Trigger points for FVR-Medical

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Trigger points for FVR-Medical
By Corporate FVR TEAM
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Medical Cases
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Medical Case
Diarrhea / acute gastro enteritis Verify the initial admission complaints of the patient Frequency of the stools , quantity of the stool Indication for hospitalization verify for Dehydration symptoms To verify Vitals at the time of admission Line of management Whether patient took out patient treatment if so details of the treatment
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Fever Verify the indication of hospitalization Verify the temperature , vitals , dehydration status Verify Exact duration of fever To verify TPR chart To get Positive investigation reports Reports of outpatient treatment ,if any
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lower respiratory infection To verify indication for hospitalization Verify for vitals at the time of admission To verify the resp rate ,saturation level-02 saturation To verify whether oxygen / nebulisation given To verify the x ray or ct chest report To rule out whether any underlying bronchial asthma, copd
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Typhoid Indication for hospitalization verify for fever , vitals , dehydration status Exact duration of fever /TPR chart Positive inv reports diagnosis, blood culture rpt ( confirmatory )
Leptospirosis Indication for hospitalization To verify for fever , vitals , dehydration status of the patient Exact duration of fever/ TPR chart Positive inv reports diagnosis MAT TEST rpt ( mandatory )
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• Persistent vomiting
• Dehydration
• Abdominal tenderness
• Hepatomegaly
• Ascites
• edema

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• Dropping trend of platelets to lt50000
• Comorbid conditions Heart disease, Bronchial
  Asthma, DM, HTN,
• Peptic Ulcer, Hemolytic anemias,
• Pregnancy, Infancy,
• Old age,. along with ns1 antigen.

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• Dengue -
• Mucosal bleed
• Respiratory distress
• Pleural effusion
• Hypotension/shock
• Oliguria
• Rising Haematocritgt 60

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• If any one of the above condition is met, then
  admission is indicated

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Medical Case
Chronic kidney disease How and when was the symptoms started What was the initial symptom When was it first diagnosed? First consultation report and creatinine value at the time of diagnosis Serial urea and creatinine values with hemoglobin rpt , usg , ct rpt Any biopsy done if yes result ( mandatory ) Any past history of kidney disease If dm /ht - what was the duration
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Medical Case
Hypertension How and when diagnosed as hypertension Initial consultation report and medications given What was the current medication taken Ecg, Rft, echo reports
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Medical Case
Acute pancreatitis Usg or ct report along with Liver function test reports , s.amylase, s.lipase To verify whether patient has any previous history of similar pain and admission details To check for alcohol history
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Diabetes How and when was the dm diagnosed Exact duration of DM All past inv reports HBA1C reports Treatment taken so far for DM.
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Asthma To enquire regarding exact duration of asthma To verify whether patient was taking any steroid treatment if yes duration Whether any PFT report available all past medications including x ray previously taken PRESENT- x ray , ct report / oxygen given / any nebulisation done
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Heart Disease /CAD Exact duration of heart disease To ask any previous episodes/hospitilisation for similar illness Previous ECG, Echo,Tmt ,Cag report ( If available) HISTORY OF asprin intake Plan of management.
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Heart Disease /RHD Whether Pt Had Any Rheumatic Fever Past H/O Hospitalisation FOR RH.FEVER Any Penicillin prophylaxis taken before ,If Yes Duration Echo Report
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Heart disease / conduction defects Holter monitor report Any regular intake of any anti arrythmic drugs Any past history of Syncope ,Tia, Palpitation
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Accidental Injury
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Verify the exact circumstance of injury Whether two wheeler vs two wheeler , or four wheeler Whether patient was riding or sitting in the back Whether pt. was under influence of alcohol, If late night suspect alcohol Mlc/Ar copy, check x-rays.
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Back Pain To verify Indication for hospitalization If trauma look for any other Soft tissue injury Exact duration of symptoms confirm whether previous hospitalization done To verify the previous treatment details.
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Giddiness Etiology for giddiness To ask whether Patient a known case of DM/HT/IHD or any other systemic disorder CT or MRI reports Any other medication for vertigo or any other illness
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Knee Replacement To verify How and when did the knee pain started for the patient All past treatment records including medicines taken for To verify Pre operative , post operative x ray
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Urinary Infection Verify for Vitals ,fever at the time of admission Verify for Usg report and urine routine analysis Cbc report ,urine culture To verify for any history of calculus To verify whether any treatment or investigation previously done for urinary infection
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Stomach Pain To verify for exact duration of Pain Whether pt had previous similar pain Whether any endoscope was done(with report) To verify whether patient was on any proton pump inhibitors Any investigation or treatment taken with records Current Usg report To verify for alcohol history
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Head Injury Exact mode of injury like any fall from height( what was the height ) Any associated leg fracture To rule out any suicidal attempt Any AR / MLC / FIR copy done To collect the Ct or Mri report To verify any alcohol history if RTA To verify treatment plan.
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Burns Exact Circumstance how burns occurred for the patient To verify if any mlc / fir done
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Surgical Cases
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Surgical Case
Acute appendicitis Exact duration of the abdominal pain To verify for fever , vomiting , cbc count , To verify for vitals on admission Investigation - usg report or ct report , Whether any previous abdominal surgery was done if so all those details , any other co morbid conditions for the patient
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Surgical Case
Cholelithiasis / gall bladder calculi Exact duration of abdominal pain First/past consultation report Cbc count with usg abdomen report or ct scan report /Ercp/Mrcp
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Calculus of kidney and ureter Exact duration of the pain First consultation report for the pain Usg or ct evidence for the calculus Verify whether patient had done previous surgery ( laser therapy ) or medical treatment for calculus
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Benign neoplasm of uterus / fibroid uterus /dub What was the initial complaint ( like heavy bleeding or abdominal pain with duration ) and duration since when the patient had those problems First consultation report and the usg done at the time with prescription report Duration of dub /medical treatment for dub /usg rpt Any previous gynaecological consultation was done for the patient for any complaints.
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Hernia What was the exact type of hernia ( whether inguinal , umbilical , incisional or femoral hernia ) Exact duration of hernia symptoms with the first consultation report Usg report Any past history of any previous abdominal surgery done if yes all those details including cesearean surgery If the patient is a child ask mother when the swelling was noticed
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Surgical Case
Neoplasm of the breast Verify the patient when exactly did the patient noticed the swelling First consultation report for the same Mammogram report , fnac and hpe report Whether pt had done previous surgery or treatment for the other breast in the past
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Surgical Case
Haemorroids To verify for the exact duration of pain , bleeding per rectum for the patient Any medical management taken for the same Any past history of previous surgery done for hemorrhoids ( laser surgery /stapler surgery ), Proctoscopy report
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Deviated nasal septum What was the initial complaint for the patient What was the medical treatment taken Ct scan reports / x ray para nasal sinus
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PART - II
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Acute appendicitis

• Exact Duration of the Abdominal pain.
• To verify for Fever, Vomiting, CBC count,
• To verify for Vitals on Admission.
• Investigation - USG Report or CT Report,
• Whether any previous Abdominal Surgery was done
  if so all those details, any other co-morbid
  conditions for the patient.

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Cholelithiasis / gall bladder calculi

• Exact Duration of Abdominal Pain
• First / Past Consultation Report
• CBC Count with USG Abdomen Report or CT Scan
  Report /Ercp/Mrcp.

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Calculus of kidney and ureter

• Exact Duration of the pain
• First Consultation Report for the pain
• USG or CT evidence for the calculus
• Verify whether Patient had done previous
  surgery ( laser therapy ) or medical treatment
  for calculus.

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Benign neoplasm of uterus / fibroid uterus / dub

• What was the initial complaint ( like heavy
  bleeding or abdominal pain with duration ) and
  duration since when the patient had those
  problems
• First consultation report and the USG done at
  the time with prescription report
• Duration of DUB /Medical Treatment for DUB /
  USG Report
• Any previous Gynecological consultation was done
  for the patient for any complaints.

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Hernia

• What was the exact type of hernia ( whether
  inguinal , umbilical , incisional or femoral
  hernia )
• Exact duration of Hernia Symptoms with the First
  Consultation Report.
• USG Report.
• Any past history of any previous abdominal
  surgery done if yes all those details including
  cesarean surgery.
• If the patient is a child ask mother when the
  swelling was noticed.

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Neoplasm of the breast

• Verify the Patient when exactly did the patient
  noticed the swelling.
• First consultation Report for the same.
• Mammogram Report , FNAC and HPE Report.
• Whether Patient had done previous surgery or
  treatment for the other breast in the past.

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Haemorroids

• To verify for the exact duration of pain,
  bleeding per rectum for the patient.
• Any medical management taken for the same
• Any past history of previous surgery done for
  hemorrhoids ( laser surgery /stapler surgery )
• Proctoscopy Report.

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Deviated nasal septum

• What was the initial complaint for the patient
• What was the medical treatment taken
• Ct scan reports / x ray para nasal sinus

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FRACTURE CASES

• AS PER FOR RTA CASES ( PREVIOUS SLIDES )
• LOOK FOR OTHER INJURIES , IN THE OTHER SITES LIKE
  BRUISE , LACERATED WOUND
• LOOK FOR X RAY FILM ,
• ANY PAST HISTORY OF PREVIOUS FRACTURE
• ANY EVIDENCE OF OLD HEALED FRACTURE

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TEAR OF ARTICULAR CARTILAGE OF KNEE

• WHEN WAS THE INJURY OCCURRED
• ANY ASSOCIATED INJURIES LIKE HEMATOMA , BRISE
• IF POLICY IS IN 1 ST YEAR , GET ALL THE
  DETAILS OF INJURY LIKE WHEN IT OCCURRED , FIRST
  CONSULTATION PAPER ( ACL TEAR CAN BE OPERATED UP
  TO 6 MONTHS )
• MRI RPTS ( LOOK FOR THE DATE OF MRI )

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