1. If a patient has a fever, give acetaminophen (unless it is contraindicated)2. If a patient is on a statin or you order a statin, get baseline LFTs and chec fre!uently". If a patient is found to have abnormal LFTs, get a T#$%. If a patient is going to surgery (including cardiac catheteri&ation), mae them '()*. +ll '() patients must also have their urine output measured (type ,urine output,)-. If a .oman is bet.een 12 and *2 years old and there is no mention of a very recent menses (that is, / 2 .ees ago), order a beta0h123. 4on5t forget to discontinue anything that is no longer re!uired (especially if you are sending the patient home)6. 7hen a patient is stable, decide .hether or not you should change locations (if you anticipate that the patient could crash in the very near future, send the patient to the I189 if the patient :ust needs overnight monitoring, send to the .ard9 if the patient is bac to baseline, send home .ith follo.0up);. In any diabetic (ne. or long0standing), order an $b+1c as .ell as continuous +ccuchecs.1212. In any overdose, do a gastric lavage and activated charcoal (no harm in doing so, unless the patient is unconscious or has ris for aspiration)1". In any suicidal patient, admit to .ard and get ,suicide contract, and ,suicide precautions,1%. (atients .ho cannot tolerate +spirin get 1lopidogrel or Ticlopidine1*. (ost0(T1+ patients get +bci=imab1-. In any bleeding patient, order (T, (TT, and >lood Type and 1rossmatch (:ust in case they have to go to the ).?.)13. In any pregnant patient, get ,>lood Type and ?h, as .ell as ,+typical +ntibody #creen,16. In any patient .ith e=cess bleeding (especially 2I bleeding), type ,no aspirin, upon 4@1 of patient1;. If the patient is having any upper 2I distress or is at ris for aspiration, order,head elevation, and ,aspiration precautions,2efore you 4@1 a patient, change all IB meds to () and all nebuli&ers to C4I22. In any patient .ho has 2I distress, mae them '()2". +ll diabetic in0patients get +ccuchecs, 4@1 oral hypoglycemic agents, start insulin, $b+1c, advise strict glycemic control, recommend diabetic foot care2%. +ll patients .ith altered mental status of unno.n etiology get a ,fingerstic glucose, chec (for hypoglycemia), IB thiamine, IB de=trose, IB nalo=one, urine to=icology, blood alcohol level, '()2*. If hemolysis is in the differential, order a reticulocyte count2-. If you administer heparin, chec platelets on 4ay " and 4ay * (for heparin0induced thrombocytopenia), as .ell as fre!uent $D$23. If you administer coumadin, chec daily (T@I'? until it is .ithin therapeutic range for t.o consecutive days26. >efore giving a .oman coumadin, isotretinoin, do=ycycline, )1(s or other teratogens, get a beta0h122;. If you give furosemide (Lasi=), also give E1l (it depletes EF)"8'@1r before and after treatment "1. 4on5t forget about patient comfortG Treat pain .ith IB morphine, nausea .ithIB phenergan, constipation .ith () docusate, diarrhea .ith () loperamide, insomnia .ith () tema&epam"2. +ll I18 patients get stress ulcer prophyla=is .ith IB omepra&ole or ranitidine"". If you put a patient on complete bed rest (such as those .ho are pre0op), get ,pneumatic compression stocings,"%. If fluid status is vital to a patient5s prognosis (such as those .ith dehydration, hypovolemia, or fluid overload), place a Foley catheter and order ,urine output,"*. If a 1H? sho.s an effusion, get a decubitus 1H? ne=t"-. If you intubate a patient you also have to order ,mechanical ventilation, (other.ise the patient .ill :ust sit there .ith a tube in his mouthG)"3. 7ith any ma:or procedure (including surgery, biopsy, centesis), you C8#T type ,consent for procedure, (typing consent .ill not reveal any results)"6. 7ith any fluid aspiration (such as paracentesis or pericardiocentesis), get fluid analysis separately (it is not automatic). If you don5t order anything on the fluid, it .ill :ust be discarded.";. 7ith high0dose steroids (such as in temporal arteritis), give IB ranitidine, calcium, vitamin 4, alendronate, and get a baseline 4AH+ scan.%1KL, and any appropriate antibiotics*". If a patient re!uires epinephrine (such as in anaphyla=is), and he@she is on abeta0blocer, give glucagon first*%. If lipid profile is abnormal, order a T#$**. +ll dementia and alcoholic patients should be advised KLMno drivingKL*-. To diagnose +l&heimerKLNs, first rule out other causes. )rder a 1T head, vitamin >12 levels, folate levels, T#$, and routine labs lie 1>1, >C(, LFT, 8+. +lso, if the history suggests it, order a B4?L and $IB ALI#+ as .ell*3. +lso rule out depression in suspected dementia patients*6. For all .omen .ho are se=ually active and of reproductive age, give folate. In fact, you should give +LL your patients a multivitamin upon 4@1 home*;. +ll pancreatitis patients should be made '() and have '2 suction so that nofood can stimulate the pancreas-efore giving a child prednisone, get a ((433. If a patient is found to have high triglycerides, chec KLMamylaseKL and KLMlipaseKL (high triglycerides can cause pancreatitis)36. ?emember that any ne.born under " .ees of age .ho develops a fever is #A(#I# until proven other.ise. +dmit to the .ard and culture ABA?OT$I'2J KLMblood cultureKL, KLMurine cultureKL, KLMsputum cultureKL, and even KLM1#F cultureKL. +nd give antibiotics to cover ABA?OT$I'2.3;. If you get a high lead level in a child, you have to chec a KLMvenous blood lead levelKL to confirm. If the value is I 3efore a colonoscopy or a sigmoidoscopy, you should prepare the bo.elJ mae the patient '(), give IB fluids (if necessary) and order KLMpolyethylene glycolKL.63. +ny patient .ith Cobit& II or complete heart bloc gets an immediate KLMtranscutaneous pacemaerKL. Then order a cardiology consult to implant a KLMtransvenous pacemaerKL66. If calcium level is abnormal, order a KLMserum magnesiumKL, KLMserum phosphorusKL, and KLM(T$KL6;. Treat both malignant hyperthermia and neuroleptic malignant syndrome .ithKLMdantroleneKL;ed ?est5 and choose 51omplete bed rest5 or 5>ed rest .ith bathroom privileges5 or type restrain and choose 5?estrain patient in bed5. 4iet R 'ormal, li!uid, '(), 2 gram #odium, +4+, etc. )rder 54iet5 and you .ill see the list of options, choose .hich is the best for this case. Tubes R '2 TubeQ Foley5s catheterQ Fluids R #aline, ?inger, etc. Type 5Fluids5 and choose .hich is the best for this case. 8rine output R Type 58rine )utput5 and choose fre!uency. There is no option for Input@output chart. Cedications J #topG 1hec for allergies on erasable boardG )rder standard drugs for this case. 4ecide IB or )ral. 4ecide bolus or continuous. 4ecide fre!uency. Labs J +dditional labs to confirm diagnosisQ Labs to monitorQ 1ardiac ConitorQ (ulse )=imetryQ 1onsults J )rder consults if necessary. 2I, )phthalmology, (sychiatry, 2enetics, #ocial .orer, etc. Then move clocG 4epending on severity of case, move by "< minutes@1 hour@2 hours@" hours@- hours@12 hours@1 day@2 days@1 .ee. 4o Interval@follo.0up history. 8nderstand the results of the labs. Then asJ $as the patient5s condition changed significantlyQ If yes, change locations. If the condition has improved, move the patient to the ne=t location in the order A? 00I I18 00I 7ard 00I )ffice@$ome. If the condition has .orsened, move the patient to the ne=t location in the order $ome@)ffice 00I 7ard@A? or 7ard@A? 00I I18. If you are changing location from inpatient (A?@I18@7ard) to outpatient ()ffice@$ome)J #top unnecessary medications and change IB medications to oral. 4iscontinue IB fluids.?emove tubes. ?emove IB access. #chedule follo.up visit in 1 or 2 .ees as relevant.(atient education or counseling or diet specific and vital to this case. Type 5patient education5 and 5counsel5 and see if anything is relevant to this specific case. Type 54iet5 and see if anything is relevant to this specific case. >y this time, the * minute screen .ill appearG Then type 5counsel5 and choose the relevant things. Oou can choose multiple things ata time. #ee your erasable board for any .orrisome habits lie alcohol or smoingG Type 5patient education5 and choose the relevant things. Oou can choose multiple things at a time. (atient education @ 1ounseling options J Avery adult person 0 4rive .ith seat belt, A=ercise program, 'o illegal drug use. Avery person taing long0term medications 0 Cedication compliance, #ide effects of medication. Avery person .ho taes alcohol 0 Limit or stop alcohol intae. Avery person .ho smoes 0 #moing cessation. Avery person of reproductive capacity 0 #afe se= techni!ues. Avery person .ith long0term conditions, life0threatening allergies, chronic illnesses 0 Cedic +lert >racelet. Female re!uesting contraception or practicing unsafe se= 0 >irth control, 1ontraception, #afe se= techni!ues. 1ancer case 0 1ancer diagnosis. +sthmatic 0 +sthma care, medication compliance. Terminal case 0 +dvance 4irective (Family), +dvance 4irective ((atient) and Living .ill. Avery post0operative case 0 4eep breathing and coughing 4iabetic 0 4iabetic foot care, $ome glucose monitoring, 4iet. Learning disorder id 0 Aducational remediation. )steoporosis 0 Astrogen replacement therapy. $IB case 0 $IB support group, safe se= techni!ues. $ypothyroidism or endocrine case 0 $ormone replacement therapy. Lactose intolerance 0 Limit co.5s mil intae, 4iet. 2I bleeding, peptic ulcer case 0 'o aspirin, #it upright after meals. )ld age, epileptic, vision defects, narcolepsy 0 'o driving. +n=iety case 0 ?ela=ation techni!ues, ?ebreathing into a paper bag. Biolent psychotic case 0 ?estraining order. #pousal +buse 0 #afety plan. IB drug use 0 'o illegal drug use, #>A prophyla=is, #afe se= techni!ues, #top alcohol, #moing cessation. (elvic surgery 0 'o intercourse. #T4 0 #afe se= techni!ues, #e=ual partner needs treatment. 4epression 0 #uicide contract. ?outine screening J #chedule appropriate screening tests as per age. Type the relevant test and schedule. Immuni&ations J For (ediatrics and 2eriatrics as relevant. Type 5Baccine5, choose and schedule. +t the end of the * minutesJ Type the Final 4iagnosis. Oou are doneGGG For EidsJ +dd age appropriate va=ine.$elmets .hen >icycle riding..ater temp/12< degree.4ental health.28n safety.smoe detector.Teenage J 4)nt drin .hile drive counsel.For every one add age appropriate #1?AA'.8B protection .(oste=posure prophyla=is.1+'1A? screen everyone gets it. FemalesJ thin if she neeeds to be (+(ed.1hlamydia screen for a se=ualy active .ith many.Alderly geriatic TCamograph if older.Tosteoporosis screen.Tpneumova= and flu va= for elderly.Telderly fall prevention.T$ormone replacement. #creening J 1onsiderJ #elf0breast e=am every month after age 2en& (eni , if allergic 4o=y or tetra for 1% days . in pregnancy use peni .ith desinti&ator1(( ( t.ice@.eely ) KLWXY oligo or late dece orI%" . KLWXY delivery1