Physician Orders Pediatric: LEB ED Asthma Plan
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- Douglas Merritt
- 5 years ago
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1 LEB ED Triage Standing SOB/Wheeze Asthma Non Categorized Criteria: Patients greater than 2 years of age with a history of asthma or airway active disease or two or more previous illnesses treated with albuterol/levealbuterol with wheezing heard by occultation during triage.(note)* Choose medications based on weight based protocol.(note)* Vital Signs Vital Signs Monitor and Record T,P,R,BP, Per ED policy Patient Care O2 Sat Monitoring NSG Stat, q2h(std) Cardiopulmonary Monitor T;N Stat, Monitor Type: O2 Monitor Respiratory Care Oxygen Delivery Special Instructions: titrate to keep O2 Sat at 90% or greater. Initiate ED Ped Asthma T;N, Stat Asthma Phase 1A Non Categorized R Powerplan Open Patient Care IV Insert/Site Care LEB Stat, q2h(std) Deep nasal suction for patients less than one year, PRN for congestion Respiratory Care ISTAT POC (RT Collect) T;N Stat once, Test Select Venous Blood Gas (DEF)* T;N Stat once, Test Select Arterial Blood Gas Heliox Mild Pathway RCS (1 to 4) albuterol (MDI) 4 puff, MDI, INH, once, STAT, (360 mcg = 4 puff) Comments: Administer via spacer/mask DISPENSE FOR EDUCATION/DISCHARGE
2 TEACHING. FOR ED USE ONLY. dexamethasone 4 mg, Tab, PO, once, STAT [ kg] (DEF)* 8 mg, Tab, PO, once, STAT [ kg] 12 mg, Tab, PO, once, STAT [ kg] 16 mg, Tab, PO, once, STAT [Greater Than or Equal To 25 kg] Moderate Pathway RCS (5 to 8) 2.5 mg, Inh Soln, NEB, once, STAT, (0.5 ml = 2.5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 5 mg, Inh Soln, NEB, once, STAT, (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Greater Than or Equal To 20 kg] dexamethasone 4 mg, Tab, PO, once, STAT [ kg] (DEF)* 8 mg, Tab, PO, once, STAT [ kg] 12 mg, Tab, PO, once, STAT [ kg] 16 mg, Tab, PO, once, STAT [Greater Than or Equal To 25 kg] Severe Pathway RCS (9 to 12) 5 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 10 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (2 ml = 10 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Greater Than or Equal To 20 kg] 0.5 mg, Inh Soln, NEB, N/A, STAT, (for 2 dose ), (2.5 ml = 0.5 mg) Contact Physician now and request an order for Fluids AND/OR Magnesium per the Asthma Protocol. Comments: IF NOT ALREADY GIVEN.
3 Laboratory If possibility of pregnancy, place order below:(note)* Pregnancy Screen Serum STAT, T;N, once, Type: Blood Pregnancy Screen Urine Point of Care Stat Consults/Notifications/Referrals CHAMP Referral T;N Notify Physician-Continuing Notify For: Respiratory Clinical Score (RCS) greater than or equal to 9. Asthma Phase 1A (MD ONLY) This section is to be utilized by the MD only.(note)* methylprednisolone 2 mg/kg, Ped Injectable, IV Push, once, STAT, Max dose = 80 mg (DEF)* 2 mg/kg, Ped Injectable, IM, once, STAT, Max dose = 80 mg Bolus 20 ml/kg, Injection, IV, once, STAT, ( infuse over 15 min ), Bolus D5 1/2 NS KCl 20 meq/l 1,000 ml, IV, STAT, ml/hr DOSING RANGE FOR MAGNESIUM SULFATE: 25 TO 75 MG/KG, MAX DOSE = 2 GRAMS(NOTE)* magnesium sulfate 50 mg/kg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Less Than 40 kg] (DEF)* 2,000 mg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Greater Than or Equal To 40 kg] To Be Ordered by Physician When Needed (NOTE)* 10 mcg/kg, Ped Injectable, IV, once, STAT, Loading Dose 10 mcg/kg, Ped Injectable, Subcutaneous, once, STAT, Loading Dose, Max dose = 0.3 mg Terbutaline Drip (Pediatric) (IVS)* Diluent volume 30 ml, IV, STAT, Reference Range: 0.1 to 5 mcg/kg/min; Continuous infusion (additive) 30 mg, mcg/kg/min
4 EPINEPHrine Injection 0.01 mg/kg, Ped Injectable, IM, once, STAT, Max dose = 0.3mg Asthma Phase 1B Mild Pathway RCS (1 to 4) albuterol (MDI) 4 puff, MDI, INH, once, STAT, (360 mcg = 4 puff); Administer via spacer/mask Comments: administer via spacer/mask DISPENSE FOR EDUCATION/DISCHARGE TEACHING. FOR ED USE ONLY. Moderate Pathway RCS (5 to 8) 2.5 mg, Inh Soln, NEB, once, STAT, (0.5 ml = 2.5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 5 mg, Inh Soln, NEB, once, STAT, (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Greater Than or Equal To 20 kg] Severe Pathway RCS (9 to 12) 5 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 10 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (2 ml = 10 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Greater Than or Equal To 20 kg] 40 ml, NEB, Routine, For Patients Less than 20 kg 100 mg, 15 mg/hr 40 ml, NEB, Routine, For Patients Greater than or equal to 20 kg 100 mg, 30 mg/hr
5 Contact Physician now and request an order for Magnesium Sulfate per the Asthma Protocol. Comments: IF NOT ALREADY GIVEN. Asthma Phase 1B (MD ONLY) This section is to be utilized by the MD Only.(NOTE)* Bolus 20 ml/kg, Injection, IV, once, STAT, ( infuse over 15 min ), IF NOT PREVIOUSLY GIVEN D5 1/2 NS KCl 20 meq/l 1,000 ml, IV, Routine, ml/hr, IF NOT PREVIOUSLY GIVEN DOSING RANGE FOR MAGNESIUM SULFATE: 25 TO 75 MG/KG, MAX DOSE = 2 GRAMS(NOTE)* magnesium sulfate 50 mg/kg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Less Than 40 kg] (DEF)* 2,000 mg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Greater Than or Equal To 40 kg] To Be Ordered by Physician When Needed:(NOTE)* 10 mcg/kg, Ped Injectable, IV, once, STAT, Loading Dose 10 mcg/kg, Ped Injectable, Subcutaneous, once, STAT, Max dose: 0.3 mg, Loading Dose Terbutaline Drip (Pediatric) (IVS)* Diluent volume 30 ml, IV, STAT, Reference Range: 0.1 to 5 mcg/kg/min,continuous infusion (additive) 30 mg, mcg/kg/min EPINEPHrine Injection 0.01 mg/kg, Ped Injectable, IM, once, STAT, Max dose = 0.3mg Asthma Phase 1C Mild Pathway RCS (1 to 4) albuterol (MDI) 4 puff, MDI, INH, once, STAT, (360 mcg = 4 puff); Administer via spacer/mask Comments: administer via spacer/mask DISPENSE FOR EDUCATION/DISCHARGE TEACHING. FOR ED USE ONLY. Moderate Pathway RCS (5 to 8)
6 2.5 mg, Inh Soln, NEB, once, STAT, (0.5 ml = 2.5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 5 mg, Inh Soln, NEB, once, STAT, (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Greater Than or Equal To 20 kg] Contact Physician now and request an order for Fluids AND/OR Magnesium Sulfate per the Asthma Protocol, Severe Pathway RCS (9 to 12) 5 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 10 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (2 ml = 10 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Greater Than or Equal To 20 kg] 40 ml, NEB, Routine, For Patients Less than 20 kg 100 mg, 15 mg/hr 40 ml, NEB, Routine, For Patients Greater than or equal to 20 kg 100 mg, 30 mg/hr Contact Physician now and request an order for Magnesium Sulfate per the Asthma Protocol. Comments: IF NOT ALREADY GIVEN. Asthma Phase 1C (MD ONLY)
7 This section is to be utilized by the MD Only.(NOTE)* Bolus 20 ml/kg, Injection, IV, once, STAT, ( infuse over 15 min ), IF NOT PREVIOUSLY GIVEN D5 1/2 NS KCl 20 meq/l 1,000 ml, IV, Routine, ml/hr, IF NOT PREVIOUSLY GIVEN DOSING RANGE FOR MAGNESIUM SULFATE: 25 TO 75 MG/KG, MAX DOSE = 2 GRAMS IF NOT PREVIOUSLY GIVEN(NOTE)* magnesium sulfate 50 mg/kg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Less Than 40 kg] (DEF)* 2,000 mg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Greater Than or Equal To 40 kg] To Be Ordered by Physician When Needed:(NOTE)* 10 mcg/kg, Ped Injectable, IV, once, STAT, Loading Dose 10 mcg/kg, Ped Injectable, Subcutaneous, once, STAT, Max dose: 0.3 mg, Loading Dose Terbutaline Drip (Pediatric) (IVS)* Diluent volume 30 ml, IV, STAT, Reference Range: 0.1 to 5 mcg/kg/min, Continuous infusion (additive) 30 mg, mcg/kg/min EPINEPHrine Injection 0.01 mg/kg, Ped Injectable, IM, once, STAT, Max dose = 0.3mg Asthma Phase 1D Mild Pathway RCS (1 to 4) albuterol (MDI) 4 puff, MDI, INH, once, STAT, (360 mcg = 4 puff); Administer via spacer/mask Comments: administer via spacer/mask DISPENSE FOR EDUCATION/DISCHARGE TEACHING. FOR ED USE ONLY. Moderate Pathway RCS (5 to 8) 5 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (1 ml = 5 mg) 0.5% soln; FOR BAN USE PER PROTOCOL [Less Than 20 kg] (DEF)* 10 mg, Inh Soln, NEB, q15min, STAT, (for 2 dose ), (2 ml = 10 mg) 0.5% soln; FOR BAN USE
8 PER PROTOCOL [Greater Than or Equal To 20 kg] Contact Physician now and request an Admit order per Asthma Protocol. Contact Physician now and request an order for Magnesium Sulfate per the Asthma Protocol. Comments: IF NOT ALREADY GIVEN. Severe Pathway RCS (9 to 12) 40 ml, NEB, Routine, For Patients Less than 20 kg 100 mg, 15 mg/hr 40 ml, NEB, Routine, For Patients Greater than or equal to 20 kg 100 mg, 30 mg/hr Asthma Phase 1D (MD ONLY) This section is to be utilized by the MD only.(note)* Bolus 20 ml/kg, Injection, IV, once, STAT, ( infuse over 15 min ), IF NOT PREVIOUSLY GIVEN D5 1/2 NS KCl 20 meq/l 1,000 ml, IV, Routine, ml/hr, IF NOT PREVIOUSLY GIVEN DOSING RANGE FOR MAGNESIUM SULFATE: 25 TO 75 MG/KG, MAX DOSE = 2 GRAMS IF NOT PREVIOUSLY GIVEN(NOTE)* magnesium sulfate 50 mg/kg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Less Than 40 kg] (DEF)* 2,000 mg, Ped Injectable, IV Piggyback, once, STAT, ( infuse over 20 min ), Max dose = 2 grams [Greater Than or Equal To 40 kg] To Be Ordered by Physician When Needed:(NOTE)* 10 mcg/kg, Ped Injectable, IV, once, STAT, Loading Dose 10 mcg/kg, Ped Injectable, Subcutaneous, once, STAT, Max dose: 0.3 mg, Loading Dose Terbutaline Drip (Pediatric) (IVS)*
9 Diluent volume 30 ml, IV, STAT, Reference Range: 0.1 to 5 mcg/kg/min,continuous infusion (additive) 30 mg, mcg/kg/min EPINEPHrine Injection 0.01 mg/kg, Ped Injectable, IM, once, STAT, Max dose = 0.3mg Discharge Planning Phase Criteria: Patient can be discharged when RS is less than or equal to 4, SpO2 is greater than 92% on room air while awake, clinically hydrated, completion of asthma education, follow up is available, and no medical non-adherence concerns.(note)* Contact Physician for a discharge order when patient meets the above criteria. Date Time Physician s Signature MD Number *Report Legend: DEF - This order sentence is the default for the selected order GOAL - This component is a goal IND - This component is an indicator INT - This component is an intervention IVS - This component is an IV Set NOTE - This component is a note Rx - This component is a prescription SUB - This component is a sub phase, see separate sheet R-Required order
Physician Orders ADULT: LEB Asthma Admit Plan. Anticipated LOS: 2 midnights or more Patient Status Initial Outpatient T;N Attending Physician:
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: LEB Asthma Admit Phase, When to Initiate: LEB Asthma Admit Phase Non Categorized Add To Problem List Problem: Asthma
Physician Orders PEDIATRIC: : LEB ED Trauma (Major) Plan
LEB ED Standing Orders Trauma (Major) Ph Non Categorized Criteria: Patients between 0-18 years of age that present with a Major Trauma that meet LeBonheur Trauma stat or Trauma Alert Guidelines.(NOTE)*
Physician Orders PEDIATRIC: LEB ED Hx of DKA with Hyperglycemia Plan
LEB ED Triage Hx of DKA w Hyperglycemia Non Categorized Criteria for use: Patients less than 18 years of age with known or suspected Diabetes Mellitus and blood glucose greater than 300mg/dL.(NOTE)* Vital
Physician Orders PEDIATRIC: LEB Critical Care Respiratory Plan
LEB Critical Care Respiratory Plan Patient Care Cardiopulmonary Monitor T;N Routine, Monitor Type: End Tidal Co2 (DEF)* T;N Routine, Monitor Type: Transcutaneous Co2 Respiratory Care Initiate Pediatric
Physician Orders ADULT: Asthma and Bronchitis Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Asthma and Bronchitis Phase, When to Initiate: Asthma and Bronchitis Phase Non Categorized Problem: Asthma Problem:
Physician Orders PEDIATRIC: LEB DKA Diabetes Mellitus Admit Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Admit DKA Two-Bag Calculations Phase, When to Initiate: Initiate Powerplan Phase Phase:
Physician Orders PEDIATRIC: LEB Kidney Transplant Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Kidney Transplant Post Op Phase, When to Initiate: LEB Kidney Transplant Post Op Phase Admission/Transfer/Discharge
Physician Orders PEDIATRIC: LEB Stroke Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Stroke Admit Phase. When to Initiate: LEB Stroke Admit Phase Admission/Transfer/Discharge Patient Status Initial
Physician Orders ADULT: Atrial Fib/Flutter Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Atrial Fib/Flutter Phase, When to Initiate: Atrial Fib/Flutter Phase Non Categorized Problem: Atrial fibrillation Problem:
Physician Orders ADULT: Sickle Cell Inpatient Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Sickle Cell Inpatient Phase, When to Initiate: When patient arrives to unit Sickle Cell Inpatient Phase Admission/Transfer/Discharge
Physician Orders PEDIATRIC: LEB NEURO Epilepsy Monitoring Unit Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Neuro Epilepsy Monitoring Unit Admit Phase, When to Initiate: LEB Neuro Epilepsy Monitor Unit Admit Phase Non Categorized
Physician Orders PEDIATRIC: LEB Oral Maxillofacial Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Oral Maxillofacial Postop Phase, When to Initiate: LEB Oral Maxillofacial Post Op Phase Admission/Transfer/Discharge
Physician Orders PEDIATRIC: LEB NEURO SURG Surgical Spine Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Neuro Surg Spine Postop Phase, When to Initiate: LEB Neuro Surgical Spine Post Op Phase Admission/Transfer/Discharge
Sample. Affix patient label within this box.
Instructions for completing orders: Determine PRAM Clinical Score as per the Alberta Acute Childhood Asthma Pathway for Emergent/Urgent Care and select orders based on PRAM Score. Custom orders can be
Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Kidney-Panc/Panc Transp Post Op Phase, When to Initiate: Kidney-Panc/Panc Transp Post Op Phase Vital Signs Vital
Physician Orders ADULT: Medical Response Team Standing Orders Protocol Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase When to Initiate: Other-See Special Instructions, If MRT is notified per MD, Condition H or any associate, review and Initiate
Physician Orders ADULT: Head and Neck Postoperative Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Head and Neck Postoperative Phase, When to Initiate: Head and Neck Post Operative Phase, Monitor and Record T,P,R,BP,
Physician Orders ADULT: Acute MI/Acute Coronary Syndrome Adult Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Acute MI/Acute Coronary Syndrome Adult Phase, When to Initiate: Acute MI/Acute Coronary Syndrome Adlt Phase Non Categorized
Physician Orders PEDIATRIC: LEB Eating Disorder Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Eating Disorder Admit Phase, When to Initiate: When patient arrives to unit LEB Eating Disorder Admit Phase Admission/Transfer/Discharge
Physician Orders: Pediatric. Title: LEB PICU Asthma Plan [X or R] = will be ordered unless marked out.
![Physician Orders: Pediatric. Title: LEB PICU Asthma Plan [X or R] = will be ordered unless marked out.](/thumbs/71/65974412.jpg "Physician Orders: Pediatric. Title: LEB PICU Asthma Plan [X or R] = will be ordered unless marked out.")
Height: cm Weight: kg Allergies: [ ] No known allergies [ ]Medication allergy(s): [ ] Latex allergy [ ]Other: Uncategorized [X] Initiate Powerplan Phase T;N, Phase: LEB PICU Asthma Phase When to Initiate:
Sample. Affix patient label within this box.
Instructions for completing orders Complete pages 1-3 for General Inpatient Orders. All pathway compatible orders (indicated by ) within the General Inpatient Orders will be followed automatically. Optional
Physician Orders ADULT: ANES Enhanced Recovery After Surgery (ERAS) Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Anes (ERAS) Pre-insertion Phase, When to Initiate: Other-See Special Instructions,
Physician Orders. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out.
![Physician Orders. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out.](/thumbs/77/75931338.jpg "Physician Orders. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out.")
Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Latex allergy [ ]Other: [ ] Initiate Powerplan Phase, Phase: LEB NICU Sepsis Phase Admission/Transfer/Discharge [ ] Patient Status Initial Inpatient
Asthma Care in the Emergency Department Clinical Practice Guideline
Asthma Care in the Emergency Department Clinical Practice Guideline Inclusion: 1) Children 2 years of age or older with a prior history of wheezing, and 2) Children less than 2 years of age with likely
Physician Orders ADULT: Renal Transplant Admit Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Renal Transplant Admit Phase, When to Initiate: Renal Transplant Admit Phase Non Categorized Initiate Powerplan Phase,
Attach patient label here. Physician Orders ADULT: Palliative Care Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Palliative Care Phase, When to Initiate: Palliative Care Phase Admission/Transfer/Discharge Patient Status Initial
Physician Orders LEB PICU Status Epilepticus Plan. [ ] No known allergies
![Physician Orders LEB PICU Status Epilepticus Plan. [ ] No known allergies](/thumbs/80/82315048.jpg "Physician Orders LEB PICU Status Epilepticus Plan. [ ] No known allergies")
Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Initiate Powerplan Phase T;N, Phase: LEB PICU Admit Phase Admission/Transfer/Discharge [ ] Admit Patient to Dr. [ ] Admit Status: [ ] Inpatient
Physician Orders ADULT: PCI Post Procedure Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: PCI Post Procedure Phase, When to Initiate: Initiate Powerplan Phase Phase: Post Cath/PCI Hydration Protocol Phase,
PEDIATRIC ACUTE ASTHMA SCORE (P.A.A.S.) GUIDELINES. >97% 94% to 96% 91%-93% <90% Moderate to severe expiratory wheeze
Inclusion: Children experiencing acute asthma exacerbation 24 months to 18 years of age with a diagnosis of asthma Patients with a previous history of asthma (Consider differential diagnosis for infants
Physician Orders ADULT Order Set: Respiratory Failure Orders
[R] = will be ordered Height: cm Weight: kg Allergies: [ ] No known allergies [ ]Medication allergy(s): [ ] Latex allergy [ ]Other: Admission/Transfer/Discharge [ ] Patient Status Initial Inpatient Attending
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available ONLY at: BMC-B BMC-D BMC-N BMC-S Intubation Phase Notify Therapy for STAT intubation SUB Rapid Sequence Induction(SUB)* ***The above subphase is available at the end of the powerplan under the
AT TRIAGE. Alberta Acute Childhood Asthma Pathway: Evidence based* recommendations For Emergency / Urgent Care
1 1 Should the child be placed into the Pathway? Asthma Clinical Score (PRAM) Inclusion Children 1 year and 18 years of age who present with wheezing and respiratory distress, and have been diagnosed by
Physician Orders ADULT: Vascular Surgery AAA Endovascular Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Endovascular PACU Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,
Physician Orders ADULT: Ortho Total Joint Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Ortho Total Joint Preop Phase, When to Initiate: Other-See Special Instructions, initiate
Emergency Department Protocol Initiative
Emergency Department Protocol Initiative ACUTE ASTHMA MANAGEMENT TOOLKIT March 2006 Provincial Emergency Services Project PHYSICIAN ORDER TEMPLATE FOR CTAS LEVEL 1 ASTHMA ADULT PEDIATRIC Date: Site: Arrival
PEDIATRIC LIFEGIFT BRAIN DEATH PLAN
PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer THIS PLAN IS TO BE ED ONLY ON THE LIFEGIFT ENCOUNTER, WITH DR LIFEGIFT AS THE ATTENDING. Patient Status Pt Status: Inpatient (Inpatient only
Physician Orders. PED Endocrine General Admit Plan [X or R] = will be ordered unless marked out. [ ] No known allergies
![Physician Orders. PED Endocrine General Admit Plan [X or R] = will be ordered unless marked out. [ ] No known allergies](/thumbs/90/102440183.jpg "Physician Orders. PED Endocrine General Admit Plan [X or R] = will be ordered unless marked out. [ ] No known allergies")
Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Initiate Powerplan Phase T;N, Phase:PED Endo General Admit Phase Admission/Transfer/Discharge [ ] Admit Patient to Dr. Admit Status: [ ] Inpatient
ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS
DRUG AND TREATMENT Intubation Phase Notify Therapy for STAT intubation Medications SUB Rapid Sequence Induction (SUB)* ***Reminder: Order SUB Rapid Sequence Induction (SUB) on a separate form*** lidocaine
Physician Orders PEDIATRIC: LEB Ortho Accelerated Posterior Spinal Fusion Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: LEB Ortho Accelerated PSF Post Op Initial Phase, When to Initiate: Initiate Powerplan Phase Phase: LEB Ortho Accelerated
Standard Precautions Droplet Precautions Standard Precautions Contact Precautions Droplet Precautions Standard Precautions Neutropenic Precautions
Unique Plan Description: Neurosurgery Subarachnoid Hemorrhage Admission Adult Plan Selection Display: Neurosurgery Subarachnoid Hemorrhage Admission Adult PlanType: Medical Version: 10 Begin Effective
Physician Orders ADULT: Vascular Surgery AAA Repair Open Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Repair Open Postop Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,
Emergency Department Guideline. Asthma
Emergency Department Guideline Inclusion criteria: Patients 2 years old with: o Known history of asthma or wheezing responsive to bronchodilators presenting to the ED with cough, wheeze, shortness of breath,
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Non Categorized SUB Sub Phase (SUB)* Non Categorized Quality Measures STK Diet ED NPO Until Bedside Swallow Screen passed Nursing Orders Activate Code Stroke Vital Signs Q15MINS Int
Emergency Department Guideline. Anaphylaxis
Emergency Department Guideline Inclusion criteria: 1. Acute onset of an illness (minutes to hours) with a AND (b OR c): a. Skin and/or mucosa (pruritus, flushing, hives, angioedema) b. Respiratory compromise
(31189) Hypothermia Initiation Phase One
Hypothermia Initiation Phase One Diagnosis Allergies For hypothermia tracking purposes only. Please do not uncheck.- Required Cardiac Emergency Tracking For hypothermia tracking purposes only. Consults
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S Nursing Orders Communication Order If CVP unavailable, administer fluid boluses every 30 minutes except monitor O2 requirements Comments: Every
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available at: BMC-B BMC-D BMC-N BMC-S Activity Activity Bedrest with BRP, with assistance at nurse's discretion (DEF)* Ambulate with Assistance Diet Communication Order Patient to remain NPO while in PACU
PHYSICIAN ORDERS Diagnosis
PICU PROCEDURE PLAN PHYSICIAN S Diagnosis Weight Allergies DETAILS Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Patient Care
PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase:.
- Phase:. PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert IV to INT when tolerating
ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS
Available at: ALL Adult Facilities Non Categorized SUB Protocol(SUB)* SUB Protocol Lab Orders(SUB)* ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as a separate form*** Nursing Orders
LIFEGIFT BRAIN DEATH PLAN
Diagnosis Weight Allergies Admit/Discharge/Transfer ***THIS PLAN IS TO BE ED ONLY ON THE LIFEGIFT ENCOUNTER, WITH DR LIFEGIFT AS THE ATTENDING*** Patient Status Pt Status: Inpatient (Inpatient only procedure)
PICU BRONCHIOLITIS PLAN
PICU BRONCHIOLITIS PLAN Diagnosis Weight PHYSICIAN S Allergies Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Patient Care Code
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT *****ALSO ORDER SUB ACUTE DKA IV FLUIDS REGIMEN & SUB ACUTE ELECTROLYTE REPLACEMENT on separate forms ***** Condition/Status For purpose of this DKA Regimen, DKA is considered clear
Physician Orders ADULT: Routine Deceased Donor Adult Plan
Initiate Orders Phase Non Categorized NOTE: Nurse - confirm PM Discharge disposition set to "Donor and or Life Support" on hospital encounter. Enter these orders on new OP encounter created by Access/Registration
Physician Orders ADULT: Cardiac Surgery Post Op Plan
Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Cardiac Surgery Post Op Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients (Vent
PEDIATRIC CYSTIC FIBROSIS PLAN - Phase:.
PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Per Unit Standards, with Sleeping SpO2 nightly until sat greater than 92% Daily Weight Every AM In AM on Monday, Wednesday,
PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders
- Phase: Pediatric Spine Surgery General Orders PHYSICIAN S Diagnosis Weight Allergies Patient Care Patient Activity Bedrest Maintain Surgical Drain Maintain JP Drain, Measure Output q12h, and PRN Convert
10/6/2014. Tommy s Story: An Overview of Asthma Mangement. Disclosure. Objectives for this talk.
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WHS POSTOPERATIVE POWERPLAN CHANGES
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