(31189) Hypothermia Initiation Phase One
|
|
|
- Ralf Douglas
- 5 years ago
- Views:
Transcription
1 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 Consult to Intensivist Indicate the physician group { } Staff to call consultant(s), add to the treatment team, and update the order with date and time of call placed. Consult to Cardiology Indicate the physician group { } Staff to call consultant(s), add to the treatment team, and update the order with date and time of call placed. Vital Signs Vital Signs Hypothermia Induction Procedures Intubate 1. Obtain vital signs including core temp, pulse, respiratory rate, BP, O2 saturation and document prior to initiation of cooling procedure. 2. Obtain vital signs every 15 minutes during the cooling process until target temperature is reached, then every 15 minutes x 4 and then hourly per maintenance phase. 3. More frequent vital signs as needed per unit policy or per patient condition. Oral gastric tube Indwelling Urinary Catheter with Bladder Temperature Probe Esophageal Temperature Probe Continuous to low intermittent suction. Care and maintenance per site specific policy. Continuous temperature monitoring with catheter to drainage bag. If patient arrives with an Indwelling Urinary Catheter without a temperature probe, do not remove catheter. Instead, place esophageal temperature probe for continuous temperature monitoring. Continuous temperature monitoring. Insert if patient has an Indwelling Urinary Catheter without temperature probe. Page 1 of 5
2 Respiratory Mechanical Ventilator Settings A Separate Order Set is Optional CMV / AC Mechanical Ventilator Settings CMV/AC (Controlled Mandatory Ventilation) Rate: [ ], Vt: [ ] ml, FIO2: [ ]%. Titrate O2 sats to > [ ] %. Other [ ]. PEEP +: [ ] cmh2o, Flow: Auto Flow Rate [ ] Lpm. PCV Mechanical Ventilator Settings Cooling Process Initiate cooling by applying Cooling Device/Unit Apply ice packs to axilla/groin areas (If cooling device is not available or incremental cooling is desirable) Cooling blankets (If cooling device is not available or incremental cooling is desirable) PCV (Pressure Control Ventilation) Rate: [ ], FIO2: [ ] %. Titrate O2 sats to > [ ] %. Other [ ]. Inspiratory Pressure [ ] cmh2o, PEEP +: [ ]cmh2o, I:E ratio: [ ] : [ ]. Cooling device per facility Hypothermia policy for cooling process. 1. Determine appropriate cooling pad size and order pads. 2. Apply cooling pads and connect/slave core temperature to cooling device. 3. Begin cooling process and document the time and method. 4. Set for 33 degrees Celsius and push the automatic mode button. 5. May place defibrillation pads under cooling pads if necessary. Initiate cooling process. 1. Initiate cooling with ice packs on patient s axilla, groin, neck and torso until cooling device blankets started. 2. Continue as needed once cooling device blankets applied. Initiate cooling process. 1. Place one cooling blanket under the patient and one over the patient with sheets placed between the patient and the cooling blankets. Set for 5 º Celsius. 2. Goal temperature is 33º Celsius. Temperature will fall a bit lower after cessation of active cooling. Page 2 of 5
3 Medications IV Fluids select a maintenance IV fluid CONTINUOUS, Intravenous, IV Fluid: [ ] With added potassium chloride [ ] meq per liter, With added [ ][ ] meq per liter, Rate: [ ] ml/hr. Medications Sedation - Additional bolus midazolam (VERSED) IV bolus Medications Sedation (Select ALL) LORazepam (ATIVAN) IV bolus LORazepam (ATIVAN) IV PRN LORazepam (ATIVAN) IV - infusion Medications Analgesia (Select ALL) fentanyl (SUBLIMAZE) IV - bolus fentanyl (SUBLIMAZE) IV - PRN fentanyl (SUBLIMAZE) IV - infusion ONE TIME, Intravenous, Dose: 2 mg. Give prior to starting sedation infusion therapy in addition to LORazepam bolus. ONE TIME, Intravenous, Dose: 2 mg. Give prior to starting sedation infusion therapy. Q30MIN PRN, Intravenous, Dose: 1-2 mg. PRN for sedation AND *Give LORazepam (ATIVAN) IV bolus dose PRIOR TO EACH LORazepam infusion rate increase.* CONTINUOUS, Intravenous, Dose: 1-5 mg/hr. Begin infusion at 1 mg/hr (usual infusion range: mg/hr). Titrate by 1 mg every 30 minutes as needed for sedation. Notify physician if dose exceeds 5 mg/hr. **Give LORazepam IV bolus dose PRIOR TO EACH infusion rate increase**. Comment: Usual infusion range: mg/hr. ONE TIME, Intravenous, Dose: 50 mcg. Give prior to starting fentanyl infusion. Q30MIN PRN, Intravenous, Dose: 50 mcg for pain or shivering. CONTINUOUS, Intravenous, Dose: 50 mcg/hr. Begin infusion at 50 mcg/hr (usual dose range: mcg/hr). Titrate by 25 mcg every 30 minutes as needed for pain or shivering. Notify physician if rate exceeds 300 mcg/hr. Comment: usual dose range: mcg/hr Page 3 of 5
4 Medications Paralytic Bolus (Single Select Section) atracurium (TRACRIUM) IV bolus vecuronium (NORCURON) IV bolus (ED ONLY) Medications Paralytic Infusion atracurium (TRACRIUM) IV infusion Laboratory ED ONLY POC / ISTAT TESTS ISTAT 8 I STAT Creatinine ISTAT ABG Troponin T, Qualitative, POC Laboratory Stat Basic Metabolic Panel STAT EACH TIME PRN, Intravenous, Dose: 0.4 mg/kg bolus. *GIVE A BOLUS DOSE prior to starting paralytic infusion.* May repeat bolus dose once, 30 minutes after initial bolus to abolish shivering. Patient MUST be intubated, sedated and mechanically ventilated prior to and during paralytic treatment. **NEUROMUSCULAR BLOCKER EACH TIME PRN, Intravenous, Dose 0.1 mg/kg. *GIVE A BOLUS DOSE prior to starting paralytic infusion.* May repeat bolus dose once, 30 minutes after initial bolus to abolish shivering. *FOR USE IN ED ONLY.* Patient MUST be intubated, sedated and mechanically ventilated prior to and during paralytic treatment. **NEUROMUSCULAR BLOCKER CONTINUOUS, Intravenous, Dose: 4 mcg/kg/min. (Usual dosage is 4-12 mcg/kg/min.) Begin after paralytic bolus dose. Patient MUST be intubated, sedated and mechanically ventilated prior to and during paralytic treatment. Train of Four Monitoring (TOF) Via Peripheral Nerve Stimulation: 1) Get baseline TOF before paralytic bolus and initiation of infusion. Document level of current and response. 2) Titrate infusion by 1mcg/kg/min to obtain 2 out of 4 TOF. 3) Measure TOF hourly. Notify physician if no response. 4) Call physician if shivering is observed. Comment: usual dosage is 4-12 mcg/kg/min Page 4 of 5
5 Arterial Blood Gas CBC with Platelets INR Lactate CK-MB Index Panel Troponin T Quant Magnesium Hepatic Function Panel Brain Natriuretic Peptide Pregnancy, Serum EKG 12 Lead EKG STAT 12 Lead EKG STAT For all women less than 50 years of age. STAT. ONE TIME, Post arrest. STAT. ONE TIME, Repeat in one hour after admission. Medical Imaging XR Chest Portable 1 View Post Arrest RAD ONE TIME, STAT, for evaluation of ETT placement and to confirm esophageal probe placement if appropriate. CT Head without Contrast RAD ONE TIME, STAT. Reason for exam: [ ]. Hypothermia Initiation Phase II Admission A separate order set is available Additional Orders Physician Signature Date Time Page 5 of 5
Therapeutic Hypothermia for Post Cardiac Arrest Plan Initial Orders
Arrest Plan Initial Orders Weight Allergies Therapeutic Hypothermia Guidelines ***Required to continue with ordering Plan.*** Strict Intake and Output q1h, throughout cooling and re warming. Set Up for
PICU Therapeutic Hypothermia Post Cardiac Arrest Re Warming Phase
Arrest Re Warming Phase Weight Allergies Patient Care ***After 24 hours initiate re warming (or after 72 hours for an infant less than one month old)*** PICU Re Warming Protocol ***See Reference Text***
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
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)
Hypothermia Short Set-Critical Care HYPOTHERMIA SS- CRITICAL CARE
Hypothermia Short Set-Critical Care HYPOTHERMIA SS- CRITICAL CARE Inclusion Criteria all must be present Cardiac arrest with return of spontaneous circulation (ROSC) ROSC within 60 mins of witnessed arrest;
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 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
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
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)*
SYSTEM-WIDE POLICY & PROCEDURE MANUAL. Policy Title: Hypothermia Post Cardiac Arrest Policy Number: PC-124. President & CEO Page 1 of 9
Approved By: President & CEO Date Page 1 of 9 POLICY: PURPOSE: To define and describe the implementation of induced hypothermia post cardiac arrest and the nursing assessment and interventions required
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
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 SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT 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***
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
Available at ALL facilities Non Categorized SUB ED Chest Pain: STEMI Protocol(SUB)* SUB ED Chest Pain: STEMI Protocol Lab Orders(SUB)* ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as
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
Baptist Health South Florida - Therapeutic Hypothermia for Comatose Survivors of Cardiac Arrest Critical Care / ICU Admission Orders
Date: Time: Inclusion Criteria all must be checked: Non traumatic cardiac arrest with return of spontaneous circulation (ROSC ) Mean arterial blood pressure maintained greater than 50 either with fluids
Routine, Every 2 hours, Starting today, If temperature greater than 38.5 C initiate Evaluation for Possible Sepsis Physician Order #829
Height Weight Allergies General Vital Signs [X] Frequent vital signs Indication: Q15 minutes x (# of occurrences): 4 Q30 minutes x (# of occurrences): 4 Q1 hour x (# of occurrences): Q2 hours x (# of occurrences):
Standardize comprehensive care of the patient with severe traumatic brain injury
Trauma Center Practice Management Guideline Iowa Methodist Medical Center Des Moines Management of Patients with Severe Traumatic Brain Injury (GCS < 9) ADULT Practice Management Guideline Contact: Trauma
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 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
Therapeutic Hypothermia after Resuscitated Cardiac Arrest
Therapeutic Hypothermia after Resuscitated Cardiac Arrest The purpose of this protocol is to improve the neurologic outcomes of patients who have experienced cardiac arrest and have been successfully resuscitated.
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
DONATION AFTER CARDIAC DEATH PLAN
DONATION AFTER CARDIAC DEATH PLAN Diagnosis Weight Allergies Patient Care Core Body Temperature Monitoring Maintain body temp 96-99 degrees Farenheit. Utilize Hyper/Hypothermia blanket prn Insert Gastric
POST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT
PHYSICIAN S SHEET Automatically Activate, if not in agreement, cross out and initial Activated by Checking Box ALLERGIES: None known YES Patient s Height: Patient s Weight: ALL MEDICATION and INTRAVENOUS
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,
Printed copies of this document may not be up to date, obtain the most recent version from
Children s Acute Transport Service Clinical Guidelines Acute Severe Asthma Document Control Information Author E Randle Author Position CATS Consultant Document Owner E Polke Document Owner Position Co-ordinator
Organ Donor Management Recommended Guidelines ADULT Brain Death (NDD)
Date: Time: = Always applicable = Check if applicable ADMISSION INSTRUCTIONS Neurological Determination of Death (NDD) has been performed by at least 2 licensed physicians Contact initiated with BC Transplant
INDUCED HYPOTHERMIA. F. Ben Housel, M.D.
INDUCED HYPOTHERMIA F. Ben Housel, M.D. Historical Use of Induced Hypothermia 1950 s - Moderate hypothermia (30-32º C) in open heart surgery to protect brain against global ischemia 1960-1980 s - Use of
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,
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
INPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders
- Phase: Pre-Procedure Orders DETAILS Patient Care Obtain Consent If one is not present on chart today. Vital Signs Per Policy Insert Peripheral Line T;N, Start IV on right side If left radial access is
Emergency Department Chest Pain, Suspected Cardiac Adult Order Set
Form Title Form Number Chest Pain, Suspected Cardiac Adult Order Set 20746 2018, Alberta Health Services, CKCM This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
Physician Orders Pediatric: LEB ED Asthma Plan
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
UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
PICU GENERAL PLAN UMC Health System PHYSICIAN S Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards Daily Weight Patient Activity Bedrest Up Ad Lib/Activity as Tolerated Strict Intake
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
Organ Donor Management Recommended Guidelines ADULT CARDIAC DEATH (DCD)
Date: Time: = Always applicable = Check if applicable ADMISSION INSTRUCTIONS Move to Comfort Care Note in chart. Contact initiated with BC Transplant Consent for Organ Donation obtained Code Status: Full
Module 2. Troubleshooting / Case Studies
Module 2 Troubleshooting / Case Studies Alarms / Alerts If an alarm or alert occurs, the Arctic Sun will produce both an audible and visual cue The screen will appear that displays: alarm or alert number,
PICU ADMIT DKA PLAN - Phase: Begin Immediately
- Phase: Begin Immediately Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: PICU, Pt Status: Inpatient (LOS > 2 midnights) Requested Location: PICU, Pt Status: Observation
PHYSICIAN'S ORDERS Mark in for desired orders. If is blank, order is inactive. VENTILATOR SEDATION / ANALGESIC / DELIRIUM ORDER
Nursing Daily awakenings PHYSICIAN'S ORDERS Mark in for desired orders. If is blank, order is inactive. VENTILATOR SEDATION / ANALGESIC / DELIRIUM ORDER Do not perform daily awakenings: Rationale: Daily
State of Florida Hypothermia Protocol. Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology
State of Florida Hypothermia Protocol Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology I. Entry Criteria 1. Gestational Age greater than or equal to 35 weeks gestation
Hypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC
Hypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC Objectives 1. Define Hypoxic-Ischemic Encephalopathy (HIE) 2. Identify the criteria used to determine if an infant qualifies for therapeutic
Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other
![Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other](/thumbs/96/128298591.jpg "Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other")
Neurosurgery Pre-Op [1710] Patient Name MRN General Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT Inpatient Only Procedure (Single Response) ( ) Admit to Inpatient Diagnosis:
ADULT POST NEUROLOGIC INTERVENTION ORDERS 2 of 4
9 Actual 9 Estimated DOWNTIME INTERVENTION 1 of 4 Weight kg 9 Actual 9 Estimated Height cm ALLERGIES: REFER TO ALLERGY PROFILE/ POWERCHART Admit to Dr.: Bed Type: Dx: ( ) Check, circle and/or fill in all
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: 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 s Order Form. Physician s Order Form. Telemetry/Progressive Care Orders. Continued on next page. >>>>>>> Continued on next page.
DATE: TIME: DATE TIME INTRAVENOS FLID and MEDICATION Status: Admit to Telemetry Admit to Progressive Care nit Transfer to Progressive Care nit Note: Discontinue Previous Orders Transfer to Telemetry nit
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:
INTUBATION/RSI. PURPOSE: A. To facilitate secure, definitive control of the airway by endotracheal intubation in an expeditious and safe manner
Manual: LifeLine Patient Care Protocols Section: Adult/Pediatrics Protocol #: AP1-009 Approval Date: 03/01/2018 Effective Date: 03/05/2018 Revision Due Date: 12/01/2018 INTUBATION/RSI PURPOSE: A. To facilitate
WHS POSTOPERATIVE POWERPLAN CHANGES
Medications simplified and standardized to improve safety and effectiveness in the management of pain, itching, nausea/vomiting. Management: o The Anesthesiologist will continue to manage pain in the PACU.
Targeted Temperature Management: Normothermia for Neuroprotection
Targeted Temperature Management: Normothermia for Neuroprotection I. Rationale Elevated body temperature is associated with increased cerebral metabolic rate and associated metabolic demand, which can
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
EFFECTIVE DATE: 01/2007 REVISED: 07/2008, 6/11, 3/12, 8/12, 1/15. Purpose:
1 TITLE/DESCRIPTION: DEPARTMENT: PERSONNEL: Rapid Response Team (RRT) Patient Care Services RN s and RT s EFFECTIVE DATE: 01/2007 REVISED: 07/2008, 6/11, 3/12, 8/12, 1/15 Purpose: A group of select health
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
Module 3 Troubleshooting/Case Studies
Module 3 Troubleshooting/Case Studies If an alarm or alert occurs, the ARCTIC SUN Temperature Management System will produce both an audible and visual cue A screen will appear that displays: alarm or
PICU CARD SURG Post Operative Cardiac Transplant Age LESS than 6 months (Page 1 of 5)
(Page 1 of 5) Code Status Full code Status/Admit/Transfer/Discharge Surgical Procedure(s) and date performed (if applicable): Cardiologist: Cardiac Surgeon: Intensivist: Patient Care CMV status Donor CMV
Zzbeacon,Zayna [MR ]
![Zzbeacon,Zayna [MR ]](/thumbs/89/98203205.jpg "Zzbeacon,Zayna [MR ]")
AALL1131-DS INDUCTION HR-ALL, DAYS 1-14 Properties Cycle 1 9/27/2012 through 10/10/2012 (14 days), Planned Day 1, Cycle 1 Planned for 9/27/2012 Release Labs CBC and differential Release Release Comprehensive
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: ALL Adult Facilities Non Categorized SUB ED Abdominal Pain Protocol(SUB)* ***The above subphase is available at the end of the plan*** SUB ED Abdominal Pain Protocol Lab
Zzbeacon,Zayna [MR ]
![Zzbeacon,Zayna [MR ]](/thumbs/86/93872827.jpg "Zzbeacon,Zayna [MR ]")
AALL1131 INTERIM MAINTENANCE, HR-ALL, ARM B, HD MTX Properties Cycle 1 9/27/2012 through 11/28/2012 (63 days), Planned Day 1, Cycle 1 Planned for 9/27/2012 Release CBC and differential Release Release
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 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:
UMC Health System Patient Label Here PHYSICIAN ORDERS
Weight Allergies Patient Care Vital Signs Per Unit Standards, Q5 min during critical event. Insert Peripheral Line Use 20 gauge or larger. Notify Nurse (DO NOT USE FOR MEDS) Place crash cart with cardiac
Therapeutic hypothermia
INDUCED HYPOTHERMIA Dr. Attilla Kiss M.D. Acting Medical Director Emergency Services EMS Medical Director St. John Medical Center OBJECTIVES Define and explain Induced Hypothermia Discuss both pre-hospital
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
Pediatric Intensive Care Unit (PICU) Pediatric Diabetic Ketoacidosis (DKA) Admission Order Set
Discontinue all previous orders Weight: kg DKA admit order set is for initial management Ongoing management required based on frequent reassessment of TFI, fluid balance and lab results. Admit to PICU
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
Prehospital Resuscitation for the 21 st Century Simulation Case. VF/Asystole
Prehospital Resuscitation for the 21 st Century Simulation Case VF/Asystole Case History 1 (hypovolemic cardiac arrest secondary to massive upper GI bleed) 56 year-old male patient who fainted in the presence
GENERAL ACUTE CORONARY SYNDROME (ACS) AND CHEST PAIN PAGE 1 OF
Status Orders (CHOOSE ONE) Admit to Inpatient Initiate to Observation Status Service: Admitting Physician: Level of Care: Acute Care Intermediate Care Critical Care Patient Class: Inpatient Diagnosis:
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
WEIGHT: KG HEIGHT: CM ALLERGY CAUTION sheet reviewed Code Status Full code
(Page 1 of 5) Code Status Full code Status/Admit/Transfer/Discharge Surgical Procedure(s) and date performed: Cardiologist: Cardiac Surgeon: Intensivist: Patient Care CMV status Recipient CMV status Donor
Level 1: Acute CHF with Hypotension (SBP < 90 torr)
PENNSYLVANIA HOSPITAL ED ACUTE CONGESTIVE HEART FAILURE STANDING DERS Level 1: Acute CHF with Hypotension (SBP < 90 torr) Intake: Vital signs Pulse oximetry Weight Allergies: Obtain old chart Obtain old
IDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015
Purpose: To provide guidance to practitioners caring for pediatric patients who need inpatient hospital care during a disaster. Disclaimer: This guideline is not meant to be all inclusive, replace an existing
Simulation 15: 51 Year-Old Woman Undergoing Resuscitation
Simulation 15: 51 Year-Old Woman Undergoing Resuscitation Flow Chart Flow Chart Opening Scenario Section 1 Type: DM Arrive after 5-6 min in-progress resuscitation 51 YO female; no pulse or BP, just received
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:
SUMMARY OF MAJOR CHANGES 2010 AHA GUIDELINES FOR CPR & ECC
SUMMARY OF MAJOR CHANGES 2010 AHA GUIDELINES FOR CPR & ECC The following is a summary of the key issues and changes in the AHA 2010 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac
Therapeutic Hypothermia. Jonas Cooper, MD MPH
Therapeutic Hypothermia Jonas Cooper, MD MPH Hypothermia in Cardiology Early cardiac surgery included cooling to 15 C and stopping all blood flow for one hour while surgery proceeded Belsey RH et al. Profound
Interventional Radiology Skills Checklist
Interventional Radiology Skills Checklist This assessment is for determining your experience in the below outlined clinical areas. This checklist will not be used as a determining factor in accepting your
IR Central Venous Access [ ] Pre Procedure
![IR Central Venous Access [ ] Pre Procedure](/thumbs/90/104119758.jpg "IR Central Venous Access [ ] Pre Procedure")
IR Central Venous Access [1050200001] Pre Procedure Case Request/Scheduling Procedure Enter IR Case Request if not already completed (All hospitals except Grant Medical Center) [ ] Case Request IR Lab
UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
PHYSICIAN S Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: NICU, Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Pt Status: Inpatient
SCVMC RESPIRATORY CARE PROCEDURE
Page 1 of 8 Rev. - 11/99, 11/05, 4/11 R-NC - 08/99,08/00, 04/03,10/08,04/09, 07/11, 6/12 B7180-43 OBJECTIVE Continuous Nebulization allows for continuous, controlled drug delivery to the lung, avoiding
** Medication exercises ** NICU Phase II
** Medication exercises ** NICU Phase II A) Baby A has had a bowel resection six hours ago. She weighs 3 kg. Post-op, she is quite agitated and she is on a fentanyl drip at 2 micrograms/kg/hr (#1). She
Printed copies of this document may not be up to date, obtain the most recent version from
Children s Acute Transport Service Clinical Guidelines Septic Shock Document Control Information Author Claire Fraser P.Ramnarayan Author Position tanp CATS Consultant Document Owner E. Polke Document
Q1HR (DEF)* Q2HR Intra-Abdominal Pressure Notify Provider if greater than 15mmHg, Q4HR Activity Activity Bedrest, Constant Indicator (DEF)* Bedrest
Unique Plan Description: ICU General Admission Adult Plan Selection Display: ICU General Admission Adult PlanType: Medical Version: 28 Begin Effective Date: 4/13/2015 03:46 End Effective Date: Current
Adult Critical Care Intravenous Infusions Titration Protocol
Adult Critical Care Intravenous Infusions Protocol Nursing staff to titrate drip to achieve goal ordered by provider in assigned time intervals. Amiodarone (Pacerone ) Argatroban Non-heparin anticoagulant
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
UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis
Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards q12h q12h, Temperature Only - Every Shift and PRN Patient Activity Assist as Needed, Bed Position: As Tolerated, elevate to patient
HeartCode PALS. PALS Actions Overview > Legend. Contents
HeartCode PALS PALS Actions Overview > Legend Action buttons (round buttons) Clicking a round button initiates an action. Clicking this button, for example, checks the child s carotid pulse. Menu buttons
Diagnosis: Allergies:
Patient Name: Diagnosis: Allergies: ICU Sepsis Version 5 1/11/17 This order set must be used with an admission order set if patient not already admitted. Nursing Orders Verify that cultures have been obtained
CBC with Differential. PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Non Categorized SUB ED Snakebite Protocol (SUB)* Non Categorized ***(NOTE)*** This plan is designed to be used as part of a larger plan, not independently. Please do NOT order individually.
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,
CLINICAL POLICY AND PROCEDURES
SUPERSEDES POLICY: PAGE: 1 OF 16 POLICY STATEMENT: Patients undergoing post-cardiac arrest resuscitation and therapeutic hypothermia (TH) will have nursing care provided according to the following policy.
Post Resuscitation (ROSC) Care
Standard Operating Procedure 2.10 Post Resuscitation (ROSC) Care Position Responsible: Medical Director Approved: Clinical Governance Committee Related Documents: This document is the intellectual property
Patient Case. Post cardiac arrest pathophysiology 10/19/2017. Disclosure. Objectives. Patient Case-TM
Disclosure TARGETED TEMPERATURE MANAGEMENT POST CARDIAC ARREST I have nothing to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect
Page 1 of 9 PATIENT PRESENTATION COOLING. See Page 2 for Re-Warming Phase. Patient not eligible for TTM protocol. Yes
1 Page 1 of 9 PATIENT PRESENTATION Cardiac arrest PEA Asystole Ventricular fibrillation Pulseless ventricular tachycardia Sustained ROSC greater than 20 consecutive minutes? PEA = pulseless electrical
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
UMC Health System Patient Label Here PHYSICIAN ORDERS
Diagnosis Weight Allergies Patient Care Vital Signs Per Unit Standards q12h q12h, Temperature Only - Every Shift and PRN Patient Activity Assist as Needed, Bed Position: As Tolerated, elevate to patient
New Therapeutic Hypothermia Techniques
New Therapeutic Hypothermia Techniques Joseph P. Ornato, MD, FACP, FACC, FACEP Professor & Chairman, Emergency Medicine Virginia Commonwealth University Health System Richmond, VA Medical Director Richmond
Post-Cardiac Arrest Syndrome. MICU Lecture Series
Post-Cardiac Arrest Syndrome MICU Lecture Series Case 58 y/o female collapses at home, family attempts CPR, EMS arrives and notes VF, defibrillation x 3 with return of spontaneous circulation, brought
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
(30689) PROT Pain PCA Adult Patient Controlled Analgesia
Diagnosis Allergies Nursing Assess and Document PCA: 1. Assess and document pain rating, sedation level and respiratory rate every 2 hours; assess and document pain rating, sedation level and respiratory
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,