Presenting Complaint

Headache
Dizziness
Chest pain

History of Presenting Complaint

Headache has been present for three days.
Cough for seven weeks.
Photophobia.
Some nausea.

Observations

Not discussed

On Examination

Chest was crackly.
Pupils equal and reactive.

Plan

Prescribed Amoxicillin 500 milligrams three times a day.
Prescribed Triptan 50 milligrams once a day, can take another 50 milligrams after two hours if it works on the onset of migraine.

Safety Netting

Not discussed

Audit

Presenting Complaint

Headache [1]
Dizziness [1]
Chest pain [1]

History of Presenting Complaint

Headache has been present for three days. [2][3]
Cough for seven weeks. [3]
Photophobia. [3]
Some nausea. [3]

Observations

Not discussed

On Examination

Chest was crackly. [1]
Pupils equal and reactive. [2]

Plan

Prescribed Amoxicillin 500 milligrams three times a day. [3][4]
Prescribed Triptan 50 milligrams once a day, can take another 50 milligrams after two hours if it works on the onset of migraine. [4][5]

Safety Netting

Not discussed

References

[1] Patient with headache, dizziness and chest pain. On examination, chest was crackly, headache,

[2] pupils equal and reactive. History presenting the complaint, headache has been present for three

[3] days, cough seven weeks, photophobia, some nausea. Plan prescribed Amoxicillin 500 milligrams,

[4] three times a day and then some Triptan 10 50 milligrams once a day can take another

[5] 50 milligrams after two hours if it works on the onset of migraine