Department of Orthopedics

WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER

E. Lopez St. Jaro Iloilo City

ORIENTATION MANUAL
Schedule in Orthopedics
Unexcused Absence
2 Weeks Rotation (CC Manual p5) Regular Day 16H
Sundays/ Holidays 24H X 3
General Duties of CC: Xmas/ New Year 24H X 7
1. Comprehensive History and PE of all admitted patients within
24 hours after admission Grading System:
2. Formulates Working Diagnosis based on problems manifested Exams and quizzes - Shifting Exam 25%
3. Writes daily progress notes and case discussion of assign Cognitive – Conferences 25%
patients Reports - Skills 25%
4. Arranges patient charts Work Ethics - Ward Work, Attitude 25%
5. Participates in bedside rounds with medical specialists and HX, PE, Imaging (proper xray request and
residents positioning), Resuscitation, Splinting, Bandaging, Traction, Pain
6. Does minor surgical procedures under supervision of residents and infection therapeutics, Surgical scrubbing, gowning, aseptic
and medical specialist technique, ortho prep drapes, Anatomy, post op wound care,
7. Monitors status and vital signs and refers to resident on duty patient monitoring
8. Writes prescriptions countersigned by residents
9. Assists PGIs and Residents in patient conduction and for Required Papers
diagnostic procedures
10. Evaluates patients referred by nurses and notifies residents a.
Paperworks for Admitted Patient
for appropriate actions i. PHIC Comprehensive history and PE
11. Writes chart orders countersigned by residents ii. Admitting Notes
12. Writes discharge summaries iii. Daily progress note9s
13. Performs Labs (College of Med) iv. Discharge Summary and Ortho Slip
14. Endorses patients to next clinical clerk on duty v. Medical abstract /Certificate (as needed)
15. Accomplishes referral notes b. Paperworks for OPD Patient
16. Receives referral notes and forwards to resident on duty for i. Ortho slip (ER)
countersigning ii. MIS form (ER)
17. Presents cases during bedside rounds iii. OPD Chart SOAP format for all ff up
18. Assists PGIs and residents in ER procedures iv. OPD Chart Complete History and PE
c. Logbooks
Official Time i. ER – Trauma, Sports logbook
Mon – Sat 7:30 AM – 5:00 PM (FD, OC) ii. OPD 5 logbooks (Adult, trauma, spine,
Sunday 8:00 – 10:00 AM (FD, OC) hand, pedia)
Mon – Sun 7:30 AM – 7:30 AM (OD) EMERGENCY ROOM

*Clinical clerks are allowed 30 mins lunch break after properly informing New Patients:
resident
**Meals should be taken within hospital premises only 1. Always obtain VITAL SIGNS FIRST.
*** No two clinical clerks assigned to the same department may leave at 2. Pack actively bleeding wounds. Immobilize any gross
the same time deformities.
3. Always weigh pedia patients.
Merits 4. Make a brief yet concise history of the injury – place, time,
Blood donation 24 H for 250 cc date, mechanism of injury, nature of injury, management done
Medical/ Surgical Mission 24H prior to ER consult.
Research Work 5. Always ask about the past medical/surgical/tetanus
Case Study 24H prophylaxis history.
Retro Study 72H 6. Include patient’s handedness and occupation in the
Prosp Study 96H personal/social history
Autopsy 72H 7. Perform PE thoroughly. Palpate for Point of Maximal
Tenderness.
Extensions 8. Obtain pictures (AP and L views) of each ortho injury. Always
Posted 2 weeks post rotation or 3 days prior to April 30 use a green background. Compile pics of trauma patients for
Complaints shall be entertained 48H after the posting trauma conference.
9. Initial management/First Aid should be done by the clinical
Demerits clerk (ie, dressing and/or packing of wounds, tetanus
Penalty C/O Department prophylaxis, pain meds, etc.)
Out of Post 10. Always refer every patient to your resident.
When on 24 H Duty 7 days of 24H duty
When on Ward Duty 24 H
When on OPD Duty 24H Sat and Sunday Duty
 Department of Orthopedics
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
E. Lopez St. Jaro Iloilo City

Decking:
ROD first to see patient is assigned deck of patient regardless OPD
of ROD admitting patient
Clinical clerk who first attends to patient at ER decks the 1. Ask for Discharge summary and ortho slip
patient regardless of duty status 2. SOAP for ff up patients and refer to resident in charge
3. Complete history and PE for the new consults and refer
Patients Awaiting Admission: to RIC
1. Get new vital signs. 4. Carry out labs, prescription and procedure orders
2. Review ER chart and medications. Prescribe medications (Removal of cast, removal of sutures, wound suturing,
before they are due during your tour of duty. etc)
3. Dress each patient at the ER. 5. Log all consults to respective logbooks
Update resident on each patient regarding his/her status and/or
new symptoms.
 Department of Orthopedics
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
E. Lopez St. Jaro Iloilo City

Schedule of Activities

TIME SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

8-10 CHAIRMAN’S
730 – SPINE TRAUMA HAND PEDIA
WARD SERVICE
9 AM CONFERENCE CONFERENCE CONFERENCE CONFERENCE
WORK ROUNDS
9 – 12 OPD OPD OPD
MINOR OR
AM CONSULTATION CONSULTATION CONSULTATION
RESIDENTS’
1–3 OR DAY ADULT
TEACHING
PM CONFERENCE
CONFERENCE OR DAY
CHIEF
3–5 RESIDENTS’
PM SERVICE
ROUNDS

REMARKS
730 AM Residents TR Trauma Con OPD Consult Secure: Chief Res SR Chairman SR
Endorse: Endorse: Endorse: 1. Accomplish Xrays for Endorse: Endorse:
MIS 1. Complete 1. Complete SOAP for ff patients 1. Complete HX, 1. Complete
Pictures HX, PE HX, PE up undergoing PE HX, PE
ALL xrays 2. Xray 2. Xray 2. Complete Hx OR 2. Xray Findings 2. Xray
in tour of Findings Findings PE for New Power drills 3. Mgt Findings
duty 3. Mgt 3. Mgt px Tourniquet 4. Provide 3. Mgt
Daily 4. Provide 4. Provide 3. Log date and Loopes pictures 4. Provide
Census: pictures pictures time CC Green 5. Updates on px pictures
Large interview picknick status – labs, 5. Updates on
print 4. Carry out labs basket antibx, px status –
Small and meds Secure all wound/fx labs, antibx,
print 5. Dressing, materials status wound/fx
Splinting, post op status
casting Accomplish
6. Interdept OPREC
referral NOI, TOI,
7. Logbooks DOI, TOC,
(ADULT, DOC, ADD,
PEDIA, HAND, DOB,
TRAUMA, OCC for all
HAND, trauma cases
SPINE)
 Department of Orthopedics
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
E. Lopez St. Jaro Iloilo City

TETANUS PROPHYLAXIS IV adaptor #1

- inquire about the patient’s tetanus prophylaxis history 3 cc syringe #1
sterile water for injection #1
R/ Tetanus Toxoid 0.5 mL/ amp #1
Sig: 1 amp deep IM right deltoid Prepare:
------------------------------------------------------------------- 1. Place patient on NPO
R/ 3 cc syringe #1 2. Secure patient’s x-rays
------------------------------------------------------------------- 3. Pail of water 1/2 fille
R/ HTIG 250 IU/amp #1 4. Insert heplock, secure patency
Sig: 1 amp deep IM left deltoid 5. Secure prescribed materials
Or 6. IV anesthetics: Midazolam and Nalbuphine
7. Ask permission from DID to use one room for reduction and
R/ ATS 0.5 mL/amp #1 casting
Sig 1 amp deep IM left deltoid 8. Post-reduction and post-casting x-ray request to be settled prior
to procedure
DRESSING MATERIALS:
At the Xray room:
Prescribe: 1. Secure all materials and Betadine balls and finger trap (Ortho
Sterile OS 4X4 # 10 Bag)
Betadine #1 2. Mount patient Xrays at scope
H2O2 #1 3. Ask patient to lie down at table
Plaster #1 4. Inform your resident materials are available
5. Post Reduction and casting
SUTURING MATERIALS a. Dispose Casting Water at Room 2 CR Sink
b. Clean xray table and floor
Prescribe:
Minor Set #1
MAY GO HOME
Sterile OS 4x4 # 20
PNSS 1L for irrigation #1 1. Prescribe home medications and verbally instruct the patient
H2O2 # 1 bottle about each one.
Betadine # 1 bottle 2. Instruct patient on other home instructions (ie, keep cast dry,
Lidocaine 2% #2 complete antibiotic regimen prescribed, OPD follow-up date and
Leukoplast #1 time, COMPARTMENT SYNDROME S/SX, etc.)
3 cc syringe #1 3. Accomplish ORTHO SLIP for the patient to bring upon OPD
10 cc syringe #1 follow-up.
Nylon 3-0* #1 4. Fill out the MIS form during your tour of duty before discharging
Sterile gloves s. 7 #2 patients. Submit the accomplished form at 7:30 AM sharp the
next day for signature of ROD.
* may use 2-0 for larger wounds (i.e. leg wounds) 5. Log each ER ortho case in the Ortho ER logbooks (Trauma,
Hand, etc) accordingly.
CASTING/SPLINTING MATERIALS
Prescribe:
POP – available in 2”, 4”, 6”; ORTHOFIX
Elastic bandage – available in 2”, 4”, 6”
Wadding sheet – available in 2”, 4”, 6”
Arm sling – indicate if pediatric or adult (S, M, L)

* always ask your resident or PGI how many to prescribe for each patient.
* For casting, no elastic bandage needed. For splinting, elastic bandage is
needed.

CLOSED REDUCTION UNDER IV SEDATION

Prescribe:
IV cannula #1
* according to patient’s age (G. 22 or 20)
Leukoplast 1” #1
 Department of Orthopedics
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
E. Lopez St. Jaro Iloilo City

COMMONLY USED ORAL MEDICATIONS

*Write brand names at the back of the prescription using pencil Antibiotics:
and instruct patients R/ Co-amoxiclav 625 mg/cap # 14-20*
 For pain: Sig: 1 capsule 2x a day for 7-10* days
R/ Tramadol 18.75 mg + Paracetamol 162.50 mg #4
(Dolcet Mini) R/ Ciprofloxacin 500 mg/cap # 14-20*
Sig: Sig: 1 tablet every 8 hours as needed for pain Sig: 1 capsule 2x a day for 7-10* days

R/ Diclofenac cholestyramine 140 mg/cap #5 R/ Metronidazole 500 mg/tab # 21-30*

Sig. Take 1 casule once a day for pain Sig: 1 tablet 3x a day for 7-10* days

R/ Mefenamic Acid 500 mg/cap #4 R/ Sultamicillin tosylate 750 mg/tab # 14

Sig: 1 capsule every 6 hours as needed for pain Sig: 1 tablet 2x a day for 7 days

R/ Celecoxib 200 mg/cap (Celcox/ Celebrex) # 2 R/ Clindamycin 500 mg/cap # 14

Sig: 1 capsule 2x a day as needed for pain Sig: 1 capsule 2x a day for 7 days

R/ Celecoxib 400 mg/cap R/ Cloxacillin 500 mg/cap # 28

Sig: 1 capsule daily as needed for pain #1 Sig: 1 capsule every 6 hours for 7 days

R/ Etoricoxib 60 mg/cap (Arcoxia) #2 Amoxicillin 30-50 mkday(TID) Cap:250mg;500mg

Sig: 1 capsule 2x a day as needed for pain (Pediamox) Syr:250mg/5ml
Ped.drops:
R/ Tramadol 37.5 mg + Paracetamol 325 mg #4 125mg/1.25ml
(Dolcet) 100mg/ml
Sig: 1 tablet every 6 hours as needed for pain Vial:500mg
Ampicillin 50-100mkday(IV) Cap:250mg;500mg
R/ Carisoprodol 300 mg + Paracetamol 250 mg # 15 30-50mkday(oral) Syr:125mg/5ml
(Lagaflex) 1mg/kgBW(alternate Forte Syr:250mg/5ml
Sig: 1 tablet 3x a day for 5 days day) Ped
drops:125mg/1.25ml
R/ Naproxen Na 550 mg/cap #2 Vial:500mg
Sig: 1 capsule 2x a day as needed for pain Augmentin 20-40 mkday(BID- Tab:375mg;625mg
Co Amoxiclav TID) Susp:156.25mg/5ml
R/ Paracetamol 500 mg/tab #6 228.5mg/5ml
Sig: 1 tablet every 4 hours as needed for pain 312.5mg/5ml
457mg/5ml
Paracetamol 5- Tab: 250 mg, 325 IV Vial:300mg;600mg
25mkdose(q4hrs) mg, 500mg Tab: 1g
Susp:120mg/5ml; Cefazolin 50-100mkday Vial: 500mg; 1g
250mg/5ml Ceftriaxone 50-100 mkday(TID- Vial:250mg; 500mg;
Drops: 100mg/ml QID) 1mg plus 10ml
Nalbuphine 0.1-0.2 mkdose 10mg/ml diluents
Cefuroxime 50-100 mkday (IV) Tab: 500mg/500mg
R/ Pregabalin (Lyrica) 20-40mkday (oral) Susp:125mg/5ml;
CAPSULE ORAL SOLUTION 250mg/5ml
(mg) (mg/mL) Vial: 250mg; 750mg;
25 150 1.5g
50 200 Cefalexin 30-50mkday (oral) Cap:250mg; 500mg
20
75 225 50-100mkday (IV) Susp:125mg/5ml;
100 300 250mg/5ml
Drops:100mg/ml
R/ Gabapentin (Gabix) Ciprofloxacin 20-30mkday Tab:250mg;500mg
100 mg/tab IV infusion:
300 mg/tab 100mg/50ml
* Dosage may vary according to each patient, especially with renal 200mg/100ml
impairment. Always ask your resident. 400mg/200ml
 Department of Orthopedics
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
E. Lopez St. Jaro Iloilo City

Cloxacillin 50-100 mkday (QID) Cap: 250mg; 500mg

Oral soln R/ Ibandronic Acid 150 mg (Bonviva) #1
powder:125mg/5ml Sig: Take once monthly
Cotrimoxazole 8-12 mkday (BID) Tab: 400mg/80mg; S/P Take ½ hour prior to 1st injestion of food in AM
800mg/160mg Take only with water, do not crush, suck or chew
Susp: Maintain upright for 30 mins after injestion
200mg/40mg/5ml Wait 30 mins prior to injesting any food or beverage
Doxycycline 2-4 mkday Cap: 100mg
Erythromycin 30-50mkday Cap: 250mg;500mg COMMONLY USED IV MEDICATIONS
Susp:200mg/5ml;
400mg/5ml Ampicillin-Sulbactam 1g or 1.5g/vial
Drops: 100mg/2.5ml Cefazolin 1g or 1.5 g/vial
Gentamycin 5-8 mkday Vial: 40mg/ml Co-Amoxiclav 1.2 g/vial
80mg/2ml Gentamycin 80 mg/amp
Metronidazole 30-50mkday (TID) Tab:250mg; 500mg Metronidazole 500 mg/vial
Susp: 125mg/5ml Oxacillin 500 mg/vial
Inj:500mg Paracetamol 300 mg/amp
Infusion:500mg/100ml Piperacillin-Tazobactam 2.25 g/vial, 4 g/vial
Vial:5mg/ml Tramadol 50 mg/amp
Ofloxacin 20-30mkday Tab: 200mg; 400mg
IV soln: 200mg/100ml OPERATING ROOM
Oxacillin 50-100mkday Vial 500 ml
Penicillin G 50-100,000 1.2M “U” 1. Clinical clerks are expected to do ortho prep for all service deck
U/mkday patients
200,000-400,000 2. Clinical clerks are expected to scrub in all service and pay cases
U/mkday(meningitic 3. CC informs resident prior to wheel in and secures Xray of
dose) patient
Piperacillin 100-300mkday Vial: 2.25g; 4.5g 4. Secure specimen
5. Accomplish OP REC
6. If the clinical clerk assigned for elective OR is on duty, OC intern
 Supplements:
takes his or her post in ER
R/ Calcium + Vitamin D # 30
Sig: 1 tablet daily
ORTHO RESIDENTS’ LICENSE NUMBERS
R/ Vitamin B-Complex # 30
Sig: 1 tablet daily
Dr. Balucanag, M. C. – 0121624
R/ Vitamin ACE + Zinc #30
Dr. Baga, S. M. E. – 0123227
Sig: 1 tablet daily
Dr. Flores, E.A. - 0123635
R/ Collagen Hydrolysate 400 mg/tab #30
Dr. Balajadia Y.R – 0125626
Sig. take 2 tabs before bedtime
Dr. Flores, C. – 0128096
Dr. Yap, J.A. - 0128456
 Topical
R/ Ketoprofen Gel (Fastum) #1
IMPORATANT LOCAL NUMBERS
Sig: Apply 2 times a day
R/ Aescin Diethylamine Salicylate 40 mg gel
Ortho Office: 221
(Reparil) #1
SLR: 210
Sig: Apply 2 times a day
OR: 216/201
SVW: 204
 Biphosphanates
SICU: 207
3rd Floor: 300
R/ Alendronic Acid 70 mg #4
4th Floor: 400
(Reventa)
X-Ray: 126
R/ Alendronate 70 mg + Cholecalciferol 5600iu #2
Pharmacy: 117
(Fosavance)
Laboratory: 138/108
Sig: Take once weekly
Histopath: 168
S/P Take ½ hour prior to 1st injestion of food in AM
Admitting: 129
Take only with water, do not crush, suck or chew
Maintain upright for 30 mins after injestion
Wait 30 mins prior to injesting any food or beverage

WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
FOR THURSDAY (or when we’re hungry!!!)
Afrique’s. 5096092
Al Dente. 336-7813
Bauhinia. 329-6951
Barrio Inasal. 337-2482
Bourbon St. Grill. 320-3028
Buto't Balat. 3296794
Chowking. 3206421, 3351274,
3370479, 5091885
Cilantro. 337-1812
Dainty House. 3372394; 3371233
Escas Restaurant. 338-3477
Floyd’s. 3373168
Greenwich. 3292061
Hong Kong Kitchen. 3382677
Jollibee. 32072112; 5085999
Jo's Jaro. 3210234
KFC. 3380213; 3368049
Kong Kee. 3350507
Love n Kisses Pizza. 336-5207
Mang Inasal. 5099526
Department of Orthopedics
E. Lopez St. Jaro Iloilo City
Mango Tree. 5007877
McDo. 3366236
Ocean City. 3369272
Ocean City Bistro. 508-6814
Peppy Thai. 8575854
Pizza Hut. 3383838
PIzzaro. 5087218
Ponsyon by Breakthrough. 508-8859
Porras/For Orders.3202648
Roberto’s. 3350484; 3371595
Salvi’s Grill. 3014659
Samurai Talabahan. 09209706125
Shakey’s. 3202020
Sharetea. 3200517
Sir Jerry Thomas. 3018501
Summer House. 337-425
Steps of Rome. 3333509
Tatoy's Manokan. 337-1360
Uncle Tom's. 336-3706