4. Tre dang di@utri khang sinh: Kham, danh gia ly tinh tr~ng b~nh ly, nSu tre khong co ch6ng chi dinh ho~c t~m hoan: Thvc hi~n tiem chung cho tre thea Iich. Tre nhiSm ho~c nghi nhiSm HIV[r]
(1)BOYTE CONG HoA. xi\.HOI CHU NGHiA VIET NAM. . DQc l~p - T\f - H~nh phuc
S6:.2~10/QD-BYT Ha N(Ji,ngay 44 thong 6 nam 2019
QUYETDINH
V~vi~c ban hanh Huong d§n
Kham sang lQc trmrc tiem cluing oBivrri tre em
BO TRUONG BO Y TE. .
Can ctr Nghi dinh s6 75/2017/ND-CP 22 thang nam 2017 cua Chinh phu quy dinh clnrc nang, nhiem vu, quyen han va co d.u t6 clurc BQ Y tS;
Theo dS nghi cua C\lCtnrong C\lCQuan ly Kham, chua benh - BQ Y tS,
QUYETDINH:
Di~u 1.Ban hanh kern thea Quyet dinh Huang d~n kham sang loc tnroc tiem chung d6i voi tre em
Di~u Quyet dinh co hieu hrc kS tir ky ban hanh Bai bo Quyet dinh s6 2301lQD-BYT 12 thang nam 2015 cua BQ tnrong BQ Y tS vS viec ban hanh Huang d~n kham sang loc tnroc tiem chung d6i voi tre em
Di~u Cac ong, ba: Chanh Van phong BQ, C\lC tnrong C\lC Qmin ly Kham, chua b~nh, Chanh Thanh tra BQ, cac V\l truOng, C\lC truang cua cac V\l/C\lC thuQc BQ Y tS; Giam d6c cac co sa kham b~nh, chua b~nh trvc thuQc BQ Y tS; Giam d6c Sa Y ts cac tinh, ph6 tn)'c thuQc Trung uang; Thu tnrOng y tS cac BQ,nganh; Thti truang cac dan vi co lien quan chiu trach nhi~m thi hanh QuySt dinh nay./
Noi nhtin:
-Nlm Di~u 3;
- BQtruang (de b/c);
-C5ng TTDTBYT, Website Cl,lCQLKCB;
(2)BOYTE eONG HoA. xA HOI eHU NGHiA VIET NAM. . DQc l~p - Tl}' - H~nh phuc
HUONGDAN
Kham sang IQctrmrc tiem chung d8i v6'i tre em
(Ban hanh.kern thea Quyet dinh s61.-!t1.0/QD-BYT ngay4.4thimg .6.narn 2019)
I Muc dich cua kham sang IQc:
Nh~m phat hien tnrong hop bfit thuong c~n hru y dS quyet dinh cho tre tiem chung, khong tiem chung, hoan tiem chung hoac chuyen kham sang loc tai benh vien
II Kham sang IQctrurrc tiem chiing cho tre em ~ thang tuAi:
1.Cac tnrong hop chong chi dinh:
a) Co tiSn sir s6c hoac phan irng nang sau tiem chung vAcxin l~n tnroc (co cung phan): s6t cao tren 39°C kern co giat hoac dfiu hieu nao/rnang nao, tim tai, kh6 tho
b) Suy giam miSn dich (benh suy giam miSn dich bam sinh, tre nhiem HIV giai doan lam sang IV hoac co biSu hien suy giam miSn dich n~ng) ch6ng chi dinh tiem chung cac v~c xin s6ng giam dQc h.rc
c) Cac trucmg hqp ch6ng chi dinh khac thea huang d~n cua nha san xufit d6i vai tUnglo~iv~c xin
2 Cac trucmg hgp t~m hoan:
a) U6i v6i co sa tiem chung ngoai b~nh vi~n:
- Co tinh tr~ng suy chuc nang cac co quan (nhu suy ho hfip, suy tu~n hoan, suy tim, suy th~n, suy gan, hon me ) Tiem chung suc khoe cua tre 6n dinh - M~c cac b~nh cfip Hnh,cac b~nh nhiSm trung Tiem chung suc khoe cua tre 6n dinh
- S6t~ 37,SoC ho~c h~ than nhi~t:S 3S,SoC (do nhi~t dQt~i nach)
- Tre m6i dung cac san ph&m globulin miSn dich yang thang (tru khang huy~t viem gan B): t~m hoan tiem chung v~c xin s6ng giam dQc h.rc - Tre dang ho~c m6i k~t thuc dgt diSu tri corticoid (u6ng, tiem) liSu cao (tuang duong prednison ~ 2mg/kg/ngay), hoa tri, x~ tri yang 14 ngay: t~m hoan tiem chung vAc xin s6ng giam dQc h.rc
(3)- Co tiSn su phan irng tang d~n sau cac l~n tiem chung tnroc cua cung Ioai v~c xin (vi du: l~n d~u khong s6t, l~n sau s6t cao tren 390C ): chuyen kham sang
19C va tiem chung tai benh vien
- M~c cac benh b~m sinh hoac benh man tinh atim, phoi, h~ thong tieu hoa, tiSt nieu, mau, ung thu chua 6n dinh: chuyen kham sang 19C va tiem chung tai benh vien
- Cac tnrong hop tam hoan tiem chung khac thea huang d~n cua nha san xuAt d6i voi tung loai v~c xin
b) D6i voi co sa tiem chung tai benh vien:
- Co tinh trang suy chirc nang cac co quan (nhu suy ho hAp, suy tuan hoan, suy tim, suy th~~, suy gan, hon me ) Tiem chung sire khoe cua tre 6n dinh
- Tre mac cac benh cAp tinh, cac b~nh nhiSm trung Tiem chung suc khoe cua tre 6n dinh
- Tre s6t 2: 38°C ho~c h~ than nhi~t ::;35,5 °c (do nhi~t dQ t~i nach)
- Tre moi dung cac san ph~m globulin miSn dich vong thang (trir khang huySt viem gan B): t~m hoan tiem chung v~c xin s6ng giam dQc l\lc
- Tre dang ho~c moi kSt thuc dqt diSu tri corticoid (u6ng, tiem) liSu cao (tuong duong prednison 2:2mg/kg/ngay), hoa tri, x~ tri vong 14 ngay: t~m hoan tiem chung v~c xin s6ng giam dQc l\lc
- Tre m~c cac b~nh tim b~m sinh ho~c m~n tinh kern thea tang ap l\lc dQng m~ch ph6i (2:40mmHg)
- Cac truemg hqp t~m hoan tiem chung khac thea huang d~n cua nha san xuAt d6i voi tUng lo~i v~c xin
3 Cac truemg hqp c~n kham sang 19C va tiem chung t~i b~nh vi~n:
Cac truemg hqp t~m hoan tiem chung t~i cac ca sa tiem chung ngoai b~nh vi~n c~n chuy@ntuySn d@du<)'ckham sang 19C, tiem chung t~i b~nh vi~n:
a) Tre co can n~ng <2000g
b~ Tre co tiSn su phan Ung tang d~n sau cac l~n tiem chung truoc cua cung lo~i vac xin
c) Tre m~c cac b~nh b~m sinh ho~c b~nh m~n tinh a tim, ph6i, h~ th6ng tieu hoa, tiSt ni~u, mau, ung thu chua 6n dinh
III Kham sang IQc tnr&c tiem chung cho tre sO'sinh
1 Cac truemg hqp ch6ng chi dinh:
a) Khong tiem v&c xin BCG cho tre sinh tir m~ nhi@m HIV rna m~ khong du<)'cdiSu tri d\l phong t6t lay truySn tir m~ sang
(4)2 Cac tnrong hop tam hoan:
a) D6i voi co sa tiem chung ngoai benh vien:
- Co tinh trang suy chirc nang cac co quan (nhir suy ho h~p, suy tu~n hoan, suy tim, suy than, suy gan, hon me ) Tiem chung sire khoe cua tre on dinh
I" f'OW
- Tre mac cac benh cap tinh, cac benh nhiem trung Tiern chung sire khoe cua tre 6n dinh,
- Tre s6t ~ 37,SoC hoac than nhiet ::; 3S,SoC (do nhiet dQ tai nach) Tiem chung than nhiet cua tre 6n dinh
- Tre co can nang duoi 2000g: chuyen kham sang loc va tiem chung tai benh vien,
- Tre sinh non co tuoi thai < 34 tuan: N@ume co HBsAg (-) tam hoan tiem v~c xin viem gan B so sinh, tiem chung tre du 34 tufrn tu6i (tinh ca tu6i thai) N@ume co HBsAg (+) hoac me khong xet nghiem chuyen kham sang lQc va tiem chung t?i b~nh vi~n
- Tre sinh non co tu6i thai <34 tufrn t?m hoan tiem v~c xin BCG Tiem chung tre du 34 tuk tu6i (tinh ca tu6i thai)
- M~c cac b~nh bAm sinh ho~c b~nh m?n tinh atim, ph6i, h~ th6ng tieu hoa, ti@t ni~u, mau, thfrn kinh, ung thu chua 6n dinh: chuySn kham sang lQc va tiem chung t?i b~nh vi~n
- Cac truOng hqp t?m hoan tiem chung khac theo huang d~n cua nha san xu~t d6i v6i timg lo?i v~c xin
b) D6i v6i co sa tiem chung t?i b~nh vi~n:
- Tre co.chi dinh c~p cUu Tiem chung suc khoe cua tre 6n dinh
- Tre s6t 2: 37,SoC ho~c h? than nhi~t ::; 3S,S °c (do nhi~t dQ t?i nach), tiem chung than nhi~t cua tre 6n dinh
- Tre co tu6i thai < 28 tufrn.Tiem chung v~c xin viem gan B tre du 28 tufrn tu6i (tinh ca tu6i thai)
- Tre co tu6i thai < 34 tuAn t?m hoan tiem v~c xin BCG Tiem chung khi'tre du 34 tufrn tu6i (tinh ca tu6i thai)
- Tre co can n~ng < 2000g rna m~ co HbsAg (-) TruOng hqp m~ co HbsAg (+) ho~c khong xet nghi~m cho m~ thi cfrn tiem v~c xin viem gan B cho tre
- Tre m~c cac b~nh tim bAm sinh co tang ap Ivc dQng m?ch ph6i (2:40mmHg) - Cac truOng hqp t?m hoan tiem chung khac theo huang d~n cua nha san xu~t d6i v6i timg lo?i v~c xin
3 Cac truOng hqp cfrn kham sang lQc va tiem chung t?i b~nh vi~n:
(5)a) Tre co din nang < 2000g va my co HBsAg (+) hoac my kh6ng xet nghiem, b) Tre co tu6i thai < 34 tuan va my co HBsAg (+) hoac my kh6ng xet nghiem, c) Tre mac cac benh b~m sinh a tim, phoi, h~ thong tieu hoa, gan, than, mau, than kinh, ung thu, chua 6n dinh
IV M<)ts8 hru y khi kham sang loc trmrc tiem chung t~i b~nh vi~n Tre co ti@nsir di irng voi v~c xin hoacnghi ngodi irng voi v~c xin:
a) NSu tre co bang clnrng di img voi loai v~c xin tiem l~n tnroc: kh6ng tiem chung cho tre
b) Tre co ti@nsir nghi ngo di ung voi v~c xin: Kham, danh gia nguyen nhan va
rmrc dQ di img,
2 Tre co yang da sa sinh:
a) Kh6ng chong chi djnh va kh6ng tarn hoan tiem chung d6i voi tnrong hop yang da sinh ly co n6ng dQ bilirubin huySt :S 7mg/dL Trong truang hgp kh6ng thvc hi~n xet nghi~m thi dVa vao phan vung yang da Krammer
b) T~m hoan tiem chung vai truang hgp yang da b~nh ly ho~c yang da sinh ly co n6ng dQ bilirubin mau >7mg/dL
3 Tre de non ho~c nhy can so vai tu6i, suy dinh duOng, m6 de:
a) Kh6ng co ch6ng chi dinh va kh6ng t~m hoan tiem chung d6i vai tre co can n~ng ~ 2.000g ho~c m6 de Thvc hi~n tiem chung dung lich cho tre
b) Kh6ng co ch6ng chi dinh va kh6ng t~m hoan tiem chung v~c xin viem gan B d6i vai tre sinh non co tU6i thai 28-36 tu~n
c) Kh6ng co ch6ng chi dinh va kh6ng t~m hoan tiem chung v~c xin BeG d6i vai tre sinh non co tU6i thai 34-36 tu~n Tinh tU6i cua tre dS xac dinh tiem chung thea thang nam sinh cua tre
4 Tre dang di@utri khang sinh: Kham, danh gia ly tinh tr~ng b~nh ly, nSu tre khong co ch6ng chi dinh ho~c t~m hoan: Thvc hi~n tiem chung cho tre thea Iich Tre nhiSm ho~c nghi nhiSm HIV nhung chua atrong giai do~ AIDS: NSu tre khong co cac ch6ng chi dinh ho~c t~m hoan, tiem chung cho tre thea lich kS ca v~c xin s6ng giam dQc Ivc
6 Tre co b~nh b~m sinh ho~c b~nh m~n tinh atim, ph6i, h~ th6ng tieu hoa, gan, th~n, mau, ung thu, th~n kinh
a) NSu tinh tr~ng b~nh cua tre dang a giai do~n 6n dinh, tre kh6ng a tinh tr~ng c~p tinh, kh6ng co chi dinh can thi~p di@utri c~p CUu: Kh6ng ch6ng chi dinh ho~c t~m hoan W~mchung Thvc hi~n tiem chung cho tre thea Iich
(6)v.T8 clnrc tlnrc hi~n:
1.D6i voi co sa tiem chung ngoai benh vien a) Ngtroi thuc hien
- Bac sy, y SI: true tiSp tham kham cho tre va ghi cac thong tin cua tre, tnrc tiSp va ghi kSt qua nhiet dQ cua tre khong co diSu duong vien, hQ sinh vien Can bQ y tS kham sang loc tnroc tiem chung phai diroc t~p huan chuyen mon vS tiem chung thea quy dinh tai Nghi dinh s6 155/2018/NI)-CP 12 thang 11 nam 2018
- DiSu duong vien, hQ sinh vien: Ghi cac thong tin cua tre, tnrc tiSp can tre, va ghi kSt qua nhiet dQ cua tre
b) Phuong tien
- Nhiet kS,6ng nghe
- Bang kiem truce tiem chung cho d6i nrong tir thang tu6i tro len (phu luc I)
- Bang kiem tnroc tiem chung cho tre sa sinh (ph\ll\lc II) c) Cac buac thvc hi~n kham sang lQctruac tiem chung
Cac buac thvc hi~n va diSn thea bang kiSm truac tiem chung bao g6m: - Hoi tiSn sir va cac thong tin co lien quan
- Danh gia tinh trC;lngsuc khoe hi~n tC;li - KSt lu~n
d) Ghi chep vi~c kham sang IQcva luu bang kiSm
Toan bQ nQi dung kham sang lQc duQ'c ghi thea bang kiSm, luu tC;licac diSm tiem chung Thai gian luu: 15
2 D6i vai ca sa tiem chung tC;lib~nh vi~n:
a) Nguo'i thvc hi~n
- Bac sy, y SI kham sang lQc truac tiem chung: kham, danh gia, ph6i hQ'Pvai cac th~y thu6c chuyen khoa (nSu c~n), dua nh~n xet va kSt lu~n vS chi dinh tiem chung cho tre
- Bac sy chuyen khoa: kham, danh gia tinh trC;lngb~nh ly cua tre thea chuyen khoa; ph6i hQ'Pvai bac sy tu vftn tiem chung dS dua kSt lu~n vS chi dinh tiem chung cho tre
- Can bQ y tS co lien quan dSn tu vftn, tiem chung v~c xin va thea d5i phan ll'ng sau tiem chung
b) PhU011gti~n
(7)- PhiSu kham sang 19C tnroc tiem chung cho d6i nrong tir 1 thang tu6i tro len (phu luc III) va phieu kham sang IQctnroc tiem chung cho tre sa sinh (phu luc IV)
c) Cac buoc thuc hien
- Bac sy tu van, kham sang IQctiem chung: kham danh gia toan dien cac diSu
kien tiem chung cho tre; tham v~n thay thuoc chuyen khoa vS tinh trang benh ly
theo chuyen khoa (neu cftn) Dira kSt luan vS diSu kien tiem chung cho tre
- Bac sy chuyen khoa: duoc yeu cftu, danh gia dftydu vS tinh trang benh ly
theo chuyen khoa cftn tham van; dua nhan xet, dS nghi lien quan dSn tiem
chung vS tinh trang benh ly cua tre, Ph6i hQ'Pvoi can bQtiem chung thirc hien
tiem chung va theo d6i sau tiem chung cho tre cftn
d) Ghi chep vi~c kham sang IQcva luu hi) sa
- Thvc hi~n vi~c ghi chep, luu gifr ca sa dfr li~u tiem chung theo quy dinh hi~n
hanh va cac quy dinh vS ghi chep s6 kham b~nh, hi) sa b~nh an nhu d6i vai tre
dSn kham, diSutri ngo~i tru, nQi tru t~i b~nh vi~n
- Truang hQ'Pco hi) sa b~nh an t~i b~nh vi~n: toan bQ nQi dung kham sang IQc
trong bang kiSm va y l~nh chi dinh tiem phai duQ'c ghi hi) sa b~nh an ho~c
phiSu kham sang IQc truac tiem chung duQ'c luu cung hi) sa b~nh an theo qui dinh
(8)PHULUCI
(Ban hanh kern thea Quyet atnhs6 ..~ iQD-BYTngay thang ndm 2019)
TTYTDP/TYT IPKlNHS CO.NG HoA xA HOI CHU N. GHiA VIET NAM. DQc l~p - TV - H~nh phuc
BANG KIEM TRUdc TIEM CHUNG DOl v6'I DOl TUQNG 2: 1THANG TUOI
TAl cAc CO. Sa TIEM CHUNG NGoAI BENH VIEN. .
HQ va ten tre: Nam 0 NfrD
Tu6i: sinh thang nam
Dia chi:
HQ ten bo/me: Dien thoai:
Can nang: kg Than nhiet: °c
I Kham sang loc:
l S6c, phan img nang sau l~n tiem chung tnroc Khong 0 CoO
2 Dang mac benh cfrP tinh hoac benh man tinh ti~n trien" Khong 0 Co 0
3 Dang hoac moi k~t thuc dot dieu tri corticoid li~u cao (tuong
Khong 0 Co 0
duong prednison >Zmg/kg/ngay), hoa tri, xa tri, gammaglobulin ** S6t/H~ than nhiet ( S6t: nhiet d92:37,5 o, H~ than nhiet: nhiet d9
Khong 0 CoO
::;35,50C )
5 Nghe tim bfrt thuOng*** Khong 0 CoO
6 Nhip tho, nghe phoi bfrt thuong Khong 0 I CoO
7 iiigiac bfrt thuong (li bi hoac kich thich) Khong 0 CoO
8 Can nang <2000g ong 0 CoO
~ , _
9 Cac chong chi dinh/tam hoan khac, neu co ghi ra:
Khong 0 CoO
...... . . . .. .... . .
_
*:Khong hoiintiem v6c xin a6i voi treco benh nhe (ho,.'1'6mUi,lieu chay muc apnhr;: va khOng s6t),
bu t6t, {m t6t
**: Tru khang huydt thanh viem gan B. Tieu chudn chi ap d1:lngv6'i v6c xin s6ng giam apehrc.
II K~tlu~n:
- Du di~u ki~n tiem chung (Tfrt cft d~uKHONG co di€m bftt thuOng)
L :, t'A h' 1~ ,
O~lvac xm lem c ung an nay:
- Ch6ng chi dinh tiern chung (Khi CO di€rn bfrt thuOng t~i m\lc 1,9)
-T~m hoan tiem chung (Khi CObfrtkYm(>tdi€m bfrtthuOng t~i cac m\lc 2,3,4,5,6,7,8)
D~ nghi kharn sang lQc t~i b~nh vi~n: Khong 0 Co 0
+Ly do:
D
D
GJ
lJ).· • , h' , th ' ~
n01 gUY p ut, ngay ang nam .
(9)PHULUCII. .
(Ban hanh kern thea Quyit dinh s6 IQfJ-BYT ngay .)
TTYTDPITYT IPKlNHS CO.NG HoA xA HOI CHU NGHiA VIET NAM. . DQc l~p - T1}.'do - H~nh phuc
.
BANG KIEM TRUaC TIEM CHUNG DOl VOl TRE SO SINH TAl. cAc CO Sa TIEM CHUNG NGoAI BENH VIEN. .
HQ va ten tre: Nam D NfrD
Sinh: gio thang nam Tu6i thai sinh:
Dia chi:
HQ ten bo/me: Di~n thoai:
Can nang: g Than nhiet: °c
M~ daxet nghiem HbsAg: Kh6ng D C6 0 K€t qua: Duong tinh D Am tinh 0
I KhalD sang IQc:
l Tinh trang sire khoe chua 6n dinh Kh6ng C60
2 S6t/H~ than nhiet (S6t: nhiet d<)~ ,5°C; H~ than
Kh6ng C60
nhiet: nhiet d<)::;35,50C)
6c be hoac kh6ng kh6c duoc Kh6ng C60
4 Da, m6i kh6ng hong Kh6ng C60
5 Bu kern hoac bo bu Kh6ng C60
6 Tu6i thai <34 tu~n Kh6ng C60
7 Tre <2000 g Kh6ng C60
8 Cac chong chi dinh khac, neu c6 ghi ra:
Kh6ng C60
. . . . .. .. ...
II. K~tlu~n:
-Dudi~u ki~n tiem chung (Titt ca d~uKHONG co diem bitt thuong) D Loai~I Va:'c xi n tieITI~ c ung an nay:h' 1" ,
-Chong chi dinh tiem chung (Khi Co diem bitt thuong tai muc 8) D
- Tarn hoan tiem chung (Khi CO bitticym<)tdi6m bitt thuang t~i cac mvc 1,2,3,4,5,6,7) D
- D€ nghi kham sang iQc t~i b~nh vi~n: Kh6ng D Co D
+IJYdo:
lJ).· •, h ' , th' ~
nOl glO' put, ngay ang nam
Nguai th\fC hi~n sang iQC
(10)PHULUC III
(Ban hanh kern thea Quyet dinh s6 .. ";QD-BYT thang ndm 2019)
BV CONG HoA xA HOI CHU NGHiA vrsr NAM DQc l~p - T1}.'do - Hanh phuc
BANG KIEM TRUaC TIEM CHUNG DOl VOl DOl TU<}NG ~ 1THANG TUOI TAl cAc CO. saTIEM CHUNG THUOC BENH VIEN .
HQ va ten tre: Nam
TUOl:z sln nga h 'y thaang nam
Dia chi:
HQ ten b6/m~: Dien thoai:
Can nang: kg Than nhiet: °c
I Kham
1 S6c, phan img nang sau Ifin tiem chung truce ng C60
.~ ~ ~ -
ng mac benh cfrP tinh hoac benh man tinh tien trien" Khong C60
Dang hoac moi kSt thuc dot di€u tri corticoid li€u cao (nrong
Khong C60 dirong prednison >2mg/kg/ngay), h6a tri, xa tri, gammagiobulin**
S6t/H;;t than nhiet ( S6t: nhiet d{)~ 3soC; Ha than nhiet: nhiet d{)
Khong C60 :s35,50C)
Nghe tim bfrtthuong"?" Khong C60
Nhip tho, nghe phoi bfrt thuemg*** Khong C6
Tri giac bfrt thuong (li bi hoac kich thich) Khong C60
s Cac chong chi dinh khac, neu co ghi ra:
Khong C60
. . ... .. . .. .. . ... ...
*: Chi dinh tiem tre co b?nh nh? (ho, mui, lieuchily muc d(5nh? vakhOng **: Tn}khtmg huyit thanh viem gan B
***: Niu khCtmchuyen khoa khOng cdn xu trEclipcUu thi chi dinh liem chimg
- Kham sang IQctheo chuyen khoa: Khong C6 0, chuyen khoa:
+Ly do:
+Ket qua:
+KSt lu~n:
II K~t lu~n:
-Du di~u ki~n tiem chung CTfrtca d€u KHONG c6 di~m bfrt thuemg) D LO;;tl.,:_vac Xln lem t'A ch'ung an nI~ a,y: - Ch6ng chi dinh tiem chung (Khi CO di~m bfrt thuemg t;;tim\1c 1,S) D - T;;tmhoan tiem chung (Khi CO b~t ky m{)tdi~m b~t thuemg t;;ticac m\1C2,3,4,5,6,7) D
,
lJ~ • • , h " th' ~
110l . guy put, ngay ang nam
(11)PHVLVCIV
(Ban hanh kernthea Quyit dinhs6 IQD-BYT ngay .)
BV CONG HoA xA HOI CHU NGHiA VI~T NAM
DQc l~p - Tl}' - H~nh phuc
BANG KIEM TRUaC TIEM CHUNG DOl VOl TRE SO SINH
T~I cAc CO saTIEM CHUNG THUOC B~NH VI~N
HQ va ten tre: Nam Nit 0
Sinh gio thang nam Tu6i thai sinh:
Dia chi:
HQ ten bo/rn«: Dien thoai:
Can nang: g Than nhiet: °c
M~ da xet nghiern HbsAg: Khong C6 0 K~t qua: Duong tinh Am tinh 0
I Kham sang lee:
Cac d§.uhieu hien tai:
······l.···Tirili··t;~ng sire kh6~'~h~~6~···di~_···. .. . ···_··1··· Kh6~~·······D- ············(:6!-0 , - - ···u··· ,
2 SotlH~ than nhiet (Sot: nhiet dQ ~ 37,5 C; H~ than I C6
!3~~i~~9~~~~ _ - f~-D c6D
, • ••••••.•••••••••••••••••••••••••••••••••• _ j'.••._ ••• _ ••••••••••••• _ ••••.•••.•••.• • • _ •.•.•.••••••••••••••• + _ _ _
i Khong C60
_ + _
I Khong Da, moi khong hong
6 Tu6i thai <28 tu~n Khong C60
8 Tre <2000 g, me c6 HBsAg (-)
o
C60 Btl kern hoac bo btl
7 Tre <34 tuan tu6i * Khong o C60
Khong C60
9 Cac chong chi dinh khac, neu c6 ghi r5
Khong C60
*Chiapdung voi vdc xinsonggiam d(jcluc
- Kham sang loc theo chuyen khoa: Khong C60, chuyenkhoa:
+Ly do:
+Ket qua:
+.K~tluan:
II K~t lu~n:
- Du di~,uki~n tiem chung, (T§.tca d~uKHONG c6 di8m b§.tthuang) D L ~ t' ~ h' l~ ,
- O~lvac xm lem c ung an nay:
- Ch6ng chi dinh tiem chung (Khi Codi8m b§.tthuang t~i m\lc 9) D
- T~m hoan tiem chung (Khi CO b§.tky mot di8m b§.tthuang t~imvc 1,2,3,4,5,6,7,8) D
H6i gia phiLt,ngay thang nam
(12)PHULUCV. .
(Ban hanh kern thea QuyJt dinhs6 IQIJ-BYT ngay .)
TAn sB thO' binh thuimg hie nghi 0' tre theo cac nhom tu8i
Tu8i (nam) Nhjp thO' (tAnsB thO' theo phut)
So sinh 40 -50
<1 30 - 40
1-2 25 -35
2-5 25 - 30
5 -12 20 -25
>12 15 - 20
(13)PHl) Ll)C VI
(B~n hanh kern thea Quyet dinh s6 IQD-BYT )
Nhjp tim binh thuong theo tu3i
Tu3i (nam) Nhjp tim (tin sa tim/phut)
So sinh 140 -160
<1 110 - 160
I
1-2 100 - 150
2-5 95 -140
5-12 80 -120
>12 60 - 100