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Discipline

: Emergency

Sub Discipline

: Emergency

Document Title

: ETD Fever Clerking Note

Chief Complaints

HISTORY

Day Of Fever Onset

Duration Of Fever (Days)

Nil

Nil

Duration Of Afebrile (Days)

Associated Symptoms

Retro-orbital Pain

Arthalgia

Myalgia

Headache

Sore Throat

Bleeding

History Of Presenting Illness

Warning Signs

No warning signs

Abdominal pain / tenderness

Persistent vomiting

Diarrhoea >3 X over last 24H

Lethargy / Restlessness / Confusion

Tender Liver

Third space fluid accumulation

Spontaneous bleeding tendencies

Raised HCT with rapid drop in platelet

Breathing difficulty

Chest pains

Others, specify

Other Symptoms

Relevant History

Nil

Confirmed cases of dengue fever at the same location

Jungle trekking and swimming in water fall

Water source from river / well

Recent travel

Livestock Handler

Agricultural Worker

Others, specify

Co-Morbidities

No Co-morbidities

Diabetes Mellitus

Hypertension

Ischaemic Heart Disease

Heart failure

Coagulopathies

Obesity

Renal Failure

Chronic Liver Disease

Chronic Obstructive Pulmonary Disease (COPD)

Pregnant

Age > 65

Others, specify

PHYSICAL EXAMINATION

Vital Signs & Other Observations

Hydration

Peripheral (CCTVR)

Colour

Pink

Pale

Jaundiced

Cyanosed

Isles of white in the sea of red

Extremities Temp

Systemic Review

Evidence Of Third Space Loss

Peripheral Oedema

Ascites

Pleural Effusion

Pericardial Effusion

Evidence Of Bleeding

Mucosal Bleeding

Petechiae

Purpura

Echymosis

Per Rectal Bleeding

Per Vaginal Bleeding

Rashes

Problem List

DIAGNOSIS

Diagnosis

MANAGEMENT

Plan

Orders

Order Information

Others

Referral

Outgoing Referrals

Others

SIGNATURES

GENERAL EXAMINATION

Notes Component

HISTORY
PHYSICAL EXAMINATION
DIAGNOSIS
MANAGEMENT
SIGNATURES
GENERAL EXAMINATION

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