Using Data to Plan Trip Four

During past trips I kept an electronic copy of the written summary of patient visits. I typed out a short summary with the name, age, gender, symptoms, physical exam, assessment, and recommendations.  I used Google Translate to convert the text to Spanish, and the printed version was placed in the clinic chart and a copy was given to the mother. Until I got into the routine I did not save every patient, and when the clinic was hectic, I forgot to save some patients, but I managed to save all but one or two a day, so my records are pretty good.  

I reconverted the files one by one to English, and then made a spreadsheet of age, presenting complaints, diagnoses, and medications prescribed.  

The children ranged from 1 month to 11 years of age and I saw 12 to 24 children a day.

The graph below shows the most common diagnoses and the percent of patients with these diagnoses. 

I expect to see about a hundred patients during the next trip and based on this data I can predict how many of each diagnoses I will likely see and I will bring enough medications in each class to cover the common problems without dipping into the clinic pharmacy stores.  As well, I will bring my preferred medication for each problem, which obviates the need to choose a second or third line medication from the clinic stores.  

The most common prescribed medication was an anti-pyretic followed by an antibiotic.  

I'm sure that I did not diagnose all the cases of scabies, ringworm, and tinea versicolor. Many children had these skin infestations but the mother often didn't point the rash out as a problem. As well, the clinic did not have supplies of medications for these skin infestations. With the next visit I will bring enough medications to treat these problems.  

I am also sure that I did not diagnose all the cases of abdominal parasites.  A case might be made that any child who drinks well water, that is to say probably every child, likely has an abdominal parasite.  Perhaps I should bring enough to treat every child.  But, if they continue to drink the well water, the parasites will return.  

Over the next month I will prepare a teaching handout in Spanish for the common problems such as fever, cold, ear infection, rehydration with gastro, nutrition, abdominal parasites, scabies, ringworm, tinea, and impetigo. Having the handouts will save me time when I see children with these problems.