Ask the patient to sit up straight/ stands Ask the patient inhaled maximally and blow/expired as strong as he can

through the mouth piece for three times Takes the highest readings and classify the patient to 3 zones (red, yellow and green) based upon the percentage of reduction in PEFR compared to last/previous readings

Patient must be relaxed, not smoking or taking caffeinated drinks 30 minutes prior to the measurement Sit up/ Lying down position with the sphygmomanometer at the patients heart level Systolic blood pressure can be charted based on the first Korotkoff heart sound (K1) Diastolic blood pressure can be charted based on the fifth Korotkoff heart sound (K5) Measure the patient waist circumference without any clothes on the measurement tape Readings of more than >90 cm in male or >80 cm female indicative of central obesity

Take of the inhaler cap and shake for 10-30 seconds and sit up straight/stands Breath normally for few seconds than take a deep breath first before release the inhaler If need another dose, wait up for 30 seconds to 1 minute Rinse the mouth Take note that if the inhaler has not been used or >48 hours, one should pressed the inhaler once to ensure the correct amount of medications Mix the medications with normal saline according to the ratio needed e.g 1 Salbutamol with 3 Normal Saline Total of medications with normal saline must be 4 cc Ask the patient to sit up straight and breath normally through the face mask Repeat if patient still clinically not resolve from the symptoms

Prick the patients finger (2nd, 3rd and 4th digit) using lancet, make sure to swab the patients finger with spirit beforehand Drop the blood on the glucose strip and wait until glucometer gives reading of the glucose Write down the readings

Weight the patient on weighing scale. Remove heavy cloths or handbag Measure the height of the patient with feet close together Calculate the BMI The ideal body weight for asian population is 18.5 23.9 kg/m2 Formula of BMI is Weight (kg) / Height2 (m)

Measure the patients o Head circumference o Weight (remove pampers if necessary) o Height Avoid parallax error Note down the readings at growth chart

Assess the patients based on the Denver chart, which encompassed of o Gross motor o Fine motor o Visual, hearing and speech o Social Note whether the assessment is appropriate for the patients age

Screen the patient from head to toe Look for any dysmorhic features, syndromic features or any congenital abnormalities in the patient Examine specifically for Abdomen, CVS, Respiratory and neurological Note down any abnormality for further evaluation by the paediatrician

Immunization is given based on the latest MOH schedule Prepare the 3 cc syringe, 26 G and alcohol Note that the correct immunization is given and check the expired date Swab the patient midpoint of lateral thigh Introduce in the needle, aspirate if theres presence any blood (if any, take out the needle) Put cotton on the injection site and chart in the record

Expose the patient breast and find chaperone if male doctor Inspect the breast for; assymetrical, nipple discharge, skin changes or breast engorgement Palpate ; any lump, discharge or breast tenderness Examine the axillary nodes to complete your examination

Put the patients on lithotomy position Clean and draped the patient Inspection for any abnormalities of external genitalia Perform bi-manual vaginal examination Insert in speculum, and using Ayres spatula, collect the sample Smear the sample on to the slides and put it into alcohol solution

Clean the injection site, preferably at the deltoid muscle using alcohol swab Put the depo-provera into 3cc syringe and use 26 G needle (1cc of depo-provera = 190mg) Introduce the needle, aspirate if theres any presence of blood (take out the needle if any blood) Give the injection, draw out the needle and put on cotton at the injection site

Obtain the urine sample from the patient Make sure the dipstick has not been used before Pour the urine on to the dipstick and put it on the urinalysis machine Take the results, note if there is presence of any abnormalities such as blood, leukocytes, nitrates, glucose or albumin

Patient should be fasting for at least 6 hours prior to the test Take the FBS using glucometer Give the patient glucose drink, 75mg in 250 300 ml Wait until 2 hours time, repeat the blood glucose taking Normal values for pregnancy is 7.0 (FBS) 7.8 mmol (2 hours post glucose drink

Clean the injection site, preferably at the deltoid muscle using alcohol swab Put the ATT vaccination in 1cc syringe (0.5 cc of ATT = 10 Rf) Introduce the needle, aspirate if theres any presence of blood (take out the needle if any blood) Give the injection, draw out the needle and put on cotton at the injection site

Give the patient the FKC Record the fetal movement if presence If >10 times per 12 hours, mother can be reassured If the fetal movement <10 times in 12 hours, advise the patient to seek medical attention

Bring one chaperone if male Expose the abdomen region Inspect for ; scar, striae gravidarum, fetal movement, striae albicans and linea nigra, measure the SFH Palpate for ; no of fetal poles, presentation and lie. Estimate fetal weight and adequacy of the liquour Auscultate for fetal heart sound using Pinard

Patient lie in supine position Bring the ultrasound probe and detect; o AFI o Fetal growth parameters o Fetal heart Note down any abnormalities if presence

Bring the patient Make sure the room has adequate lighting Test both eyes without wearing spectacles, one at a time using Snellen chart If patient unable to see, use pinhole glasses Test both eyes with patient wearing spectacles to determine the adequacy of the lens power

Bring the patient to the room with adequate lighting Using Ishihara chart, ask the patient to call the numbers or object he/she saw on each plates Record if there is presence of any abnormalities

Dim the room Using the technique of RRR and LLL, examine the patient fundus See the; o Optic disc margin, colour and CDR o Blood vessels o Retina o Macula

Using 20 cc of syringe, fill with sterile water Pump the syringe into the patients ear not too slow and not too fast Take note if there is presence of any foreign body material in the ear canal

Give the patient novopen Make sure to recap after use Adjust the dose by turning the dial at the back of the novopen Needle can be use up to 3 times to save cost Recap after use

Put the patient on lithotomy position Uterus size is measured to determine the size of the IUCD that is needed to be used Perform bimanual to detect the os Slowly and carefully, place the IUCD inside the os before pulling the string located at the base of the IUCD