (kg) x K = cc/day TCR: IBW x K = cal/day
Kg cc/kg/day
0-3 75 0-3 120 0-11 mos 110-120
3-10 100 IMB 10 days – 1yr 150 1-2 y/o 110
11-20 75 1-3 y/o 140 3-6 y/o 90-100
21-30 60 4-6 y/o 120 7-9 y/o 89-90
31-40 50 NM 7-9 y/o 100 10-12 y/o 70-80
41-50 40 10-12 y/o 90 13-15 y/o 55-65
51-60 30 13-15 y/o 70 16-19 y/o 48-69
e.g. 10kg = 10 x 10 = 1000cc/24hrs 16-17 y/o 50
= 42 uggts/min/3 (FEU) TCR >3mos
= 14 gtts/mins for 24 hrs CHO = TCR x 0.5/4
*divided by 4 (CMC) CHON = TCR x 0.15/4

TCI: cal/kg/day TFI: cc/kg/day

TCI (oral) = cc/dayx20cal/30cc TCI (IV) = (total vol (mL) x dextrosity x 4)/100 TFI (oral) = cc/day
wt (kg) wt (kg) wt(kg)

STUNTING = actual height x 100 WASTING = actual wt (kg) x 100

ideal ht for age ideal wt for actual ht
Normal: >95 Mild: 90-95 Normal: >95 Mild: 80-90
Mod: 80-90 Severe: <80 Mod: 70-80 Severe: <70
 APGAR SCORE
SIGNS 0 1 2
HEART RATE Absent < 100 bpm > 100 bpm
RESPIRATORY RATE Absent Slow (irregular) Good cry
MUSCLE TONE Limp Slow flexion of extremities Active motion
REFLEX IRRITABILITY No response Grimace Cough/sneezing
COLOR Blue body, pale extremities Pink body, blue extremities Pink all over

APGAR SCORE: at 1 min – need for resuscitation, at 5 mins – adequacy of resuscitation

SCORE: 7-10 Good; 4-6 Borderline; 0-3 High risk
CYANOTIC BABY: if CR <80/min, do chest compression. If still <80/min: intubate. If still <80/min: Lidocaine, Atropine, Naloxone, Epinephrine (LANE)

APPEARANCE: Cardiac rate, color, respiratory rate, reflex, muscle tone

DISAPPEARANCE: Color, respiratory rate, muscle tone, reflex cardiac rate
LBW: <2,500grams VLBW: < 1,500grams ELBW: <1,000grams
ALLOWABLE BLOOD LOSS: Wt x 80 (blood volume) x 0.10
PTB STEROID TX IN
Bacteriologic Extrapulmonary TB PPD CXR S/S
PPD
Immunologic Meningitis TB exposure (+) (-) (-)
>5mm <5y/o –BCG (+)
Radiologic Pleural effusion TB infection (+) (-) (-)
>5mm >5y/o +BCG (+)
Clinical Pericarditis TB disease (+) (+) (+)
>10mm <5y/o +BCG (+)
Histologic Endobronchial TB inactive (+) (+) (-)
Epidemiology Miliary
 EXPANDED PROGRAM ON IMMUNIZATION (1-5 YEARS OLD ONLY)
VACCINE DOSE AGE INTERVAL AMOUNT SITE/ROUTE BOOSTER
If >2yr – PPD NB: 0.05mL Right deltoid,
BCG At birth
1st before BCG >1mo: 0.1 mL Intradermal
First: 1 year after the last dose
DPT 3 6 weeks 4 weeks 0.5 mL Anterolateral Thigh, IM
Second: 4-6 years old
First: 1 year after the last dose
OPV 3 6 weeks 4 weeks 2 – 3 drops Mouth
Second: 4-6 years old
NXT at 1-2months &
HEP B 3 At birth 0.5 mL Thigh IM
6-8months
MMR
First: 6 months after measles –
6 months /
MEASLES 0.5 mL Thigh SQ right deltoid SQ
9 months
Second: 4-6 years old or 11-14
years old
2 month 2 months 0.5 mL Anterolateral Thigh, IM
0 – 6 months: 3 doses If >1year old: 1 15 – 18 months after the last
6-12months: 2 doses dose dose (for <1 year old)
HIB 3
Starting 2 years old may be
2-4-6 months No booster SQ given yearly

VARICELLA
9 months / 0.5 mL Right deltoid
*Catchup 13- 4 weeks 2 doses regardless of age
12 months IM<SQ
19
 OTHER IMMUNIZATION NOT COVERED BY EPI
VACCINE RECOMMENDED SCHEDULE AMT ROUTE
TYPHOID 2 years old 0.5 mL SQ, IM
PCV 1: 6 – 12 weeks
PCV 2: 12 – 16 weeks
PNEUMOCOCCAL 0.5 mL SQ, IM
PCV 3: 14 weeks - 2 years old
PPV: 2 years old then every 5 years
MENINGOCOCCAL 2 years old then every 3 – 5 years 0.5 mL SQ, IM
ROTAVIRUS 2 doses: 4 weeks apart from 2 – 8 months 0.5 mL SQ, IM
First dose: 1 – 2 years old
MMR Second dose: 4 – 6 years old 0.5 mL SQ
Catch up: 13 – 19 years old
First dose: 12 – 18 months
HEP A Second dose: 18 months – 2 years old 0.5 mL IM
Catch up: 2 – 19 years old
HPV 0.5 mL IM
IMMUNIZATION FOR FILIPINO WOMEN
Td/Tdap 3 doses: 0,1,6-12 months; BOOSTER every 10 years 0.5 mL IM
HPV inactivated 3 doses: 0,1-2,6 months 0.5 mL IM
MMR live attenuated 2 doses: 0,1 months NOT given for pregnant women 0.5 mL SQ
Influenza inactivated 1 dose: yearly 0.5 mL IM
Hep B / Hep A 3 doses: 0,1,6-12months // 2 doses: 0,6-12months 0.5 mL IM
Pneumococcal 1 dose inactivated vaccine; repeat every 5 years 0.5 mL IM
Meningococcal 1 dose polysaccharide vaccine; repeat every 3 – 5 years 0.5 mL IM
 NORMAL VALUES OF BLOOD PRESSURE, CARDIAC RATE & RESPIRATORY RATE BY AGE
AGE BP CR RR
Premature 55-75 / 35-45 120 – 170 40 - 70
0 – 3 months 65-85 / 45-55 100 – 150 35 – 55
4 – 6 months 70-90 / 50-65 90 – 120 30 – 40
7 – 11 months 80 – 110 / 55-65 80 – 120 25 – 40
1 – 3 years old 90-105 / 55-70 70 – 110 20 – 30
4 – 6 years old 90-110 / 60-75 65 – 100 20 – 25
7 – 12 years old 100-120 / 60-75 60 – 95 17 – 22
13 – 15 years old 110-135 / 75-85 55 – 85 12 – 14
> 18 years old 110-120 / 80-89 60 - 100 16 - 20
CONVERSION FACTOR
mEq/L to mg/dl Mg/dl to mEq/L mg/dl to umol/L
Na 2.30 0.4348 Creatinine 88.4
K 3.91 0.2558 Total Bilirubin 17.1
Ca 2.005 0.4988 Mg/dl to mmol/L
Mg 1.215 0.8230 BUN 0.357
Cl 3.55 0.2817 Cholesterol 0.0259
HCO3 6.1 0.1639 Glucose 0.5555
Glucose Infusion Rate (GIR) NV: 6-8 mg/kg/min
 GRADING OF SEVERITY OF DHF
Grade I Fever, Non-specific constitutional symptoms, (+) hemoconcentration, (+) Tourniquet test
Grade II Grade I + spontaneous bleeding
Grade III Grade II + circulatory collapse (narrowing pulse pressure)
Grade IV Grade III + irreversible shock + massive bleeding
DAILY WEIGHT GAIN LIVER SPAN OF INFANTS MURMUR INTENSITY
0 – 3 mos 30 gms AGE MALE FEMALE Grade I soft, not heard in all position, no thrill
4 – 6 mos 20 gms 6 mos 2.4 2.6 Grade II soft, heard in all position, no thrill
7 – 9 mos 18 gms 1 2.8 3.1 Grade III Loud, no thrill
10 – 11 mos 10 gms 2 3.5 3.6 Grade IV Loud with thrill present
1 – 3 yrs 8 gms 3 4.0 4.0 Grade V Louder murmur with thrill
4 – 6 yrs 6 gms 4 4.4 4.3 Grade VI Loudest heard even without stethoscope, (+) thrill
Premature 10-20gm/day 5 4.8 4.5
Term 20-30gm/day 6 5.1 4.8 *Grade 1-2/6 Systolic murmur – innocent in newborn
8 5.6 5.1 * Diastolic murmur - pathology
TEMPERATURE
Subnormal . oC 10 6.1 5.4
Normal 36.6 – 37.4oC 12 6.5 5.6
Subfebrile 37.5 - 38oC
14 6.8 5.8
Low grade 37.8 – 38.4oC
Mod grade 38.5 – 39.5oC 16 7.1 6.0
High grade 9. oC 18 7.4 6.1
H perp re ia oC
20 7.7 6.3
 GLASSGOW COMA SCALE Common X-ray Request
ADULT PEDIA Cervivcal APL open mouth
EYE OPENING (E) ThoracolumbaR AP
Spontaneously 4 Spontaneously Lumbosacral APL
To speech 3 To speech Shoulder AP
To pain 2 To pain Arm APL
No response 1 No response Elbow APL
BEST VERBAL RESPONSE (V) Forearm APL
Oriented 5 Coos, Babbles Wrist APL
Confused 4 Irritable, cries Hand APO
Inappropriate words 3 Cries to pain Thigh APL
Incomprehensible 2 Moans, grunts Knee APL
No response 1 No response Legs APL
BEST MOTOR RESPONSE (M) Foot APO
Obeys command 6 Obeys command T-cage APO
Localizes pain 5 Localizes pain Pelvis AP
Withdraws from pain 4 Withdraws from pain Chest AP, APL, PAL, Apicolordotic,
Flexion (decorticate) 3 Flexion (decorticate) L/P Decubitus, AP sitting

Extension (decelerate) 2 Extension (decelerate)

No response 1 No response *Vehicular Accident with unconscious patients:
trauma series
 TERM 24 HRS 1-2 MOS 6MOS-7YRS 3-6 YRS 6-12 YRS 12-18 YRS

WBC 9-30 9.4-34 5-20 6-17 5-15 7.5-13.5 4.5-13.5

SEG 47+15 47 25 22-24 25-43 45-47 47-49

NEUTRO 14.1 14.2 8.4-9.5 8.08-8.8 8.0 8.0 8.0

EOS 2.2 2.68 2.7-2.8 2.5-2.6 2.6-2.8 2.4 2.5-2.6

BASO 0.6 0.5 0.4 0.5-0.6 0.5-0.6 0.5-0.6 0.5

LYMPHO 31 31 56-57 59-61 42-50 38-42 35-37

MONO 5.8 5.8 5.9-6.5 4.6-5.0 4.7-5.0 4.2-4.4 4.7-5.2

% NEUTRO 61 45 35 32 33 50

% LYMPHO 31 41 56 61 59 30 M F

HGB 10-20 15-22 11-20 10-15 11-16 12-15 14-18 17-18

HCT 50-60 53-63 43-54 30-40 31-43 35-40 41-86 36-41

Formula: ANC = WBC * SEG

Normal Value: 2,000-6,000
>6,000 bacterial <2,000 viral <500 immunocompromised
Sodium Correction = (desired – actual) x Wt (kg) x 0.6 Vitamin A
Eg. Wt.2.2 kg Actual Na = 131.1 Desired Na = 135 0-6 months 50. 000 units
Na = (135-131.1) x 2.2kg x0.6 >6 months 100.000 units
= 5.15 mEqs Maintenance: Na = 2-4 mEqs/kg >1 year 200,000 units
K = 1-2 mEqs/kg
Maintenance = wt x (constant maintenance – used lower limit) Zinc
= 2.2kg x 2 < 6 months 10 mg/day
=4.4 mEqs >6 months 20mg/day
Total deficit = 5.15 + 4.4 mEqs
BBPV
= 9.55 mEqs
IV used: IMB with 25 Sodium (refer to table of IV) > 42 y/o Acute onset
Spinning sensation
Running rate used: 7cc/hr in 24 hrs = 168cc
Seconds duration
25 Sodium in 1000ml (1 L) 25 = x__ If < 42 y/o think of:
1000 168cc Hypertension/Hypotension
= 4.2 mEqs Na in 24 hrs Hypoglycxemia
8.4 mEqs Na in 48 hrs *lasing*
Parkland formula (1st 24 hrs LRS) = 4ml x wt(kg) x % BSA
WEBER TEST Rule of 9 (in burn patient)
Normal – sound is symmetrical with no lateralization Head = 9% Groin = !%
Lateralized to right ear – (R) conductive or (L) sensorineural Chest (Front) = 9%
Lateralized to left ear – (L) conductive or (R) sensorineural Abdoment (front) = 9%
RINNE’S TEST Back & buttocks = 18%
Ri e’s (+) AC>BC Normal None Each arm = 9%
Sensorineural Cochlear Each leg = 18%
Ri e’s (-) AC<BC Conductive middle/external ear
 MUSCLE STRENGTH
0 No movement of muscle
1 – Trace No movement of joint; Palpable Contraction
2 – Poor Full range of motion; Gravity Eliminated
3 – Fair Full range of motion against gravity
4 – Good Full range of motion against gravity and moderate resistance
5 – Normal Full range of motion against gravity and normal resistance
Some commonly used IV fluids for infant and children
Dextrose Na mEq Cl mEq K mEq Lactate Other mEq
LRS 130 109 4 28 Ca-3
NSS 154 154
D5 0.15% NaCl 50 25 25
D5 0.3% NaCl 50 51 51
D5 0.45% NaCl 50 77 77
D5 0.9% NaCl 50 154 154
D5 IMB 50 25 22 20 23 Mg – 3; PO4 – 3
D5 LRS 50 130 109 4 28 Ca – 3
D5 NM 50 40 40 13 Mg – 3; Acetate – 26
D5 NR 50 140 98 5 Mg – 3; Acetate – 27, Gluconate – 23
Continuous fever – daily fluctuation exceed 1o C (<1.5 oF)
Remittent fever – daily fluctuation exceed 2o C (>1.5 oF) but never touch normal
Intermittent fever – temperature touching normal for a part of the day
LABORATORIES
HISTORY
GENERAL DATA:
Name, Age, Sex, Civil status, Religion, Nationality, Work, born on_____ at ______, presently residing at ____, admitted for
the ___ time at our institution on _____.
CHIEF COMPLAINT: ________________
HISTORY OF PRESENT ILLNESS:
The present illness started __ months/days/hours prior to admission when ____
PAST MEDICAL HISTORY:
Childhood illnesses – measles/mumps/chickenpox
Immunization Hx
Past illnesses, hospitalizations (date, symptoms felt, # of days admitted, dx, lab results, complications, meds, disposition
upon discharge)
Surgeries (type, date, results, and complications)
Accidents, injuries, BT, allergies
Medications (prescribed, OTC meds and homeopathic remedies)
AE Gynecologic diseases (female repro)
Psychiatric (hx of violence, suicidal attempts, drug overdose, substance abuse)
FAMILY HISTORY:
immediate family members: parents, siblings, children, grandparents (maternal, paternal), grandchildren, health status,
age, if deceased: age at time of death and COD.
Heredofamilial diseases: DM, Kidney, Lung Thyroid diseases, Bronchial asthma, stroke, CA, HPN, Heart disease, Blood
disorders, Allergies, Arthritis, Obesity, Alcoholism, Psychiatric Illnesses, Seizure, etc
Communicable diseases: TB, STI
Any member of the family with similar symptoms: Genogram
PERSONAL AND SOCIAL HISTORY:
Educational attainment, marital status: health condition of spouse
Occupational history (nature of work, #of hours of exposure to hazards, safety measures (past, present)
Interpersonal relationships and financial resources within and outside the family Living conditions, source of water, waste
disposal (Housewell lit, well ventilated bungalow/ two storey house)
Relevant Travel history
Habits( sleep, nutrition, elimination, smoking hx (passive and active),
hx of alcohol and coffee, illicit drug use)
Alcohol consumption(age when started, duration, quantity, type of alcohol and frequency of intake)
Smoker ____ 3 of sticks per day divided by 20 x # of years smoking
Self care (activity, exercises)
Sexual History (exposure and history of STI, number and variety of partners
OBSTETRIC AND GYNECOLOGIC HISTORY:
Age at menarche
M-regularity (I-interval D-duration A-amount Ssymptoms), LMP,
PMP ( previous menstrual period)
Gravida:____ Para:___
OB score: (Term-Preterm-Abortion/Death-Life)
Manner of delivery (NSD, CS, Forceps ext.), place, postpartum
complications
Age and symptoms at menopause, and use of hormonal
replacement, Contraceptive use:
When started: ____ When ended: _____
REVIEW OF SYSTEMS
Constitutional: (-) weight gain/loss (amount, period,
time), (-) weakness, (-) fatigue, (-) fever, (-) chills, (-) loss
of appetite
Skin: (-) itchiness, (-) excessive dryness/sweating,
(-) change in color (cyanosis, pallor, jaundice, erythema)
Head: (-)headache, (-) dizziness
Eyes: (-) pain, (-) blurring of vision, (-) double vision,
(-) lacrimation; photophobia; use of eyeglasses (grade)
Ears: (-) earache, (-) deafness, (-) tinnitus, (-) ear
discharge (quality)
Nose and Sinuses: (-) changes in smell, (-) nose bleeding,
(-) nasal obstruction, (-) nasal dischanrge, (-) pain
around paranasal sinus
Mouth and Throat: (-) toothache, (-) gum bleeding,
(-) disturbance in taste, (-) sore throat, (-) hoarseness
Neck: (-) pain; limitations of movement, (-) presence of
mass
Breast: (-) pain, (-) lumps, (-) nipple discharge
Respiratory System: (-) dyspnea (DOB/SOB) , (-) chest
pain, (-) cough, (-) sputum production, (-) hemoptysis,
(-) wheezing, (-) Hx of asthma
Cardiovascular system: (-) substernal pain, (-) palpitations,
(-) dyspnea (DOB/SOB) , (-) orthopnea (#of pillows),
(-) paroxysmal nocturnal dyspnea, (-) easy fatigability
Gastrointestinal System: (-) abdominal pain, (-) nausea,
(-) vomiting, (-) dysphagia, (-) diarrhea, (-) constipation,
(-) hematemesis, (-) melena, (-) hematochezia,
(-) regurgitation
Genitourinary System: dysuria, (-) urinary frequency,
(-) urgency, (-) hesitancy, (-) polyuria, (-) hematuria,
(-) incontinence; genital pruritus, (-) urethral discharge
Extremities: (-) edema (location, (-) swelling of joints,
(-) stiffness, (-) numbness, (-) intermitted claudication,
(-) limitation of movement
Nervous System: (-) headache, (-) vertigo, (-) syncope,
(-) loss of consciousness, (-) weakness, (-) paralysis,
(-) numbness, (-) paresthesia, (-) speech disorder, (-) loss of
memory, (-) confusion
Hematologic System: (-) bleeding tendencies, (-) pallor,
(-) easy bruising, (-) Hx of transfusion reactions (describe)
Endocrine System: (-)heat/cold intolerance, (-) excessive
weight gain/loss, (-) polyuria, (-) polydipsia
PHYSICAL EXAMINATION
VS: BP: ____ mmHg CR: ____ bpm RR: ____ cpm Temp: _____oC
HEENT: pink palpebral conjunctivae, anicteric sclerae, no nasoaural
discharge, no tonsilopharyngeal congestion
NECK: supple, nontender, no cervical lymphadenopathy/ no palpable
lymph node, no mass
CHEST/LUNGS: symmetric lung expansion, clear breath sounds, no
crackles, no wheezes
HEART: adynamic precordium, normal rate, regular rhythm, no murmur
ADBOMEN: flat, soft, nontender, normoactive bowel sounds, no masses
EXTREMITIES: full and equal pulses, no gross deformities, no edema
SKIN: no active dermatoses
General survey: Patient is awake, alert, and responds appropriately to stimuli, speaks
fluently, coherently, and spontaneously, well-kempt and dresses appropriately for her
age, oriented to time, place, and person, well-nourished (BMI: ____), afebrile,
ambulatory, not in cardiorespiratory distress with the following vital signs:
BP: ____ mmHg CR: ____ bpm RR: ____ cpm Temp: _____oC
Skin: _____ complexion, normal degree of moisture, elasticity, mobility and thickness;
black, short hair of normal quality and even distribution; nail beds pink, nail plates are
smooth, no lesion; nail fold normal.
Head and Face: Hair is thin, black, evenly distributed, normocephalic, no mass or
tenderness noted, no swelling or deformities. Temporal arteries are not visible but
palpable and with strong and equal pulsations, walls not thickened. Face is symmetrical
with normal facie, no lesions, no mass, no involuntary movements
Eyes: eyebrows are black, thick and evenly distributed, no erythema, and no lesions noted.
Palpebral fissure are narrow and symmetrical. Eyelashes are thin, equally distributed,
curled outward and no matting. Negative lid lag test. Normal set eyeballs. No
exophthalmos or enophthalmos. No nystagmus. Palpebral conjunctiva are pink, anicteric
sclera, cornea are transparent with no lesions, lens are clear, iris is brown. Pupils are
equal in size 2-3mm,equally reactive to light and accommodation, (+) ROR
Ears: auricles are symmetrical. No tenderness, no deformities or lesions. No tenderness
on mastoid noted. External auditory canal are patent without discharge, no redness nor
swelling or lesions. Tympanic membrane is pearly white, intact, flat and no perforations.
Nasal and paranasal sinus: nose is symmetrical, no flaring of alar nasi noted, no
tenderness no deformities. Vestibules are patent, pink mucosa. Nasal septum is straight
and at the midline, intact not perforated and has pink mucosa. Turbinates are pink and
not congested. No nasoaural discharge. No tenderness noted on frontal and maxillary
sinuses. (+) transillumination tests
Oral cavity: lips are pink dry symmetrical and has no lesions. Buccal mucosa and gums
are pink and moist, smooth, no signs of swelling. Tongue and uvula at midline Hard
and soft palates are pinkish, no lesions. Tonsils are not enlarged. Pharyngeal wall is
pink no lesions and no exudates
Neck: neck is normal in size symmetrical no visible mass or swelling or deformities, no
neck vein engorgement. With normal mobility and normal muscle tone. Trachea is at
the midline. No enlarged or tender lymph nodes. Thyroid gland not palpable. No
carotid bruit noted.y
Lungs/Chest: chest is fair without lesions. No visible superficial blood vessels. Thorax is
symmetrical, elliptical without deformities. Effortless breathing with symmetric lung
expansion, no retractions or lagging. No tenderness, no masses, resonant, vascular
breath sounds. (-)egophony (-) bronchophony (-) whispered petriloquy
• Cardiovascular: Adynamic precordium. apex beat at the 5th ICS LMCL with normal
rate, regular rhythm. No precordial thrust or lift. No murmur. Jugular vein is not
distended. Carotid artery pulsations are strong regular and equal.
• Abdomen: skin is brown in color, flat abdomen, inverted umbilicus, no superficial
blood vessels noted, no visible mass, visible peristalsis. Normoactive bowel sounds.
No bruit over the epigastrium and paraumbilical arteries. Tympanitic percussion. No
spleenic dullness. No masses or organomegaly on light and deep palpation. Negative
fluid wave and negative shifting dullness exam. No costovertebral angle tenderness.
• Extremities: No gross deformities, Muscle strength is 5/5 in all extremities with full
range of motion and full and equal pulses
NEUROLOGICAL EXAMINATION
CEREBRAL FUNCTION: Patient is ambulatory, conscious, coherent, well groomed, no mannerisms, oriented to time, place and person, intact
immediate, recent and remote memory
CEREBELLUM: a. able to perform finger-nose test, alternating pronation and supination, heel to shin test; b. Ro berg’s Test: o swa i g with e es
closed and open ; c. able to perform tandem gait without any loss of balance
Specific Cerebral Function: 1. Language Function: can talk spontaneously, repeat simple phrases, follow verbal and writen commands; 2. Object
recognition: can identify object at both hands, sound produce, name object, recognize her body parts; 3. Praxia: can follow 3-stage command and
can copy simple design
Cranial nerves:
CN I: Intact Smell
CN II: a. visual acuity: can read smallest letters of Jaeger chart at a distance of 14; b.
opthalmoscopic findings: (+) ROR, optic disc not appreciated; c. plotting of visual field: no visual
field defect
CN III, IV, VI: Pupils equally reactive to light and accommodation (PERLA) a. both pupils constrict
briskly reactive to light both direct and indirect; b. adduction of both eyes and constriction of both
pupils on accommodation test; c. equal and incomplete opening of the eye d. EOM: can move eyes
in H pattern
CN V: facial sensation: can feel pain and light touch equally on both sides; corneal reflex: prompt
and equal blinking of the eyes; motor function: can clench teeth equally on both sides; (-) jaw jerk
CN VII: can identify taste of sugar and salt, can frown, raise eyebrows, close eye tightly, nasolabial
fold symmetrical on both sides
CN VIII: Weber: no laterization, Rinne: AC>BC, no nystagmus, Romberg test: no swaying with eyes
closed and open
Mnemonics
CN IX and X: no dysphonia, uvula at midline, equal elevation of palate on phonation, (+) gag reflex Oh! Oh! Oh! To Touch And Feel A Girls Vagina Ah!
CN XI: can turn head from side to side against resistance, can elevate shoulder equally Heaven
CN XII: no atrophy nor fasciculation, tongue midline on protrusion, moves tongue from side to side Some Say Marry Money But My Brother Says Bad
Business Marry Money
MOTOR FUNCTION: muscle size, No muscle atrophy and hypertrophy, rigid right lower extremity on passive movement, muscle
tone is normal, no involuntary movement or fasciculation, muscle strength: grade 5/5 on all extremities
SENSORY FUNCTION:
1. Primary forms of sensation: Can feel light touch equally on both sides, can feel pain & temperature equally on both sides, can
sense position and vibration equally
2. Cortical and discriminatory forms of sensation: can locate the spot where she was touched, no extinction phenomenon
REFLEXES
1. Superficial reflexes: (+) abdominal reflexes
2. Deep Tendon Reflexes: Biceps ++, Brachioradialis ++, Triceps ++, Knee Jerk ++, Ankle Jerk ++
3. Frontal Release reflexes: (-) Snout reflex, (-) Grasp reflex
4. Pathological reflexes: (-) Babinski, Chaddock and Oppe hei s’s maneuver, Hoff a ’s Sign
SIGNS OF MENINGEAL IRRIATION : No nuchal rigidity, Brudzinski sign negative, Kernig sign negative
P = Provocation/Palliation
What were you doing when the pain started? What caused it? What makes it better or worse? What seems to trigger it?
Stress? Position? Certain activities?
What relieves it? Medications, massage, heat/cold, changing position, being active, resting?
What aggravates it? Movement, bending, lying down, walking, standing?
Q = Quality/Quantity
What does it feel like? Use words to describe the pain such as sharp, dull, stabbing, burning, crushing, throbbing,
nauseating, shooting, twisting or stretching.
R = Region/Radiation
Where is the pain located? Does the pain radiate? Where? Does it feel like it travels/moves around? Did it start elsewhere
and is now localized to one spot?
S = Severity Scale
How severe is the pain on a scale of 0 to 10, with zero being no pain and 10 being the worst pain ever? Does it interfere
with activities? How bad is it at its worst? Does it force you to sit down, lie down, slow down? How long does an episode
last?
T = Timing
When/at what time did the pain start? How long did it last? How often does it occur: hourly? daily? weekly? monthly? Is it
sudden or gradual? What were you doing when you first experienced it? When do you usually experience it: daytime?
night? early morning? Are you ever awakened by it? Does it lead to anything else? Is it accompanied by other signs and
symptoms? Does it ever occur before, during or after meals? Does it occur seasonally?