Ingat lagi dulu-dulu masa jaga postnatal ward kat O&G, kadang-kadang baby kuning, mesti kena ambik TSB and refer paeds. Boleh try pakai template ni.
Currently, he is ___ hours of life?
☞ Usually within 72 hours, counted in hours
☞ If >72 hours, mention in day what of life
Admitted for neonatal jaundice/NNJ
☞ Straight to the point to tell the reason of admission
☞ You know… Some people are not patient enough
Taking low/moderate/high risk, in view of XXX reason
☞ Risk factors include gestational age, G6PD status, ABO incompatibility & clinical sepsis
The TSB was taken at XXX hours of life, result was XXX, photo level was XXX
☞ Is important to mention the TSB was taken at how many hours of life, especially to more senior superior, so they can counter check back whether you look at the chart correctly
Obstetric History
☞ Mode of delivery
☞ Gestational age and birth weight
☞ Current weight, weight loss in %
☞ Antenatal history
☞ Birth history
Feeding
☞ If on exclusively breastfeeding, is the breastmilk enough?
☞ If on formula feeding, how frequent is the feeding and amount of each feeding
☞ Inadequate feeding ↣ dehyration ↣ jaundice
PU/BO
☞ How many times
☞ Usually 4-5x/day is acceptable
☞ Below that need to think of inadequate feeding
Activity
☞ Sepsis ↣ Not active
☞ Sepsis could be 1 of the causes of jaundice
Examination findings
☞ Jaundice up to which part of body
☞ Can revive Kramer’s rule
☞ If no significant findings, can consider to summarize as unremarkable
Impression & your plan
☞ If you can tell out your impression and plan, I believe it you will impress your superior
☞ Don’t feel embarrassed if you give the wrong impresison or plan, because YOU ARE STILL LEARNING 💪
📢 Example of Presentation 📢
Good morning Dr Chan, this baby boy named BO of Aisyah, currently is about 50 hours of life, admitted for NNJ, taking moderate risk in view of gestational age < 38 weeks. Otherwise, G6PD status normal, maternal blood group is A+ve. TSB taken at 48 hours of life was 190 with photo level of 171.
Otherwise, he was born via SVD at 36 weeks 1 day, birth weight 2.7kg, current weight is 2.5kg, 7.4% weight loss. Antenatally mother has anemia in pregnancy only. Birth history was uneventful. He is currently on exclusively breastfeeding about every 2-3 hour, mother claimed she has enough breastmilk. He PU & BO about 4-5x/day. He remained active at home.
On examination, he is jaundice up to upper chest. Other systemic examinations are unremarkable. My impression is neonatal jaundice. I started him on conventional phototherapy. Started cup feeding 40cc 3hourly with total fluid of 120ml/kg/day. I will trace his TSB and inform, to decide the next TSB timing.
➡️ Well, this is just a template, everyone has his/her own preference of presentation
➡️ Don’t be too rigid
➡️ Try to develop your own way and not to miss any important point
➡️ Different superior might have different preference
➡️ So, is important also to find out who is going to do round with you, and what he/she prefers
I hope this template could help you to develop your own style of presentation! 😜
