Helping Hands Non-English Order Form Page 1 of 18 Helping Hand Order Form These Helping Hands are available as of 9/24/12. The REV. DATE is the origination date or last revision, whichever is later. DIRECTIONS: Indicate quantity needed in Column 1. Send this form to the Print Shop with a Request for Print Shop Services (PS-01). Ordered: Needed: Your Name: Phone: Unit/Clinic Location: Cost Center: Spanish Miscellaneous Helping Hands HH-18-S HH-15-S HH-16-S Consent for Clinic Visits/Consentimiento Para Visitas de la Clìnica Consent for Emergency Care/Consentimiento Para Atencion Medica De Urgencia Directions to Children s Hospital/Instrucciones Para Llegar al Hospital Children s 5/00 2 5/00 2 4/01 1 Part I: Diseases, Conditions, Surgeries HH-I-106-S Abdominal Pain/Dolor Abdominal 8/05 2 HH-I-2-S Allergy to Dust/Alergia al Polvo 9/08 3 HH-I-205-S Allergies to Foods/Alergias Alimentarias 7/05 6 HH-I-4-S Allergy to Medicines/Alergia a Mecicamentos 4/09 3 HH-I-7-S Anemia: Iron Deficiency/Anemia: Deficiencia de Hierro 5/01 3 HH-I-57-S Animal Bites/Mordeduras de Animales 9/00 3
Helping Hands Non-English Order Form Page 2 of 18 HH-I-10-S Apnea/La Apnea 8/10 3 HH-I-50-S HH-I-51-S HH-I-53-S HH-I-75-S HH-I-76-S HH-I-11-S Apnea in Premature Infants/La Apnea En Bebes Prematuros Apnea: Monitoring Your Infant at Home/La Apnea: Como Controlar A Su Bebe En La Casa Apnea: Use & Care of an Apnea Monitor/ Apnea: Uso y Cuidado de un Monitor de Apnea Appendectomy: Non-Ruptured Appendix/ Apendicectomia: Sin Perforacion de la Apendice Appendectomy: Ruptured/Apendicectomia: Perforada Asthma and Reactive Airway Disease (RAD)/El Asma Y Enfermedad Reactiva de la Vias Aereas 10/93 2 10/93 5 7/10 6 9/08 3 9/08 3 6/11 5 HH-I-313-S Bedbugs/Chinches 4/09 3 HH-I-31-S Bronchiolitis/Bronquiolitis 6/11 3 HH-I-101-S Chickenpox/Varicela 5/00 3 HH-I-17-S HH-I-21-S HH-I-18-S Cleft Lip Repair/La Curacion Del Labio Leporino Cleft Palate: Bottle Feeding Your Baby/El Paladar Fisurado: La Alimentacion Bebe Con Biberon De Su Cleft Palate Repair/La Curacion Del Paladar Fisurado 4/96 2 4/96 2 4/96 2 HH-I-103-S Colic/Los Colicos 9/10 3 HH-I-150-S Congestive Heart Failure/Insuficiencia Cardiaca Congestiva 4/04 2 HH-I-114-S Conjunctivitis/Conjuntivitis 10/11 2 HH-I-15-S HH-I-14-S Constipation: Child over 1 Year of Age/El Estrenimiento En Ninos Mayores De Un Ano Constipation: Infant/El Estrenimiento En Ninos 3/03 2 6/03 2 HH-I-19-S Croup/Crup 9/11 3
Helping Hands Non-English Order Form Page 3 of 18 HH-I-207-S HH-I-28-S Dehydration: Giving Liquids at Home/ Desidratacion: Restituyendo Liquidos en Casa Diaper Rash/El Salpullido Del Bebe (Causado Por Panales) 7/10 2 7/10 1 HH-I-29-S Diarrhea/Diarrea 7/10 3 HH-I-54-S HH-I-33-S HH-I-32-S HH-I-223-S Ear Infection: Otitis Media/ La Infeccion De oidos: Otitis Media Ear Surgery: Care after Tympanoplasty or Mastoidectomy/Cirugia del Oido: El Cuidado Despues de una Timpanoplastia y/o Mastoidectomia Ear: Insertion of Plastic Tubes/Oido: Insercion de Tubos Plasticos Ear: Otitis Externa (Swimmer s Ear)/ Oido: Otitis Externa (Oido de nadador) 6/09 3 10/09 4 10/08 3 11/05 2 HH-I-104-S Eczema/Eccema 9/01 3 HH-I-34-S HH-I-147-S Enuresis (Bedwetting)/(Incontinencia de Orina) Failure to Thrive/La Insuficiencia En El Desarrollo 11/02 2 9/95 2 HH-I-195-S Febrile Seizures/La Fiebre Y Las Convulsiones 9/01 2 HH-I-105-S Fever/Fiebre 9/10 3 HH-I-212-S Fifth Disease/Quinta Enfermedad (Eritema Infeccioso) 3/06 2 HH-I-39-S G-6-PD Deficiency/ Deficienica De G 6-PD 2/06 3 HH-I-96-S HH-I-317-S HH-I-211-S HH-I-252-S Gastroesophageal Reflux (GERD)/El Reflujo Gastroesofagico H1N1 Influenza (Flu) Virus/Influenza H1N1 (Virus de la gripe) Hand-Foot-Mouth Disease/La Enfermedad Mano-Pie-Boca Head Injury Concussion/Lesion de la Cabeza-Concusion 11/04 3 9/09 3 7/04 2 8/05 3 HH-I-42-S Head Injury Mild/Lesiones en la Cabeza 8/05 2 HH-I-158-S Headaches in Children/Dolor de Cabeza en los ninos 3/06 4
Helping Hands Non-English Order Form Page 4 of 18 HH-I-169-S Headaches: Migraine/Dolores de Cabeza: Migrana 7/04 3 HH-I-184-S Heart Surgery/Cirugia Cardiaca 9/07 6 HH-I-310-S Hemangioma 4/12 3 HH-I-138-S HH-I-116-S Hematology/Oncology: Home-going Instructions/Hematologia/Oncologia: Instrucciones de Alta HIV Infection/AIDS: Care of the Child/El Sida/La Infeccion Del Virus Del Sida (VIH): El Cuidado Del Nino 1/01 2 9/05 4 HH-I-82-S Hives/Urticaria 9/11 3 HH-I-46-S Impetigo/Impetígo 10/11 3 HH-I-35-S Increased Intracranial Pressure/Incremento De Presion Intracraneal 1/04 2 HH-I-245-S Influenza (The Flu)/Influenza (Gripe) 10/11 3 HH-I-191-S HH-I-149-S Kangaroo Care for Your Infant/ Metodo Canguro Para Cargar a Su Bebe Lead Poisoning/Prevencion del envenenamiento con plomo 3/11 2 9/12 4 HH-I-124-S Leukemia/Leucemia 1/01 2 HH-I-49-S HH-I-198-S Lice: Treatment and Prevention/Los Piojos: Su Tratamiento Y Prevencion Molluscum Contagiosum/Molluscum Contagiosum 5/03 4 4/05 2 HH-I-197-S Mouth Sores (Viral)/Llagas Bucales 12/99 2 HH-I-244-S MRSA Infection/Infeccion MRSA 9/11 3 HH-I-84-S Nosebleeds/La Perdida de Sangre por La Nariz 3/03 2 HH-I-203-S Nursemaid s Elbow/Codo de Ninera 8/05 2 HH-I-58-S Pertussis/Pertusis (Tos Ferina) 8/03 3 HH-I-56-S Pinworms: Treatment and Prevention/Las Lombrices Intestinales: Su Tratamiento Y Prevencion 9/11 3 HH-I-299-S Pneumonia/Neumonía 6/11 2 HH-I-118-S Pyloric Stenosis/Estenosis Pilorica 7/06 3 HH-I-178-S Respiratory Distress/Las Dificultades 6/11 3
Helping Hands Non-English Order Form Page 5 of 18 Respiratorias HH-I-276-S Retinopathy of Prematurity (ROP)/Retinopatia por Prematurez (ROP) 3/07 2 HH-I-143-S Ringworm/Tina Corporal 9/03 3 HH-I-206-S Rotavirus 9/11 2 HH-I-59-S Scabies/Sarna 9/03 3 HH-I-61-S HH-I-182-S HH-I-148-S HH-I-55-S HH-I-218-S HH-I-121-S Seizure Care/El Cuidado Del Nino Durante Un Ataque Convulsivo Seizures: Generalized/Las Convulsiones Generalizadas Seizures: Infantile Spasms/Los Ataques Convulsivos: Espasmos Infantiles Sickle Cell Disease/Anemia de Celulas Drepanociticas Sickle Cell Trait/Rasgos de Celulas Drepanociticas Sore Throat (Viral)/Dolor de Garganta (Virosis) 2/04 5 2/04 3 1/93 2 9/08 3 9/08 2 3/01 3 HH-I-122-S Strep Throat/Infeccion En La Garganta 9/11 3 HH-I-194-S HH-I-64-S HH-I-72-S Surgery: Short Term, Home Care Instructions/ Cirugia: A Corto Termino Instrucciones de Alta T & A (Tonsillectomy and Adenoidectomy)/ Tonsilectomia Y Adenodectomia T & A Home Care/Atenciaon en Casa Despuest de Una T & A 6/01 3 3/01 5 3/01 3 HH-I-117-S Thrush/ Las Aftas 9/11 3 HH-I-209-S Tuberculosis/Tuberculosis 3/03 6 HH-I-30-S HH-I-79-S Upper Respiratory Infections (Colds)/Infeccion de los vias Respiratorias Superiores (Resfriados) Urinary Tract Infection: Prevention/Infeccion Del Tracto Urinario: Prevencion 6/11 3 6/01 2 HH-I-71-S Vomiting/Vomitos 9/11 3 HH-I-86-S VP or VJ: Shunt Pumping/ Dervacion Ventriculoperitoneal o Jugular: Bombeando la 2/04 2
Helping Hands Non-English Order Form Page 6 of 18 Derivacion HH-I-70-S VP Shunt: Care at Home/Derivacion Ventriculoperitoneal Atencion en Casa 7/06 3 Part II: Procedures HH-II-2-S HH-II-144-S Cast and Splint Care/Cuidado De Una Escayola Y Ferula Cast: Hip Spica Checklist for Care of the Child/ Espiga 8/01 5 3/02 2 HH-II-60-S Circulation Checks/Chequeo de Circulacion 5/00 2 HH-II-47-S HH-II-52-S HH-II-59-S CPR for Children Age 1 Through Puberty/Reanimacion Cardiopulmonar (RCP) Para Ninos de 1 Ano a la Pubertad CPR for Children Who Have Gone Through Puberty/Reanimacion Cardiopulmonar (RCP) Pare Ninos Que Han Pasado la Pubertad CPR for Infants/La Resucitacion Cardiopulmonar Para Los Bebes 9/11 4 9/11 2 9/11 3 HH-II-6-S Crutch Walking/Andando Con Muletas 7/09 3 HH-II-143-S HH-II-160-S HH-II-165-S HH-II-106-S HH-II-90-S HH-II-57-S HH-II-145-S Dental Injury: Post Treatment Instructions/ Instrucciones De Tratamiento Posterior Dermabond Wound Care/Cuidado de la Herida con Dermabond Dressing Change: AquaCel AG/Cambio de Aposito: Aquacel Ag Dressing Change: Burns/Cambio de Vendajes: Quemaduras ECMO (Extracorporeal Membrane Oxygenation)/ECMO: (Oxygenacion de Membrana Extracorporea) Exercises: Lower Extremities - Infant (Passive)/ Ejercicios: Extreidades Inferiores en un Lactante (Pasivo) GJ Tube (Gastrojejunostomy Tube) Daily Care/ La Sonda De Gastroyeyunostomia-GJ 11/01 2 10/11 2 9/07 3 12/02 4 5/04 5 1/08 2 6/03 5
Helping Hands Non-English Order Form Page 7 of 18 Tube El Cuidado Diario HH-II-12-S Gastrostomy Tube Care/El Cuidado De la Sonda De Gastrostomia 6/03 6 HH-II-36-S IV: Broviac Catheter/IV Cateter Broviac 11/04 4 HH-II-134-S HH-II-156-S HH-II-154-S HH-II-45-S HH-II-116-S HH-II-24-S HH-II-26-S IV: PICC Catheter: Care at Home/IV: Cateter Central de Insercion Periferica (PICC) Massage Therapy: General Information (Infant/Toddler)/Terapia De Masaje: Informacion General Massage Therapy: General Information (Preschool to Adult)/Terapia De Masaje: Informacion General Mouth Care for Patients Receiving Chemotherapy/El Cuidado de la Boca Para Pacientes Quimioterapia Oxygen Therapy at Home/La Terapia Con Oxigeno En La Casa Suctioning Nose with Bulb Syringe/Cuando Hay Que Limpiarle La Nariz Con La Jeringa De Goma Sutured Wound Care/Cuidado de Heridas Con Suturas 9/08 7 7/06 2 7/06 2 11/04 3 1/01 6 6/10 3 7/01 3 HH-II-173-S Tummy Time/Tiempo Boca Abajo 2/11 2 Part III: Diagnostic Tests HH-III-74-S Allergy Testing/Pruebas de Alergia 6/04 2 HH-III-10-S Anal Manometry/Manometria Anorrectal 10/10 2 HH-III-76-S HH-III-3-S Blood Counts for Patients Receiving Chemo or Radiation/Recuento Sanguineo Para Pacientes Que Reciben Quimioterapia O Terapia Radioactiva Cardiac Catheterization/Cateterizacion Cardiaca 1/01 5 1/08 5 HH-III-104-S Colonic Manometry/Manometria del Colon 10/10 3 HH-III-19-S CT Scan/Tomografia computarizada 9/12 5
Helping Hands Non-English Order Form Page 8 of 18 HH-III-114-S HH-III-5-S Echocardiogram: Sedated/Ecocardiograma Con Sedacion EEG (Electroencephalogram)/ Electroencefalograma 8/10 2 12/08 2 HH-III-78-S EMG & NCV/EMG & YVCN 9/08 2 HH-III-9-S HH-III-69-S HH-III-88-S Gastrointestinal Test - Upper GI/Estudio Gastrointestinal (Tracto Digestivo Superior) MRI (Magnetic Resonance Imaging)/IRM (Imagen De Resonancia Magnetica) Newborn Screen Blood Test/Analisis Sangre Del Recien Nacido 12/02 2 5/11 4 3/01 2 HH-III-77-S Shunt-O-Gram/Imágenes de una Derivación 3/04 3 HH-III-21-S Spinal Tap/Puncion Raquidea 6/00 2 HH-III-54-S Ultrasound Scan/Ultrasonido 7/09 4 HH-III-59-S Urodynamics/Estudio Urodynamicas 1/08 3 HH-III-80-S Videofluoroscopic Swallow Study (VFSS)/ Evaluacion Motora Oral Y Estudio De Deglutacion Videofluoroscopico 12/06 3 HH-III-17-S X-ray/Radiografia de Torax 9/07 2 Part IV: Well Child Care, Safety and Prevention HH-IV-2-S Bathing Your Baby/Banar a Su Bebe 11/11 3 HH-IV-9-S Bicycle Safety/La Seguridad En La Bicicleta 11/11 2 HH-IV-15-S HH-IV-18-S HH-IV-17-S HH-IV-129-S Burn Prevention: Infant-Toddler/Las Quemaduras: Su Prevencion En Bebes Y Ninos Pequenos Burn Prevention: Preschool-School Age/ Prevencion de Quemaduras: Preescolares y Escolares Burn Prevention: Teenage - Adult/ Prevencion de Quemaduras Adolescentes y Adultos Button Battery Safety/La Seguridad con las Pilas de Boton 11/11 3 11/11 4 11/11 4 3/12 2 HH-IV-14-S Car Seat Safety/Asientos De Seguridad Infantil 9/11 4
Helping Hands Non-English Order Form Page 9 of 18 HH-IV-4-S HH-IV-29-S Dental: Teeth & Gum Care/La Salud Dental: El Cuidado De Los Dientes Y Las Encias Dental: Teeth & Gum Care for Infants & Toddlers/La Salud Dental De Bebes Y Ninos Pequenos: El Cuidado De Los Dientes Y las Encias 3/03 4 2/03 4 HH-IV-75-S Diet: Ketogenic/Para Terapia anticonvulsiva 12/02 3 HH-IV-62-S HH-IV-83-S HH-IV-8-S Eye Care & Safety/Cuidado y Seguridad de los Ojos Fall Prevention in the Healthcare Setting/ Prevencion de Caidas en un Excenario de Salud Feeding Your Baby Solid Foods/A La Hora De Comer Alimentos Solidos 11/11 2 1/10 2 6/03 3 HH-IV-80-S Hand Hygiene/La Higiene de las Manos 3/11 3 HH-IV-73-S Home Safety for Infants and Toddlers/ Seguridad en el Hogar para Bebes y Ninos Pequenos 11/11 4 HH-IV-89-S Mealtime Success/Éxito en las Comidas 11/11 4 HH-IV-82-S HH-IV-30-S HH-IV-35-S Patient Safety in the Healthcare Setting/La Seguiridad Del Paciente en el Escenario Medico Poison Prevention/Prevencion Contra Envenenamiento School and Illness: Should Your Child Stay Home?/La Escuela (O La Guarderia Infantil) Y Las Enfermedades: Debe El Nino Quesdarse En La Casa? 2/03 3 5/04 3 4/96 2 HH-IV-68-S Secondhand Smoke/Humo Indirecto 11/04 3 HH-IV-69-S SIDS Reduction (Safe Sleep Practices for Infants)/ Reducción en el número de bebés con SMSL 11/11 3 HH-IV-16-S Toilet Training/Como Ensenarle A Dejar De Usar Panales 3/03 5
Helping Hands Non-English Order Form Page 10 of 18 Part V: Medications HH-V-2-S Aerosol Therapy/Terapia Aerosol 2/02 4 HH-V-170-S Azathioprine (Imuran )/ Azatioprina 3/08 5 HH-V-95-S Baclofen (Lioresal )/Baclofen (Lioresal) 9/10 3 HH-V-22-S Captopril, Enalapril y Lisinopril 4/07 5 HH-V-65-S Chemotherapy/Quimioterapia 1/01 2 HH-V-111-S Chlorhexidine (Peridex )/ Chlorhexidina 11/04 3 HH-V-86-S HH-V-162-S Cortisone (Hydrocortisone) Injections/ Inyecciones De Cortisona (Hidrocortisona) Diazepam Rectal Gel (Diastat)/Diazepam Rectal Gel (Diastat) 5/04 5 4/05 4 HH-V-122-S EpiPen/Inyeccion Automatica de Epinefrina 4/09 3 HH-V-14-S Eye Drops/Gotas Oculares 9/00 2 HH-V-20-S Eye Ointment/Pamada Ocular 9/00 2 HH-V-172-S Ganciclovir/Ganciclovir 6/07 5 HH-V-137-S General Anesthesia for Dental Treatment/ Anestesia General Para Tratamiento Dental 4/05 3 HH-V-136-S Inhalers: Spacers/ Inhaladores: Espaciadores 1/06 3 HH-V-157-S HH-V-28-S HH-V-167-S HH-V-81-S HH-V-134-S Medicine Safety/La Seguridad Con Las Medicinas Medicine:How to Give by Mouth/ Medicamentos: Como Administrarlos Por la Boca Mycophenolate (CellCept )/Micofenolato (CellCept) Nystatin Oral Suspension/La Nistatina en Suspension Oral Oral Sedation Dental/Sedacion Oral Para Pacientes 3/11 3 11/10 5 3/08 5 11/04 2 2/02 2 HH-V-146-S Palivizumab (Synagis )/Palivizumab (Synagis ) 1/02 2 HH-V-32-S HH-V-169-S Prednisone and Prednisolone/Prednisona Y Prednisolona Procedural Sedation/Procedimiento con Sedacion 5/06 4 10/05 3
Helping Hands Non-English Order Form Page 11 of 18 HH-V-179-S Procedural Sedation Care at Home/ Procedimiento con Sedacion: Atención en Casa 10/05 2 HH-V-56-S Rifampin/Rifampicina 9/05 3 HH-V-171-S Tacrolimus (Prograf, FK-506) 4/07 5 HH-V-155-S Tuberculosis Medications/Medicamentos Para La Tuberculosis (TBC) 3/03 3 Somali Miscellaneous Helping Hands Quantity Form # English Title/Somali Title Rev. HH-18-SO Consent for Clinic Visits/Aftida Booqashada Kiliniga 12/01 3 HH-24-SO Diabetes (Somali)/Sonkorowgu 9/03 1 HH-25-SO Eat Healthy (Somali)/Cun Cunto Caafimaad 7/03 7 Part I: Diseases, Conditions, Surgeries Quantity Form # English Title/Somali Title Rev. HH-I-2-SO Allergy to Dust/Xasaasida Busta (Boodhka) 3/08 3 HH-I-205-SO Allergies to Foods/Xasaasiyada Raashinka 2/08 7 HH-I-7-SO Anemia: Iron Deficiency/Dhiig Yari: Birta Ol Ku Yar 12/00 3 HH-I-57-SO Animal Bites/Qaniinyo Xayawaan 3/02 3 HH-I-10-SO Apnea/Neefshasho-joogsi 8/10 3 HH-I-53-SO HH-I-11-SO Apnea: Use & Care of an Apnea Monitor/Neefshasho-joogsi: Isticmaalka Iyo Daryeelka Qalabka la Socodka Neefshashojoogsiga Asthma and Reactive Airway Disease (RAD)/ Neef Iyo Kacdoonka Cudurka Dabayl Mareenka 7/10 6 6/11 5 HH-I-313-SO Bedbugs/Dlilqe/Dukhaan 4/09 3
Helping Hands Non-English Order Form Page 12 of 18 Quantity Form # English Title/Somali Title Rev. HH-I-31-SO Bronchiolitis/Hurgunka Dhuumaha Dabaysha YarYar 6/11 4 HH-I-16-SO Circumcision/Gudniinka Wiilasha 8/01 3 HH-I-103-SO Colic/Koolik 9/10 3 HH-I-114-SO Conjunctivitis/Daaf 10/11 3 HH-I-14-SO Constipation: Infant/Saxaro Ku Dheg: Dhallaan 9/00 2 HH-I-19-SO Croup/Xiiq Caruureed 9/11 3 HH-I-28-SO Diaper Rash/Furuuruca Bambarka 7/10 2 HH-I-29-SO Diarrhea/Shuban 7/10 3 HH-I-54-SO HH-I-33-SO HH-I-32-SO Ear Infection: Otitis Media/Infekshanka Dhagta Ear Surgery: Care after Tympanoplasty or Mastoidectomy/Qalitaanka Dhegaha: Xanaanada Qalitaanka Tympanoplasty iyo/ama Mastoidectomy Ear: Insertion of Plastic Tubes/Dheg: Gelinta Tuubooyinka Caaga Ah 6/09 3 12/09 5 3/01 3 HH-I-104-SO Eczema/Eksema 9/03 3 HH-I-147-SO Failure to Thrive/Koritaan La aan 12/00 3 HH-I-105-SO Fever/Qandho 9/10 3 HH-I-317-SO HH-I-42-SO H1N1 Influenza (Flu) Virus/Hargabka H1N1 Influenza (Flu) Virus Head Injury Mild/Dhaawacyo Madax (Booqashada Bukaansocodka) 9/09 3 3/02 2 HH-I-43-SO Hepatitis B/Cargaarshowga B 8/02 2 HH-I-82-SO Hives/ Finan Xajiin 9/11 3 HH-I-46-SO Impetigo/ Boog 10/11 3 HH-I-245-SO Influenza (The Flu)/Ifilo Flu 10/11 3 HH-I-137-SO Jaundice/ Joondis 12/00 2 HH-I-149-SO HH-I-49-SO Lead Poisoning and Prevention/Ka Hortagga Sumowga Ledka Lice: Treatment and Prevention/Injir: Daaweyn Iyo Ka Hortag 3/08 3 9/03 4
Helping Hands Non-English Order Form Page 13 of 18 Quantity Form # English Title/Somali Title Rev. HH-I-198-SO Molluscum Contagiosum/Molluskum Kontajosum 4/05 2 HH-I-197-SO Mouth Sores (Viral)/Af Xanuunyo (Fayral) 8/02 2 HH-I-244-SO MRSA Infection/Cudurka MRSA eek u Jira Beesha 9/11 3 HH-I-84-SO Nosebleeds/Sangoror 9/00 2 HH-I-58-SO Pertussis/Pertussis 8/03 3 HH-I-56-SO Pinworms: Treatment and Prevention/ Gooryaan Dhudhuub: Daaweyn Iyo Ka Hotag 11/01 2 HH-I-299-SO Pneumonia/Nuumooniya 6/11 2 HH-I-178-SO Respiratory Distress/Dhibaato Neefsi 11/99 3 HH-I-206-SO Rotavirus/Rootafayras 9/11 2 HH-I-122-SO Strep Throat/Cunaha Leh Strep 9/11 3 HH-I-194-SO HH-I-64-SO HH-I-72-SO Surgery: Short Term, Home Care Instructions/ Qalliin: Xilli Gaaban Daryeelka Guriga T & A (Tonsillectomy and Adenoidectomy)/ Gooynta Qunka Iyo Hilibka Sanka T & A Home Care/Daryeela Guriga Ee Goynta Qunka Iyo Hilibka Sanka 8/01 3 1/02 4 3/01 3 HH-I-117-SO Thrush/Cabeeb 9/11 3 HH-I-145-SO Tinea Capitis/Tiiniya Kabitis 8/02 2 HH-I-209-SO Tuberculosis/Qaaxo 2/02 6 HH-I-30-SO Upper Respiratory Infections (Colds)/ Infekshanka Dhuumaha 6/11 3 HH-I-71-SO Vomiting/Mantag 9/11 3 Part II: Procedures Quantity Form # English Title/Somali Title Rev. HH-II-59-SO CPR for Infants/Dib U Naaxinta Wadnaha Iyo Sambabka EE Dhallaanka 9/11 4 HH-II-6-SO Crutch Walking/Ku Socodka Qoryaha 6/02 3 HH-II-160-SO Dermabond Wound Care/Daryeelka Dhaawaca ee Dermabond 10/11 2
Helping Hands Non-English Order Form Page 14 of 18 Quantity Form # English Title/Somali Title Rev. HH-II-165-SO HH-II-106-SO HH-II-12-SO HH-II-50-SO HH-II-24-SO HH-II-26-SO HH-II-27-SO Dressing Change: Aquacel Ag/Sida Loo Bedelo: Aquacel Ag Dressing Change: Burns/Bedelka Faashada: Gubasho Gastrostomy Tube Care/Daryeelka Tuubada Caloosha Saline (Salt Water) Preparation/Diyaarinta Biyo Cusbo Leh Suctioning Nose with Bulb Syringe/Dhuuqida Sanka EE Siliinghaha Gluubka Leg Sutured Wound Care/Dhaawac La Tolay Ama Daryeelka Dhaawaca Dermabond Temperature: Oral, Rectal, Axillary/Xumadda: Afka, Dabada iyo Kilkisha 7/06 4 12/02 4 1/08 6 12/00 2 6/10 3 6/02 3 9/05 3 HH-III-74-SO Allergy Testing/Baaritaan Xasaasiyadeed 6/04 2 HH-III-19-SO CT Scan/Fiirinta CT 6/02 3 HH-III-114-SO Echocardiogram: Sedated/Eko Kardiogram 8/10 2 HH-III-5-SO HH-III-69-SO HH-III-29-SO EEG (Electroencephalogram)/ Electroencephalogram MRI (Magnetic Resonance Imaging)/ Sawirka MRI Stool Specimen Collection Ova and Parasites/ Ururinta Saamiga Saxaradaukun Iyo Ku Dulnoole Ama Jaardiya/Baaritaankacryptosporidium 12/08 2 5/11 4 8/03 3 HH-III-54-SO Ultrasound Scan/Fiirinta Ultrasoundka 7/09 4 HH-III-59-SO Urodynamics/Yuurodaynamiks 3/08 3 HH-III-17-SO X-Ray/Raajo 3/09 2 Part IV: Well Child Care, Safety and Prevention Quantity Form # English Title/Somali Title Rev. HH-IV-2-SO Bathing Your Baby/U qubeynta nuunuugaaga 11/11 3 HH-IV-9-SO Bicycle Safety/Amaanka Baasgeelka/Bushkuleetiga 11/11 2
Helping Hands Non-English Order Form Page 15 of 18 Quantity Form # English Title/Somali Title Rev. HH-IV-6-SO HH-IV-15-SO HH-IV-18-SO HH-IV-17-SO HH-IV-129-SO Breastfeeding Your Baby/Naasnuujinta Cunuggaaga Burn Prevention: Infant & Toddler/Kahortagga gubashada: Ilmaha Yar Iyo Socod- Baradka Burn Prevention: Preschool-School Age/Kahortagga gubashada: d ada dugsiga ka hor iyo da da dugsiga Burn Prevention: Teenage-Adult/Ka-hortagga gubashada: tobaneeyo-jirka iyo qofka weyn Button Battery Safety/Amaanka Baatariga Badhanka ah 12/00 4 11/11 3 10/11 4 11/11 4 3/12 2 HH-IV-14-SO Car Seat Safety /Nabadgelyada 3/01 3 HH-IV-12-SO HH-IV-62-SO HH-IV-83-SO HH-IV-8-SO HH-IV-73-SO HH-IV-82-SO HH-IV-30-SO HH-IV-69-SO Dental: Baby Bottle Tooth Decay/Ilko: Bololka Ilkaha Dhaladu Keento Eye Care and Safety/Daryeelka iyo amaanaka isha Fall Prevention in the Healthcare Setting/Ka Hortagga Dhicitaanka Rugta Caamifaadka Feeding Your Baby Solid Foods/Siinta Cunugga Cuntada Adag Home Safety for Infants and Toddlers/ Amaanka guriga ee nuunuuga iyo socodbaradka Patient Safety in the Healthcare Setting/ Nabadgelyada Bukaanka EE Xarunta Daryeelka Caafimaadka Poisonings and Poison Prevention/Sumowga iyo ka hortagga sunta SIDS Reduction (Safe Sleep Practices for Infants)/Yareynta geerida degdegga ah ee ilmaha yaryar 9/00 3 11/11 2 11/11 2 12/00 3 11/11 4 4/03 3 11/11 3 11/11 3
Helping Hands Non-English Order Form Page 16 of 18 Part V: Medications Quantity Form # English Title/Somali Title Rev. HH-V-58-SO Acetaminophen/Daawo Qandho 1/00 3 HH-V-2-SO Aerosol Therapy/Daaweynta Ayrosoolka 12/00 3 HH-V-95-SO Baclofen (Lioresal )/Baclofen (Lioresal) 8/10 4 HH-V-225-SO Cough & Cold Medications (OTC) / Daawooyinka Qufaca Iyo Hargabkakawntarka Korkiisa HH-V-162-SO Diazepam Rectal Gel (Diastat)/Diyasabamka Jeelka Ah EE Dabada La Geliyo (Diastat) 11/07 3 12/05 3 HH-V-18-SO Ear Drops/Goojo Dhegood 1/00 2 HH-V-122-SO EpiPen/Epinephrine Qalimada Sida Otomaatiga Ah La Isugu Duro Ee - Ebibeen 4/09 3 HH-V-14-SO Eye Drops/Goojo Indhood 1/00 2 HH-V-20-SO Eye Ointment/Boomaato Indhood 1/00 2 HH-V-137-SO General Anesthesia for Dental Treatment/ Suuxin (Guud) Ee Daaweynta Ilkaha 4/05 3 HH-V-157-SO Medicine Safety/Amaanka dawada 11/11 4 HH-V-134-SO Oral Sedation Dental/Dejinta Afka Ee Bukaanka Ilkaha 12/02 2 HH-V-146-SO Palivizumab (Synagis )/Palifizumaab (Sinajis) 12/01 3 HH-V-169-SO Procedural Sedation/Nidaam Dejineed 4/04 2 HH-V-179-SO Procedural Sedation: Care @ Home/Nidaam Dijineed: Daryeelka Guriga 3/04 2 Russian Quantity Form # English Title Rev. HH-I-205-R Allergies to Foods 12/02 3 HH-I-4-R Allergy to Medicines 12/08 3 HH-I-57-R Animal Bites 12/08 5 HH-I-50-R Apnea in Premature Infants 12/02 3 HH-I-31-R Bronchiolitis 12/02 2 HH-I-114-R Conjunctivitis (Pinkeye) 12/08 3
Helping Hands Non-English Order Form Page 17 of 18 Quantity Form # English Title Rev. HH-I-14-R Constipation: Infant 12/02 2 HH-I-19-R Croup 12/02 2 HH-I-207-R Dehydration: Giving Liquids at Home 12/02 2 HH-I-29-R Diarrhea 12/08 3 HH-I-54-R Ear Infection: Otitis Media 12/08 2 HH-I-147-R Failure to Thrive 12/02 2 HH-I-105-R Fever 12/02 2 HH-I-195-R Fever and Seizures (Febrile Seizures) 12/02 2 HH-I-39-R G-6-PD Deficiency 12/02 2 HH-I-96-R Gastroesophageal Reflux (GERD) 12/02 2 HH-I-151-R Gastroschisis 12/02 2 HH-I-252-R Head Injury Concussion 12/08 3 HH-I-42-R Head Injury Mild 12/08 2 HH-I-258-R Henoch-Schonlein Purpura 11/08 2 HH-I-168-R Hepatitis A 11/08 2 HH-I-43-R Hepatitis B 12/02 2 HH-I-179-R Inflammatory Bowel Disease (IBD) 12/02 2 HH-I-137-R Jaundice 12/02 2 HH-I-149-R Lead Poisoning Prevention 12/08 4 HH-I-89-R Meningitis 12/02 3 HH-I-141-R Necrotizing Enterocolitis (NEC) 12/02 2 HH-I-58-R Pertussis (Whooping Cough) 12/08 3 HH-I-118-R Pyloric Stenosis 12/02 2 HH-I-178-R Respiratory Distress 12/02 2 HH-I-71-R Vomiting 12/08 3 HH-I-156-R Warts: Liquid Nitrogen Treatment 12/02 2 HH-II-136-R Blood Separation (Apheresis) 12/02 2 HH-III-84-R Bronchoscopy and Laryngoscopy 12/02 2 HH-III-86-R Bronchoscopy (Flexible Bronchoscopy, Bronchoalveolar Lavage) 12/02 2 HH-III-19-R CT Scan 12/08 4 HH-III-69-R MRI Magnetic Resonance Imaging 12/08 3
Helping Hands Non-English Order Form Page 18 of 18 Quantity Form # English Title Rev. HH-III-59-R Urodynamics 5/10 2 HH-V-225-R Cough and Cold Medicines (Over the Counter) 12/08 3 Asian Languages Quantity Form # English Title Rev. HH-I-228-J Heart Transplant: Care at Home (Japanese) 6/03 2 HH-I-227-J Heart Transplant: Rejection (Japanese) 6/03 2 HH-I-191-CHS Kangaroo Care for Your Infant (Chinese Simplified) 11/10 2 HH-III-19-CHS CT Scan(Chinese Simplified) 1/10 3 HH-III-19-CHT CT Scan(Chinese Traditional) 1/10 3 HH-III-69-CHS MRI Magnetic Resonance Imaging (Chinese Simplified) HH-III-69-CHT MRI Magnetic Resonance Imaging (Chinese Traditional) HH-IV-31 Weaning Your Baby: Cup Feeding (Cambodian) 1/10 3 1/10 3 1987 2 HH-IV-32 Weaning Your Baby: Cup Feeding (Laotian) 1987 2 HH-IV-33 Weaning Your Baby: Cup Feeding (Vietnamese) 12/99 2 HH-V-58-J Acetaminophen (Japanese) 4/97 3 HH-V-170-J Azathioprine (Imuran ) (Japanese) 2/03 6 HH-V-22-J Captopril and Enalapril (Japanese) 5/04 6 HH-V-172-J Ganciclovir (Japanese) 10/03 6 HH-V-146-J Palivizumab (Synagis ) (Japanese) 12/06 3 HH-V-32-J Prednisone and Prednisolone (Japanese) 11/05 5