EXT PEADS

Denies allergy.
No pregnancy or breast feeding

Unable to contact in person
Mobile: Unable to leave message / Message left
Landline: Nill / Unable to leave message / Message left
Call back as required GP surgery / ooh 111 /
Walk in centre
Acute deterioration 999/ A+E

PROGRESSION / OTHER
No new or worsening symptoms or signs
No other acute concern's symptoms or signs

Meningitis check
Fever: Nill
Headache: Nill
Photophobia: Nill Ok with light
Nausea/Vomiting:Nill
No neck stiffness or pains
No none blanching rashes
/ Strep rash
Sore throat: Nill / Some
Ears: Nill obvious

Phone Exam
Sounds stable no distress.

FACE 2 FACE
GM Notes: seen
TPP: Nill / seen
Seen with mum/dad/nan

PHONE ADVICE: URGENT A+E
Advised urgent A+E
Ambulance as required
Otherwise taxi or transport by other
States will arrange as quickly as possible

Phone Exam
Alert and orientated time place person
Agitation: nill

Phone consult:
GM Notes Checked:
Consult with

Feverish/ generally unwell
Travel: nill
Ill contacts: nill
Fever: Nill
Headache/ irritability: Nill
Photophobia: Nill Ok with light
Nausea/Vomiting:Nill
No neck stiffness or pains
No none blanching rashes
/ Strep rash
Sore throat: Nill / Some
Ears: Nill obvious
Cough: nill
Phlegm: nill
wheeze: nill
Breathlessness: nill
Eating and drinking:
Normal/
Bit less than usual amounts
Bowel Motion: Normal
Diarrhoea: Nill
Urine output:
Normal usual amounts
No dysuria

Review post weeks: 2/3/4/

Review post weekend
if symptoms not settled

Review post abx
if symptoms not settled

Face 2 Face Safety net
Urgent attention if any acute deterioration
TCB / Review with own GP if not settled

Allergies: ? Nkda
Medication: ? Nill
PMSH: ? Nill

TODAY:

FACE 2 FACE
GM Notes: seen
TPP: Nill / seen

Phone consult:
GM Notes Checked:

Phone Exam
Sounds stable no distress.
Alert and orientated time place person
Managing sentences No audible wheeze

RESPIRATORY Peadiatric
Chesty cough
Occasional murky sputum
Fevers: Nill / ?on/off
Wheeze: nill
Breathlessness: nill
Hx asthma:nill
Inhalers: nill
e+d: ok
n+v: nill

PHARMACISTS
Discussed available chemists at this time
Prefers to collect at usual chemist when open

Phone Exam
Sounds stable no distress.
Managing sentences No audible wheeze

F2F Appointment needed (routine / urgent )
Patient will ring Extended access hub
/ own gp surgery / or ooh 111

RESPIRATORY Peadiatric
Asthma / copd
Chesty cough
Occasional murky sputum
Fevers: Nill / ?on/off
Wheeze: nill
Breathlessness: nill
Hx asthma:yes
Inhalers: yes
e+d: ok
n+v: nill

EXAM PEAD QUICK
Appears Stable Alert
No meningism /
Kernig / Brudzinski negative
t:
p:
hs: normal
rr:
wheeze: nill
crackles: nill
tracheal tug: nill
recessions ics scs: nill
Abdo: snt
Ears: nad
Throat: nad
Lymphadenopathy: nill
Rashes: nill

Safety net advice:
Meningitis / scarlet fever
Discussed signs of dehydration

? DNA:
>>>>> ? DNA >>> Reschedule / OOH 111/ A+E

F2F ADVICE: URGENT A+E
Advised urgent A+E
Letter given
Has Transport/ Taxi
States will attend as quickly as possible

Face 2 Face Safety net
Urgent attention if any acute deterioration
(ooh 111 / a+e )
TCB / Review with own GP if not settled

EAR EXAM :
Appears stable Alert
No meningism / Brudzinski: Negative
Apyrexial
t:
Ear: Right/ Left
Pinna changes: nill
Mastoid tenderness: nill
Trigone tenderness: nill
EAC: Clear / waxy / inflammed
Discharge: nill
TM:
Normal
Dulled
red inflamed
Retraction: nill
Perforations: nill

Other Ear Right/ Left - nad
Throat: Clear

Eye exam
Eye Right/ Left
Periorbital changes: nill
lid/lashes: nad
Conjunctiva: nad
Scleral inflammation: nill
PERLA
EOM Full rom
Photophobia: nill
Opthalmoscopy : nad

Other Eye - nad

No obvious visual disturbance

5	6	7	8	9	10
60	72	84	96	108	120

EXAM PEAD FULL
Appears Stable
Alert
interacting
No meningism
Kernig / Brudzinski negative
No irritability
Colour/Tone: Good
Moist mucous membranes
t:
p:
hs: normal
rr:
wheeze: nill
crackles: nill
tracheal tug: nill
recessions ics scs: nill
Abdo: snt
Ears: nad
Throat: nad
Lymphadenopathy: nill
Rashes: nill

EXAM PEAD QUICK
Appears Stable Alert
No meningism /
Brudzinski negative
t:
p:
hs: normal
rr:
wheeze: nill
crackles: nill
tracheal tug: nill
recessions ics scs: nill
Abdo: snt
Ears: nad
Throat: nad
Lymphadenopathy: nill
Rashes: nill

EAR TREATMENT :
Keep ears dry
Abx oral: Amoxicillin
Ear med: otomize
Deny allergy:
Urgent attention if any acute deterioration
TCB / Review with own GP if not settled

EAR EXAM :
Appears stable Alert
No meningism /
Brudzinski: Negative
Apyrexial
t:
Ear: Right/ Left
Pinna changes: nill
Mastoid tenderness: nill
Trigone tenderness: Slight
EAC: Slightly inflammed
Discharge: nill
TM:
Dulled
red inflamed / slightly
Retraction: nill
Perforations: nill

Other Ear Right/ Left - nad
Throat: Clear

RESPIRATORY Croup
Chesty cough
Occasional murky sputum
Fevers: Nill / ?on/off
Wheeze: nill
Stridor: nill
Salivary pooling: nill
Croupy cough: nill
Breathlessness: nill
Hx asthma:nill
Inhalers: nill
e+d: ok
n+v: nill

Safety net advice:
Meningitis / scarlet fever
Discussed signs of
respiratory distress

Gestation: Term
nvd/ c sectio
Postnatal issues: nill
Feeding: Breast / Bottle
Formula
immunisatiions: utd

Allergies: ? Nkda
Medication: ? Nill
PMSH: ? Nill

TODAY:

IN THE DARK
See previous consults
No access to test results / opd letters

COUGHS AND COLDS

Likely Viral illness Common cold
Liaise with chemist
OTC Cough cold meds
TCB as required
Urgent attention if any acute deterioration
Review with own GP if not settled

Delayed script: Amoxicillin / clarithromycin/ Doxycycline
Deny allergy
Salbutamol as required

STREP THROAT Clarithro
Clarithromycin deny allergy
Calpol / otc neurofen if required
Difflam / deny asthma
Dioralyte if required
TCB as required
Urgent attention
if any acute deterioration
(ooh 111 / a+e )
Review with own GP if not settled
Safety net advise
Meningitis / Scarlet fever
Dehydration

STREP THROAT pen v
Penicillin v deny allergy
Calpol / otc neurofen if required
Difflam / deny asthma
Dioralyte if required
TCB as required
Urgent attention
if any acute deterioration
(ooh 111 / a+e )
Review with own GP if not settled
Safety net advise
Meningitis / Scarlet fever
Dehydration

EAR TREATMENT :
Keep ears dry
Abx oral: Clarithromycin
Ear med: otomize
Deny allergy:
Urgent attention if any acute deterioration
TCB / Review with own GP if not settled

EAR TREATMENT :
Keep ears dry
Abx oral: Amoxicillin
Ear med: otomize
Deny allergy:
Urgent attention if any acute deterioration
TCB / Review with own GP if not settled

EAR TREATMENT :
Keep ears dry
Abx oral: Clarithromycin
Ear med: otomize
Deny allergy:
Urgent attention if any acute deterioration
TCB / Review with own GP if not settled

UROLOGY: male

Suspected UTI
Dysuria and frequency
last few days,
Fevers: nill ? on/ off
No renal angle pains
No loin to groin pains
No haematuria

UROLOGY: female

Suspected UTI
Dysuria and frequency
last few days,
Fevers: nill ? on/ off
No renal angle pains
No loin to groin pains
No haematuria
Vaginal symptoms: Nill
lmp:

Abx issued: Nitrofurantoin,
no allergies.
egfr satisfactory
Stop after 3 days if settled
Urine for mc+s if not settling after 3 days
TCB as required
Urgent attention if any acute deterioration
(ooh 111 / a+e )
Review with own GP if not settled
Safety net advise pyelonephritis

Abx issued: Trimethoprim,
no allergies.
Stop after 3 days if settled
Urine for mc+s if not settling after 3 days
TCB as required
Urgent attention if any acute deterioration
(ooh 111 / a+e )
Review with own GP if not settled
Safety net advise pyelonephritis

Face 2 Face Safety net
Urgent attention if any acute deterioration
TCB / Review with own GP
With full access to
notes test results and specialist letters

Face 2 Face Safety net
Urgent attention if any acute deterioration
(ooh 111 / a+e )
TCB / Review with own GP
With full access to
notes test results and Specialist letters

EXAM PEAD QUICK
Appears Stable Alert
No meningism /
Brudzinski negative
t:
p:
hs: normal
rr:
wheeze: nill
crackles: nill
Abdo: snt
Ears: nad
Throat: nad
Lymphadenopathy: nill
Rashes: nill