Clinical Hub & GP Checklist
Essential guardrails for every consultation. Check red flags before you prescribe.
Pediatrics
👶 Rapid Pediatric Check
- Fever (< 1 month): Immediate referral TRO neonatal sepsis.
- Dosing: PCM 15mg/kg (Wt x 0.3mL of 250mg/5ml).
- Resp Rate: < 60 (<2mo); < 50 (<1yr); < 40 (<5yrs)[cite: 25].
- Dehydration: ORS 10ml/kg in frequent small sips.
- Max Dose: Always verify capped pediatric max before dispensing[cite: 36].
Adult Acute
💊 Acute Management
- Fever: FBC on Day 3 to rule out Dengue[cite: 66].
- Cough: Chronic (>2w) workup for PTB; check ACE-i induced[cite: 48].
- Chest Pain: Typical symptoms + Normal ECG still requires ED referral.
- Asthma: Neb Salbutamol 1:3; avoid drip in GP[cite: 70, 469].
- Infection: Use NAG 2024 selections (e.g., Amox 500mg TDS for Tonsillitis)[cite: 78, 79].
Chronic
📊 Clinical Targets
- Hypertension: SBP ≥160 or DBP ≥100 requires global CV risk assessment[cite: 232, 234].
- Diabetes: Symptomatic + single VPG ≥7.0 (Fasting) or ≥11.1 (Random) = T2DM [cite: 317-323].
- DM Target: HbA1c ≤6.5%; Fasting 4.0–7.0 mmol/L.
- Lipid Target: LDL <1.8 (High Risk); <1.4 (Very High Risk).
Dermatology
🔍 Derm Safety
- Tinea: Annular/scaly; Avoid topical steroids (Tinea Incognito)[cite: 91, 100].
- Scabies: Permethrin 5% neck-down ON; repeat in 1 week[cite: 135].
- Eczema: Use Aqueous cream LA QID + Hydrocortisone (Face only)[cite: 83].
- HFMD: Notifiable; isolate daycare/school until ulcers/fever resolve[cite: 168].
Procedures
✂️ Procedure Guardrails
- STO (Face): 6-0 Nylon; remove in 3–5 days[cite: 216].
- STO (Limbs/Scalp): 4-0 Nylon; remove in 7–10 days[cite: 216].
- Eye Splash: Immediate saline irrigation ≥30 mins until pH neutral[cite: 464].
- Injections: Pantoprazole MUST be IV; cannot be given IM[cite: 469, 472].
Neonatal/OBGYN
🍼 Infant & Maternal
- NNJ Referral: Refer if weight loss > 7% or Direct Bili > 25 µmol/L[cite: 520, 537].
- TcB Rules: Do not use for infants on phototherapy or < 24h of life[cite: 523].
- Pregnancy UTI: Cephalexin 500mg QID even if asymptomatic[cite: 78, 479].
- Referral: Antepartum hemorrhage or severe pre-eclampsia to hospital[cite: 223].