My site evaluation was with PA Shu. Over the two evaluations I presented three H&Ps, 10 pharm cards and a journal article. The first H&P I presented was of a patient that was diagnosed with choledocholithiasis. The second one was hematuria and the 3rd H & P was of a patient with small bowel obstruction. Some important parts of a note from surgery are to notate where the previous surgery has taken place and who was the surgeon. In order to have a concise and straightforward plan, listing out the problems the patient has in a numbered fashion is helpful. It is also important to mention why the patients are being given certain treatments. For example, IV fluids for hydration, Tylenol for pain and Zosyn for an infection. Calculating fluids by using the parkland formula is also something I was able to review during my site evaluation.
4, 2, 1 formula
- 4 mL/kg/hr for the first 10 kg
- 2 mL/kg/hr for the next 10 kg
- 1 mL/kg/hr for each further kilogram after 20
- Ex: 70kg man
- 4mL x 10kg = 40
- 2mL x 10kg = 20
- 1mL x 50kg = 50
- Total: 110mL/hr
- Ex: 70kg man
Overall, I received constructive feedback that would help me improve my notes as a practicing PA.
