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PNCU-NOVEMBER-2023-FINAL SAMPLE CENSUS.pptx
- 1. BAGUIO GENERAL HOSPITALAND MEDICAL CENTER DEPARTMENT OF PEDIATRICS PNCU CENSUS NOVEMBER 2023 DR VIGILIA/DR DELA PEÑA DR VELASCO/DR TORRES/DR CALLUENG DR. TAMANG/DR. SOLONIO
- 2. PNCU NOVEMBER 2023 CONSULTANTSIN CHARGE RESIDENTS IN CHARGE NICU STEPDOWN • Dr. Cuarte • Dr. Ignacio • Dr. Viloria • Dr. Velasco SICK NON-NICU • Dr. Laking • Dr. Fangonilo • Dr. Dizon • Dr. Callueng WELL/CATCHER • Dr. Laking • Dr. Fangonilo • Dr. Dizon • Dr. Torres
- 3. PNCU ADMISSIONS (JAN-NOVEMBER 2023) JANUARY FEBRUARY M ARCH APRIL M AY JUNE JULY AUGUST SEPTEM BER OCTOBER NOVEM BER 0 100 200 300 400 500 600 117 175169 114 132 129 105 141 157 150 116 362 387 377 383 273 325 242 256 311 328 342 68.6% 31.3% 2023 SICK WELL N: 458
- 4. PNCU DISCHARGES (JAN-OCTOBER 2023) FEBRUARYMARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER 0 100 200 300 400 500 600 158 141 122 118 129 129 140 238 129 137 372 401 344 261 321 258 257 313 282 319 N: 456 2023 SICK WELL 69.9% 30%
- 5. MODE OF DELIVERY(NOVEMBER 2023) 76 61 1 209 103 6 SICK WELL NSD (N: 285) LSCS (N: 164) FORCEPS (N: 7) 62.5% 35.96% 1.5 % N=456
- 6. 5th MINUTE APGAR (NOVEMBER2023) 7 to 10 5 to 6 3 to 4 1 to 2 0 50 100 150 200 250 300 350 125 10 2 2 319 0 0 0 SICK WELL Axis Title Axis Title N= 444 (97.36%) N=10 (2.1%) N=2 (0.43%) N= 2 (0.43%) N=456
- 7. AGE OF GESTATION(NOVEMBER 2023) 24-25 weeks 26-27 weeks 28-31 weeks 32-33 weeks 34-36 weeks 37-42 weeks 0 50 100 150 200 250 300 350 1 0 4 1 12 119 0 0 0 0 0 319 SICK WELL N=456 TERM, n=438, 96% Preterm Babies: n=18, 3.9%
- 8. CLASSIFICATION ACCORDING TOWEIGHT (NOVEMBER 2023) <1000 1000-1499g 1500-2499g 2500-3499g >3500g 0 50 100 150 200 250 300 350 400 450 1 3 59 72 2 0 313 6 SICK WELL 385= 84.4% 8=1.7% N=456 46=10% 3=0.65% 1=0.21%
- 9. APPROPRIATENESS BASED ONWEIGHT FOR AGE (NOVEMBER 2023) SGA AGA LGA 0 50 100 150 200 250 300 350 400 450 500 4 14 10 426 2 PRETERM FULL TERM N= 2: 1.7% N=456 N= 440: 96.49% N =14: 3%
- 10. MEDICAL SOCIAL CLASSIFICATION NOVEMBER2023 (N=456) PRIVATE CHARITY N: 416 = 91.2% N: 40= 8.7%
- 11. DISPOSITION AT THEPNCU-NOVEMBER 2023 N=456 Chart Title N: 1= 0.21% DISCHARGED IMPROVED DIED HAMA THOC N: 440= 96.4% N: 4= 0.87% N: 11= 2.4%
- 12. CAUSES OF MORBIDITIES TOPCAUSES OF MORBIDITY DISEASE ENTITY TOTAL % 1 LOW BIRTHWEIGHT 64 64.70% 2 PREMATURITY 24 17.50% 3 NEWBORN AFFECTED BY MATERNAL CONDITION 20 14.50% 4 HYPERBILIRUBINEMIA 18 13.10% 5 NEONATAL SEPSIS 6 4.30% 6 RESPIRATORY DISTRESS SYNDROME 5 3.6% 7 NEONATAL PNEUMONIA 4 2.9% 8 HEALTH CARE ASSOCIATED SEPSIS 3 2.1% 9 TRANSIENT TACHYPNEA OF THE NEWBORN 3 2.1% 10 CONGENITAL HEART DISEASE 2 1.4%
- 13. NEONATAL PROGRAMS BIRTH DEFECTSURVEILLANCE FORM TOTAL # OF PTS WITH CONGENITAL ANOMALIES 3 # OF FORMS SUBMITTED NEWBORN SCREENING NO. OF DISCHARGED PTS SCREENED NBS (INITIAL) 447 TOTAL NBS NOT DONE A. REFUSED 0 B. DIED 2 C. OUTBORN 7 VACCINATIONS NO. OF DISCHARGED PTS VACCINATED BCG 447 HEPATITIS B 447
- 14. 0 10 20 30 40 50 60 70 58 57 57 55 11 NICU ADMISSIONS
- 15.
- 16. NEONATAL SURVIVAL &MORTALITY ACCORDING TO WEIGHT VS. PEDIATRIC AGING BW (gm) <24 24-25 26-27 28-29 30-31 32-33 34-36 >37 >42 TOTAL CFR MR CMR <500 500-999 1(1) 1 2 9% 1000-1499 1(1) 2(2) 4 36% 1500-1999 1 1(1) 4(1) 2 7 54% 2000-2499 8 31(1) 39 63% 2500-3499 387(4) 387 100% >3500 18 18 TOTAL 1 1 1 3 1 12 438 456 CFR 0.72 MR CMR 9% 18% 54% 100%
- 17. BAGUIO GENERAL HOSPITALAND MEDICAL CENTER DEPARTMENT OF PEDIATRICS PEDIATRIC NEWBORN CARE UNIT MORTALITIES FOR NOVEMBER 2023 1. TOMAS, FRANKLIN DR. VILORIA/VELASCO • Date of Birth: OCTOBER 29, 2023 • Date of Admission: OCTOBER 31 7:10PM • Date of Death: NOVEMBER 03, 2023 1:51AM • Length of Hospital Stay: 2 DAYS, 6 HOURS, 41 MINS • • Final Diagnosis: COMPLEX CONGENITAL HEART DISEASE (EBSTEIN ANOMALY GR 2, VENTRICULAR INVERSION, DOUBLE OUTLET LEFT VENTRICLE, MALPOSED GREAT ARTERIES, ATRIAL SEPTAL DEFECT SECUNDUM, PATENT DUCTUS ARTERIOSUS, MESOCARDIA); EARLY ONSET NEONATAL SEPSIS • • • • Death Certificate: • Main Disease/Condition of the Infant: COMPLEX CONGENITAL HEART DISEASE • Other Diseases/Conditions of Infant: EARLY ONSET NEONATAL SEPIS, LOW BIRTH • WEIGHT • Main Maternal Disease/Condition Affecting Infant: NONE •Other Maternal Disease/Condition Affecting Infant: NONE •Other Relevant Circumstances: NONE
- 18. 2. FELIPE, THEOALPHONSE G. DR. VILORIA (CIC)/ DR. VELASCO (RIC) • Date of Birth: NOVEMBER 6, 2023 11:01PM • Date of Death: NOVEMBER 8, 2023 03:17PM • Length of Hospital Stay: 1 DAY, 16 HOURS, 16 MINS • • Final Diagnosis: • SINGLETON, MALE, PRETERM, 29-30 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA EMERGENCY VERY LOW SEGMENT CESAREAN SECTION FOR CHRONIC HYPERTENSION WITH SUPERIMPOSED PREECLAMPSIA WITH SEVERE FEATURES, UNCONTROLLED, WITH A BIRTHWEIGHT OF 1KG., APPROPRIATE FOR GESTATIONAL AGE, VERY LOW BIRTH WEIGHT, RESPIRATORY DISTRESS SYNDROME SEVERE, PULMONARY HEMORRHAGE S/P SURFACTANT THERAPY (TRADITIONAL) X2 • • Death Certificate: • Main Disease/Condition of the Infant: RESPIRATORY DISTRESS SYNDROME, SEVERE • Other Diseases/Conditions of Infant: PREMATURITY, VERY LOW BIRTH WEIGHT • Main Maternal Disease/Condition Affecting Infant: CHRONIC HYPERTENSION •Other Maternal Disease/Condition Affecting Infant: NONE •Other Relevant Circumstances: NONE •
- 19. 3. AGLOLO, EIJAZLUKE B NICU: DR. CUARTE (CIC)/ VELASCO (ROD) • Date of Birth: NOVEMBER 8, 2023 2:09AM • Date of Death: NOVEMBER 9, 2023 2:17AM • Length of Hospital Stay: 1 DAY, 6MINS • Final Diagnosis: SINGLETON, MALE, TERM, 38-39 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA EMERGENCY LOW SEGMENT TRANSVERSE CESAREAN SECTION FOR CORD PROLAPSE, WITH A BIRTH WEIGHT OF 3.17 KGS., APPROPRIATE FOR GESTATIONAL AGE, HYPOXIC ISCHEMIC ENCEPHALOPATHY STAGE 3, ASPHYXIA SEVERE • • Death Certificate: • Main Disease/Condition of the Infant: HIE STAGE 3 • Other Diseases/Conditions of Infant: ASPHYXIA SEVERE • Main Maternal Disease/Condition Affecting Infant: CORD PROLAPSE •Other Maternal Disease/Condition Affecting Infant: NONE •Other Relevant Circumstances: NONE
- 20. 4. CAJUCOM, MASIHIUNNICU: DR. VILORIA/DR CALLUENG (ROD) • Date of Birth: NOVEMBER 10, 2023, 4:03AM • Date of Death: NOVEMEBER 10, 2023 4:50AM • Length of Hospital Stay: 47MINS • Final Diagnosis: SINGLETON, MALE, TERM, 37-38 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA "E" PRIMARY LOW SEGMENT CESAREAN SECTION FOR ARM PROLAPSE, WITH A BIRTHWEIGHT OF 2.02 KGS., SMALL FOR GESTATIONAL AGE, LOW BIRTH WEIGHT; ANENCEPHALY • Death Certificate: Main Disease/Condition of the Infant: ANENCEPHALY Other Diseases/Conditions of Infant: LOW BIRTH WEIGHT Main Maternal Disease/Condition Affecting Infant: NONE Other Maternal Disease/Condition Affecting Infant: NONE Other Relevant Circumstances: NONE
- 22. 5. TAM, ATHENAQUINN NICU: DR. VILORIA/ DR. TORRES (ROD) • Date of Birth: NOVEMBER 09, 2023, 10:57AM • Date of Death: NOVEMEBER 11, 2023 6:57AM • Length of Hospital Stay: 1 DAY 20HOURS • Final Diagnosis: LIVE, SINGLETON, FEMALE, PRETERM, 30-31 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA LOW SEGMENT TRANSVERSE CESAREAN SECTION FOR NRFS, WITH A BIRTH WEIGHT OF 1.10 KGS., APPROPRIATE FOR GESTATIONAL AGE, VERY LOW BIRTH WEIGHT, PULMONARY HEMORRHAGE, RDS SEVERE S/P SURFACTANT (INSURE X1) • Death Certificate: Main Disease/Condition of the Infant: RDS SEVERE Other Diseases/Conditions of Infant: PULMONARY HEMORRHAGE, VERY LOW BIRTH WEIGHT, PREMATURITY Main Maternal Disease/Condition Affecting Infant: GESTATIONAL HYPERTENSION Other Maternal Disease/Condition Affecting Infant: NONE Other Relevant Circumstances: NONE
- 23. 6. CALIMLIM, EZEKIELNICU: DR. CUARTE/DR. TORRES (ROD) • Date of Birth: OCTOBER 23 2023 • Date of Admission: NOVEMBER 11 2023 7:00PM • Date of Death: NOVEMEBER 12, 2023 12:15AM • Length of Hospital Stay: 5HOURS, 15MINS • Final Diagnosis: SEPTIC SHOCK (E. coli), CHD (PVA, PDA, PFO, TR SEVERE) S/P PDA STENTING • Death Certificate: • Immediate cause: Septic shock • Antecedent cause: Septicemia (E. coli) • Underlying cause: • Other significant conditions: CHD (PVA, PDA, PFO, TR SEVERE) S/P PDA STENTING
- 24. 7. TABLAZON, YVETTENICU: DR. VILORIA/ DR. VELASCO • Date of Birth: OCTOBER 31 2023 2:19PM • Date of Death: NOVEMEBER 19, 2023 7:28PM • Length of Hospital Stay: 19 DAYS, 5 HOURS • Final Diagnosis • SINGLETON, FEMALE, PRETERM, 32-33 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA NORMAL SPONTANEOUS DELIVERY, WITH A BIRTHWEIGHT OF 1.72 KGS., APPROPRIATE FOR GESTATIONAL AGE, LOW BIRTH WEIGHT, HYPOXIC ISCHEMIC ENCEPHALOPATHY STAGE 3, CONGENITAL TOXOPLASMOSIS, MULTIPLE CONGENITAL ANOMALIES (BIFRONTAL NARROWING, SMALL PALPEBRAL FISSURES, CONGENITAL CATARACT, HYPOTELORISM, NARROW NASAL BRIDGE, NARROW ALA NASI, SMALL NOSE, MICROSTOMIA, CLINODACTYLY 5TH FINGER, BILATERAL, LEG LENGTH DISCREPANCY, PROXIMALLY INSERTED 1ST TOE, BILATERAL, PES CAVUS, BILATERAL), HEALTHCARE ASSOCIATED PNEUMONIA • Death Certificate: • Immediate cause: HYPOXIC ISCHEMIC ENCEPHALOPATHY STAGE 3 • Antecedent cause: CONGENITAL TOXOPLASMOSIS • Underlying cause: • Other significant conditions: MULTIPLE CONGENITAL ANOMALIES, HEALTHCARE ASSOCIATED PNEUMONIA
- 25. 8. GALBEY, BABYGIRL NICU: DR. IGNACIO/ DR. VELASCO • Date of Birth: NOVEMBER 19 2023, OUTBORN • Date and time of admission: NOVEMBER 19 2023, 11:38PM • Date of Death: NOVEMEBER 21, 2023 2:53AM • Length of Hospital Stay: 1 DAY, 3 HOURS • Final diagnosis: • SINGLETON, FEMALE, TERM, 37-38 WEEKS AGE OF GESTATION BY BALLARD SCORE, OUTBORN VIA NON-INSTITUTIONAL DELIVERY, WITH A BIRTHWEIGHT OF 2.78KGS., APPROPRIATE FOR GESTATIONAL AGE; UNSTERILE CORD CLAMPING EARLY ONSET NEONATAL SEPSIS, NON INSTITUTIONAL DELIVERY INDUCED BY MISOPROSTOL • Death Certificate: Main Disease/Condition of the Infant: EARLY ONSET NEONATAL SEPSIS (CULTURE NEGATIVE) Other Diseases/Conditions of Infant: NON INSTITUTIONAL DELIVERY INDUCED BY MISOPROSTOL Main Maternal Disease/Condition Affecting Infant: NONE Other Maternal Disease/Condition Affecting Infant: POOR OB HISTORY Other Relevant Circumstances: NONE
- 26. 9. SELGA, CARINAPATRICIA NICU: DR. VILORIA (CIC)/ DR. VELASCO • Date of Birth: NOVEMBER 22 2023, 8:20AM • Date of Death: NOVEMEBER 23, 2023 12:48AM • Length of Hospital Stay: 16 HOURS, 20MINS • Final diagnosis: • SINGLETON, FEMALE, PRETERM, 31-32 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA LOW SEGMENT CESAREAN SECTION FOR NRFS, WITH A BIRTH WEIGHT OF 1.45 KGS., APPROPRIATE FOR GESTATIONAL AGE, VERY LOW BIRTH WEIGHT, RESPIRATORY DISTRESS SYNDROME SEVERE S/P SURFACTANT (TRADITIONAL X1), PULMONARY HEMORRHAGE • Death Certificate: Main Disease/Condition of the Infant: RESPIRATORY DISTRESS SYNDROME SEVERE Other Diseases/Conditions of Infant: PULMONARY HEMMORRHAGE, PREMATURITY, VERY LOW BIRTHWEIGHT Main Maternal Disease/Condition Affecting Infant: PRETERM LABOR, ABRUPTIO PLACENTA Other Maternal Disease/Condition Affecting Infant: NONE Other Relevant Circumstances: NONE
- 27. 10. BERKING, HERSCHELACE NICU: DR. VILORIA/ DR. VELASCO • Date of Birth: OCTOBER 8 2023, 1:50PM • Date of Death: NOVEMEBER 25, 2023 1:17PM • Length of Hospital Stay: 47 DAYS, 23 HOURS • Final diagnosis: • SINGLETON, FEMALE, PRETERM, 36-37 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN NORMAL SPONTANEOUS DELIVERY, WITH A BIRTHWEIGHT OF 1.9 KGS., SMALL FOR GESTATIONAL AGE;, LOW BIRTHWEIGHT, JEJUNA ATRESIA TYPE 3 S/P EXLAP, ADHESIOLYSIS, SEGMENTAL JEJUNAL RESECTION, ILEORRHAPHY, END TO END ANASTOMOSIS (10/8/23, BGHMC), HEALTH CARE ASSOCIATED SEPSIS (CULTURE NEGATIVE), SEPTIC SHOCK, NECROTIZING ENTEROCOLITIS ST 3B • Death Certificate: • Immediate cause: SEPTIC SHOCK • Antecedent cause: NECROTIZING ENTEROCOLITIS STAGE 3B • Underlying cause: JEJUNAL ATRESIA TYPE 3 • Other significant conditions: PRETERM, LOW BIRTHWEIGHT
- 28. 11. MAMAN, SAMANTHANICU: DR. VILORIA/DR. VELASCO • Date of Birth: NOVEMBER 18 2023, 7:46PM • Date of Death: NOVEMEBER 27, 2023 8:50PM • Length of Hospital Stay: 9 DAYS, 1 HOUR • Final diagnosis: • SINGLETON, FEMALE, EXTREMELY PRETERM, 22-23 WEEKS AGE OF GESTATION BY BALLARD SCORE, INBORN VIA NORMAL SPONTANEOUS DELIVERY, WITH A BIRTH WEIGHT OF 0.625 KGS., SMALL FOR GESTATIONAL AGE, EXTREMELY LOW BIRTH WEIGHT, RESPIRATORY DISTRESS SYNDROME, MODERATE, S/P SURFACTANT VIA INSURE 1X, NEONATAL SEPSIS, SEPTIC SHOCK, HEALTH CARE ASSOCIATED SEPSIS (CULTURE NEGATIVE), HEALTH CARE ASSOCIATED PNEUMONIA, HYPERBILIRUBINEMIA SECONDARY • Death Certificate: • Immediate cause: SEPTIC SHOCK • Antecedent cause: HEALTH CARE ASSOCIATED SEPSIS (CULTURE NEGATIVE) • Underlying cause: • Other significant conditions: : EXTREME PREMATURITY, EXTREMELY LOW BIRTHWEIGHT RESPIRATORY DISTRESS SYNDROME, MODERATE, NEONATAL SEPSIS, HYPERBILIRUBINEMIA
- 29. CAUSES OF MORTALITY(N=11) CAUSES OF MORTALITY RESPIRATORY DISTRESS SYNDROME 3 EXTREME PREMATURTIY 1 HEALTH CARE ASSOCIATED INFECTIONS 3 EARLY ONSET NEONATAL SEPSIS 1 CONGENITAL HEART DISEASE 1 HYPOXIC ISCHEMIC ENCEPHALOPATHY 1 ANENCEPHALY 1
- 30. 8% DECREASE IN PRETERM ADMISSION (29PRETERM DELIVERIES IN OCTOBER AND 18 PRETERM DELIVERIES IN NOVEMBER) 11 MORTALITIES FOR NOVEMBER HIGHEST CASE MORTALITY RATE 4 PRETERM 4 SEPTIC SHOCK 1 CHD 1 HIE 1 ANENCEPHALY
Editor's Notes
- #2 The following are the consultants and resident in charge In the PNCU for MONTH OF NOVEMBER 2023
- #3 COMPARED LAST MONTH THERE IS 2.1% DECREASE IN PNCU ADMISSIONS
- #4 COMPARED FROM THE PREVIOUS MONTH, THERE IS A 10.9% INCREASE IN THE NUMBER OF DISCHARGES
- #5 Normal spontaneous delivery remains the top mode of delivery comprising 62.5% of cases. Cesarean section was at 35.96% with the Top 3 main indication of previous uterine scar, preeclampsia with severe features and arrest of cervical dilatation. Ideally, CS should be <30% of all deliveries, but due to increasing number of pus and uncontrolled preeclampsia, CS had been increasing. . There were 7 OUTLET forceps delivery done last month( DUE TO DIFFICULT DELIVERY, GRAVIDOCARDIAC. mother with hyperthyroidism) 0.7%
- #6 97.36% of our discharged patient have good apgar 2.1% has mild 0.4% has moderate 0.4% are asphyxiated
- #7 96% of deliveries last month were term and 3.9% were preterm. The lowest Age of gestation delivered was at 24-25 AOG weeks, who unfortunately, died due to extreme prematurity among other factors. COMPARING PRETERM DELIVERIES to last month, we have a 2% increase in our preterm deliveries.
- #8 Classified according to weight, 84.4% of patients had a birthweight of 2.5-3.49kgs. The smallest weight was 625 grams and the largest was at 4.1kgs
- #9 BASING ON APPROPRIATENESS, 96.49% OF THE ADMISSIONS WERE APPROPRIATE FOR AGE, MOST OF WHICH WERE CARRIED TO TERM. SMALL FOR GESTATIONAL AGE WAS AT 14.3% Largest:
- #10 For the month of NOVEMBER, there were 40 private admissions comprising 8.7% of the total discharges
- #11 440 (97.3%) were discharged with improved condition. 2.4% of the total discharges were mortalities and the other 0.6% went home against medical advice. To further emphasize these…(next slide) 6 OF OUR DEATHS ARE PRETERM, 5 TERM, , 4 DAMA With 2.4% mortality rate AT THE MONTH OF NOVEMBER
- #12 The top 3 causes of morbidity are low birth weight, prematurity and Newborns affected by maternal condition The rest are as follows (pause 3 secs) Comparing to the Ocotber top causes, Prematurity ranked 4th and newborn affected by maternal condition ranked 2nd It is important to note that on the month of November there were no reported cases of bacterial conjunctivitis which was one the top 10 morbidities for the past months.
- #13 2 congenital anomalies were noted:, 1 cleft lip and palate, Dandy walker, Anencephaly Newborn screening was done to 447 patients. The ones who did not receive the test were 7 outborn admissions. BCG and hepatitis vaccines were given to 447 patients (basta if they ask ung 6 na outborn di na binigyan)
- #17 We have 54% neonatal survival and mortality rate on patients weighing 1500-1499 w/ ballard score of 34-36 weeks
- #18 private
- #19 private
- #20 private
- #21 private
- #22 private
- #23 private
- #24 private
- #25 private
- #26 private
- #27 private
- #28 private
- #29 private
- #30 45% INCREASE IN MORTALITY RATE
- #31 NICU CASE FATALITY: # OF DEATH/ # OF DISCHARGES TERM #OF TERM DEATH / # OF DELIVERIES TERM term 438 preterm 18 PRETERM: # OF PRETERM DEAATH/ PRETERM DELIVERIES NICU INFECTION: # OF SEPSIS (INBORN AND OUTBORN PNEUMONIA, SEPSIS)/NICU ADMISSION 26 + 12 OVERALL INFECTION: ALL INFECTION/ # OF DELIVERIES PRETERM AND TERM FATALITY RATE: # TERM DEATHS/ TOTAL DEATHS X 100; #PRETERM/ TOTAL DEATHS RE-ADMISSION # OVERALL INFECTION RATE: TYPES OF INFECTION(EONS, LONS, N PNEUMONIA, HCAS, HCAI, HCAP)