INPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders

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1 - 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 needed POC by Nursing POC Chem 8 POC Blood Sugar Check POC Hemoglobin and Hematocrit POC PT with INR Communication Misc Patient Care Order IV Solutions NS IV, 20 ml/hr LR IV, 20 ml/hr Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. Antibiotics ceftriaxone 1 g, IVPush, inj, OCTOR Reconstitute with 10mL of sterile water. Administer IVPush over 3 minutes. cefazolin 1 g, IVPush, inj, OCTOR Reconstitute with 10mL of sterile water. Administer IVPush over 3 minutes. ampicillin-sulbactam 1.5 g, IVPB, ivpb, OCTOR, Infuse over 30 min clindamycin 900 mg, IVPB, ivpb, OCTOR Other Medications To be used as premeds for Transarterial Chemoembolization (TACE): diphenhydramine 50 mg, IVPush, inj, OCTOR Premed for Transarterial Chemoembolization (TACE) ondansetron 8 mg, IVPush, soln, OCTOR Premed for Transarterial Chemoembolization (TACE) 1

2 - Phase: Pre-Procedure Orders DETAILS dexamethasone 10 mg, IVPush, inj, OCTOR Premed for Transarterial Chemoembolization (TACE) Used for Vascular Cases with Radial Arterial Access lidocaine-prilocaine topical (lidocaine-prilocaine 2.5%-2.5% topical cream) 1 app, topical, cream, OCTOR Used During Vascular Procedures with Radial Arterial Access verapamil 2.5 mg, IVPush, inj, OCTOR Used During Vascular Procedures with Radial Arterial Access heparin 3,000 units, intra-arterial push, inj, OCTOR Used During Vascular Procedures with Radial Arterial Access nitroglycerin 200 mcg, intra-arterial push, inj, OCTOR Used During Vascular Procedures with Radial Arterial Access Laboratory CBC with Differential STAT Prothrombin Time with INR (PT with INR) STAT Urine Beta hcg Urine, STAT Diagnostic Tests EKG-12 Lead STAT, Pre-Procedure Exam DX Chest Portable STAT, Pre-Procedure exam Respiratory Oxygen Therapy 2

3 - Phase: History and Physical Documentation Order Diagnosis Weight Allergies DETAILS Patient Care Sedation History and Physical Update T;N 3

4 - Phase: Intra-Procedure Orders DETAILS Patient Care Patient Position Lying on Left Side Lying on Right Side Prone Supine Other Sedation Medications at Bedside Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. Other Medications lidocaine (lidocaine 1% injectable solution) 10 ml, locally, inj, ONE TIME For port placement only: bupivacaine (bupivacaine 0.25% preservative-free injectable solution) 30 ml, locally, inj, ONE TIME lidocaine-epinephrine (lidocaine-epinephrine 1%-1:200,000 preservative-free injectable solution) 10 ml, locally, inj, ONE TIME mepivacaine (mepivacaine 1% injectable solution) 1 ml, locally, inj, ONE TIME gentamicin (gentamicin 80 mg/50 ml irrigation) 80 mg, irrigation, ivpb, ONE TIME Flush port pocket Reversal Agent flumazenil 0.2 mg, IVPush, inj, q1min, PRN excess sedation naloxone 0.2 mg, IVPush, inj, q2min, PRN bradypnea 4

5 - Phase: Post-Procedure Orders DETAILS Patient Care Patient Activity Up Ad Lib/Activity as Tolerated Bedrest Bedrest, Bed Position: HOB Flat Convert IV to INT POC by Nursing POC Blood Sugar Check Communication Confirm Line Placement - Cleared for Use (Cleared for Use - CVL) Notify Nurse (DO NOT USE FOR MEDS) Notify Nurse (DO NOT USE FOR MEDS) T;N, Okay to resume diet per primary team recommendation Notify Provider of VS Parameters (Notify Provider if VS) Diagnostic Tests DX Chest Portable STAT, Post-Procedure exam 5

6 - Phase: Medication Documentation DETAILS...Additional Orders 6

7 - Phase: SEDATION MEDICATION DOCUMENTATION PLAN DETAILS Communication Procedural Sedation Medications Guidelin (Procedural Sedation Medications Guidelines) Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. Analgesics: Opioids fentanyl 25 mcg, IVPush, inj, OCTOR 50 mcg, IVPush, inj, OCTOR 75 mcg, IVPush, inj, OCTOR 100 mcg, IVPush, inj, OCTOR HYDROmorphone 0.5 mg, IVPush, inj, OCTOR 1 mg, IVPush, inj, OCTOR 2 mg, IVPush, inj, OCTOR morphine 2 mg, IVPush, inj, OCTOR 4 mg, IVPush, inj, OCTOR 10 mg, IVPush, inj, OCTOR Sedatives LORazepam 0.5 mg, IVPush, inj, OCTOR 1 mg, IVPush, inj, OCTOR 2 mg, IVPush, inj, OCTOR midazolam 0.5 mg, IVPush, inj, OCTOR 2 mg, IVPush, inj, OCTOR 4 mg, IVPush, inj, OCTOR 5 mg, IVPush, inj, OCTOR 7

8 - Phase: SEDATION MEDICATION DOCUMENTATION PLAN DETAILS The Following Medications are for Deep Sedation Use Only dexmedetomidine (dexmedetomidine 20 mcg/10 ml) 25 mcg, Slow IVPush, inj, OCTOR 50 mcg, Slow IVPush, inj, OCTOR 100 mcg, Slow IVPush, inj, OCTOR etomidate 5 mg, IVPush, inj, OCTOR 10 mg, IVPush, inj, OCTOR 20 mg, IVPush, inj, OCTOR ketamine 50 mg, IVPush, inj, OCTOR 100 mg, IVPush, inj, OCTOR 200 mg, IVPush, inj, OCTOR propofol 10 mg, IVPush, inj, OCTOR 20 mg, IVPush, inj, OCTOR 50 mg, IVPush, inj, OCTOR 100 mg, IVPush, inj, OCTOR 8

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