eSigning Pet Medication Chart Made Easy

Signature pet medication chart

the Registrar in the consultant of busy examining a patient and they ask you to call the general practice and find out the details of all his medications so you call the GP who's maybe behind a curtain or something and he tells you that so you start basically this is the entire section I'll show you this is for other regular medications this is only PRN Arjun when the patient asks and this is once only because if we want to give any medications if not PRN and it's not regular like PRN morphine just as required okay so first you mark the allergies you asked about the allergies attached to this patient so when's your name you fill up the name the family name the Amerian of the hospital male female all these liters you fill in first then you ask about any allergies suppose I say penicillin you write down penicillin you write what type of allergy if it's anaphylaxis or is it just an itch or a GI upset and you sign there you sign this you print our name and you put a date okay that's just to cover the basics next you'll have this medication like supposing the medication that has a variable dose like prednisone so ten on one day five on the next a ten on one day found the next day or gentamicin because you have to change it based on the drug levels in your body so for three twenty one day for twenty now that it so that's why you put in the variable dose of the medication so you put in the date suppose it's five third you put in the name prednisone a route poor oral frequency now this is suppose once daily so you put on daily and put down whatever indication you're giving it false was its ask them out or put your sign put your name and here you write down the dose so this is a date you put in a date here fifth of the third and the dose being exam today 5:00 tomorrow 10 milligram today five tomorrow so it changes you don't even have to enter all of these if you enter two and the next zero like okay maybe he needs 15 you put down 15 so this is for those that changes every day okay because you don't have to write the doors here that you about this data if it's a normal medication like an anti lipid region like a tourist a teen okay or an aspirin so you write down the medication here medication is a generic name don't die in lipitor if you do live lipitor in the bracket you have to write this one okay again you put in the date the route for oral 14 milligrams suppose you give it once a day or at night so knocked a and you put in the time here okay this is a time where you put it in and this sign this is going to be a constant dose every night so you don't have to worry about it once you entered it this is what they're going to give them suppose it's as plain again you put in the name of the medication the doors the frequency all this in another time we suppose you want to give it twice a day then you write it twice a day so recommend a timing so if it's the medications only once in the morning you write down money eight o'clock if it's knocked a put down either six o'clock or 20 or eight o'clock it is twice a day then it's called B D I say 8 o'clock and eight o'clock in the evening we will mark yes no no no so you use this to put in time so you know what is so you don't have to write everything is not there if you forget to write this at least a no-knock days either these times but you write that you write it here suppose it's qid then you see okay what's the most appropriate timing four times a day six hours six 12 18 24 that's the difference so that's just a reference you can put in the timings like that okay so all the normal medications you put in like using a pasar if you have for example for double is a day you would write the timings here in the vertical manner right 6 12 18 24 K they put 22 because you don't of the patient you can write q ID or you can write six hourly yeah like one yeah these are the daily medication will take that irregular medic use the time yeah doesn't mean that you gave the mitigation me no so this is for that so suppose this is today's date the nurses were saying here give you the six o'clock dosa or give it or the patient refused fine refused or the doctor said to withhold to put away the whole time so that's not you'll only be required to fill this up okay so this is all that I give a medication this is for the variable those medications now you put patients on DVD prophylaxis when they come in so suppose I asked you to put a patient on DVT prophylaxis of course they'll give you the doors it they don't want you to worry about it suppose it's like say no heparin then you write it here in VTE venous thromboembolism prophylaxis so write heparin your you put in the doors suppose it's 5,000 units B D and you enter it down okay so is it only for the heparin is like yeah help 10 clicks in an ox appear in any of the DVT prophylaxis you're giving it with that okay only what yeah that's it marked your VTE prophylaxis only okay and mechanical prophylaxis is those stockings Ted stockings so you put they put Ted's down here so you put down flex in so 14 milligrams B D so you put 0 8 and 2 0 root is a subtype yep you put in the date and you sign printer name blah blah blah okay variable dose DVD prophylaxis regular medication was its warfarin now often is given for lot of indications atrial fibrillation be with the prosthetic perhaps so again you mark which warfarin there are two types so suppose coumadin warfarin they'll tell you and now the warfarin dose changes every day right suppose suppose you're adjusting a patient based on the Ayane so you check today's ina suppose it's 1.8 so suppose you start off with four milligrams of warfarin here on the 15 sign here they give it every dates for a block it is a target and that's other thing so your target INR is between 2 & 3 most of the times okay so you put our target Ayane twist to it 3 indication atrial fibrillation okay and you sign and complete this box and you start them on whatever those that are on at home suppose it's 4 milligrams next day you do the level and you find oh it's only one point one so you bump it up so you may increase the one at a time because often when you give it the Ayane takes two days II do actually pick up okay so increase it slowly so to one point one you're not really worried that is going to shoot up too fast but still you try 5 milligram can you sign you repeat the warfarin INR level it's one point eight what would you do same dose yes maybe you pick up so next if it's when it's in the therapeutic range you continue that so every day you're supposed to fill this up checking the ANA unless it stabilized are these field and the morning grounds usually you know these are filled in patient gets admitted okay yeah because their medications have to be chart right or warfarin yeah yeah so the warfarin can't be filled in the morning because of actually practically speaking the blood results of the morning Bloods come sometime in the afternoon okay so you fill them and then it doesn't matter when you fitted for the example pieces you fill it then in there because you think they say buffering four milligrams so that's why you know I have to fill it here they say you know flexing or whatever you put it here okay then no contacts your pager number so so they can if they do give you a patient but they won't complicated I don't even remember if you had it someone told me they have it and I saw the opportunity at this chart and show it to your so I've done it PRN PRN is as and when required so if your agent is comes with with pain and you prescribe in Don okay so you write down in down here or if the patient comes in with nausea vomiting right and ondansetron here okay but it's PRN you don't need to keep on giving it to him every four hours or ever in three hours so PRN is means as required so write down the indication nausea and vomiting caddos is four to eight milligrams and yeah you want to give it every suppose you want to give it three times a day maximum 24 milligrams so the nurses will give it to him suppose you'll give it maybe you can put down four times River the nurses will give it to him they put in the date they put in the time and whenever he says I'm getting nauseous they are given one audience at all so they don't have to ask us they can do it anytime they want as long as they make sure that the maximum doses in breeched anything anything at all and on salbutamol nebulizer or morphine but yeah which is anything that the patient may be entertain here is paracetamol yep anything execute like more we call or lactose the patient and so these are just like so in the one is in the painkiller so again suppose the dose is fine and known as a combination drug so it's yeah and so it's five and two point five milligrams again you want to give it four times a day with the maximum dose off suppose twenty milligrams or thirty milligrams sleeping tablets now the thing with sleeping tablets is you don't want to make a habit out of it okay so in the nerves posit this patient asking for a sleeping tablet now if they're on regular ones at home fine you got it yet but if they're not if they just can't sleep in the hospital you write it here once only medication so I go to the patient that you really can't sleep you know you assess the patient in DB and then you write down here temazepam okay poor oral ten milligrams stat or only one now or or you write down the time so five on the third at 21 hours you know so you can just give one months only so this can't be repeated unless you actually come here through all the Medicaid the admissions it's only this this time you mean you cannot repeat it again yeah no no no this is one so when the moment you sign your printer name the noise signs it's gone this cannot be repeated on yeah I can write so the other night if you can't sleep again write down the duck chart Venezuela so which page we should like this one in a patient we know failure or something and so suppose it's one gram sorry one gram suppose once daily for three days okay so one two three and you cancel this part out okay listen in the second day the patient got deteriorated that we have to adjust leave those of the difference alone if your door just said it goes there but you don't adjust it or handy but everything was you we should have to write if they have if you want to change the noise okay yeah okay and if the patient doesn't have any allergy what should I write nil on so just right there click on yell known the meaning of the station is that you just don't copy paste the medication listening to the chart that the I think the station was in an ER patient with renal failure so you as a casa you as a doctor have to understand what medications what might have renal toxicity so you refuse to ask your senior if this is so what you do is suppose he has a no toxicity and all the drugs that cause renal toxicity you withhold or suppose you know this w to suppose they give you gentamicin suppose you write it here or what is you get the target and cause you no toxicity so all those medication that you feel are may cause orange of to wait you have to do you're creating levels and you check how bad that you know toxicity is and what the indication the patient is dying and setting senior if I need to choose two dose may be the exam yeah you can so like this is not what eight minutes over station unless you know maybe you take sine delight everything but yeah if you're worried if the if you said that the patient has Asian has had a stroke print you withhold it saying okay I'm with the confusion and he had a medication child with him and the task was the talk to your register and all the medication and discuss the situation with him okay so it is mainly from the east bar we have explained introduction explain the situation then fill up the medication so that take a conversation you have with the patient so every medication that he says like the register want that you have a stem right is that the medication of the patient is on so you check like you use your brain for every medication there may be some contraindications and some indication now they don't expect you to know something that's way beyond the scope but you need to know some basic things okay like the patient has come with a GI bleed when you wake you think about action drugs name so far I can remember there are diuretics digoxin working and paracetamol I found only paracetamol I can continue on the rest of their viola like don't with the resistor that I think that the patient as a Python of this thing would it be appropriate to give this or should I withhold this until I get the blood to start record we talk okay just I'll write the name and wait'll we go in strays at any like websites the most common of drugs like you said it it should be like in a generic name so you don't worry for the exam 120 but probably the list based on the patient's condition okay so just think very normally if the patient comes in with confusion or the patient is unconscious you say you gather edges do you want me to be cold warfarin or or any anticoagulation because you may have had a fall and had a bleed somewhere so you just you talk to the doctor and the moment he says go ahead you can chart it down so most of your case will be writing it down and the other the rest of it will be of persley reasoning why or writing these things so again you know what the purpose of EMG examines dr. as long as you ask the questions as long as you are concerned about certain medications that's it so what was the recall URL i whatever touch this video but in case they do this is for the paramedics so suppose a bar might support a patient in with complaining of chest pain and all that and they've given a mass pretty right now or GTN right now we write it down so you don't double up the medications and there's a telephone out of the medication that the patient took no no no prior to presentation the hospital ordered the patient says if I you take for example uh as angina drugs before he you can write the the pharmacy or someone can direct it down to the hospital on the way to the hospital from policies and things like that and if you I'm covering five words up at a time and I can't get there in time for a medication the patient says listen I'm feeling very nauseous so you call the board saying this is another patient this is the many other medication can you give it now so if you repeat it to two different nurses can you repeat that this is a telephone order if you can't be there at that time and you're sure that this is not a harmful drug like ondansetron so I will call them then also called me up saying can I give this side flying write it down four milligrams of ondansetron to be given to this patient you know so second can you repeat this order to my colleague okay so both of them will sign your nurses initial one and do then whenever you are the time within 24 hours go and sign the order