Name
Item
Name of attending physician
text
Phone
Item
Phone number of attending physician
integer
Admitting Diagnosis
Item
Childhood Bacterial Meningitis Associated Diagnoses
text
Nursing
Item
Vital signs with BP: every __ hrs
boolean
Nursing
Item
Neuro vitals: every __ hrs
boolean
Specification of Vital signs with BP
Item
If Vital signs with BP, please specify frequency
float
Specification of Neuro vitals
Item
If Neuro vitals, please specify frequency
float
Medications
Item
< 1 month of age: ampicillin 50 mg/kg/dose IVPB every 8 hrs; gentamicin 2.5 mg/kg/dose IVPB every 12 hrs
boolean
Medications
Item
Age 1-3 month: ampicillin (50mg/kg)__ mg IVPB every 8 hrs; cefotaxime (50mg/kg)__ mg IVPB every 6 hrs
boolean
Medications
Item
> 3 months: cefotaxime (50mg/kg)__ mg IVPB every 6 hrs
boolean
Medications
Item
Other
boolean
Age 1-3 month, specification of ampicillin
Item
If ampicillin at the age of 1-3 month, please specify amount
float
Age 1-3 month, specification of cefotaxime
Item
If cefotaxime at the age of 1-3 month please specify amount
float
Age > 3 month, specification of cefotaxime
Item
If cefotaxime at the age of > 3 month, please specify amount
float
Age > 3 month, specification of cefotaxime
Item
If cefotaxime at the age of > 3 month, please specify amount
float
Specification of Other
Item
If Other, please specify
text
IV
Item
Normal saline @__mL/hrs with 5 mEq KCI/250mL should be 2/3 maintenance
boolean
IV
Item
Maintenance: 100 mL/kg/day up to 10 kg plus 50 mL/kg/day for each kg between 10-20 plus 20 mL/kg/day for each kg > 20 kg
boolean
Specification of Saline
Item
If Saline, please specify amount
integer
Lab
Item
Send CSF for: tube 1: C&S, gram stain on centrifuge spun specimen; tube 2: glucose, protein; tube 3: cell count and diff; tube 4: hold
boolean
Lab
Item
Blood cultures X2, CBC, basal metabolic profile
boolean
Lab
Item
UA, Urine C&S
boolean
Lab
Item
If concerned about SIADH: serum Lytes every 8 hrs, urine Lytes with Osm every day, urine SG every shift
boolean