Physician Orders PEDIATRIC: LEB Critical Care Respiratory Plan
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1 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 CPT/Hyperinflation Protocol Peak Flow prn PRN, Special Instructions: when patient is able to perform test Oxygen Delivery Special Instructions: Titrate to keep O2 sat at =/>92% per policy (DEF)* Special Instructions: Titrate to keep O2 sat =/> % Heliox Highflow, Nasal Cannula ETCO2 T;N Nasal CPAP T;N q4h(std) Bubble CPAP T;N q4h(std) Mechanical Ventilation (Ped) Ventilator Weaning Trial Medical by RT Special Instructions: Rt-wean per unit protocol Extubate-RT Special Instructions: Extubate patient per PICU Guidelines of Care NOTE: FLOW for High Frequency Ventilation <1000g (6-8)LPM, 1000g-2500g flow (10-12) LPM, Term infant with severe meconium aspiration: flow LPM(NOTE)* High Frequency Ventilation Nitric Oxide (RT) 20 ppm, optimum dose = 20 ppm (DEF)* optimum dose = 20 ppm wean by ppm, q hrs T;N Stat, Test Select ABG, Special (DEF)* T;N Stat, Test Select ABG Lactate, Special T;N Stat, Test Select ABG Electrolytes Hct and Hgb Glucose Ionized calcium, Special LEB Critical Care Respiratory Plan QM0209 PP Page 1 of 5 *065*
2 T;N Stat once, Test Select ABG Electrolytes Glucose Hct and Hgb Ionized calcium Lactate, Special T;N Stat, Test Select VBG, Special (DEF)* T;N Stat once, Test Select Lactate VBG, Special T;N Stat once, Test Select Electrolytes Hct and Hgb VBG Glucose Ionized calcium, Special T;N Stat once, Test Select VBG Electrolytes Hct and Hgb Lactate Glucose Ionized calcium T;N Stat once, Test Select CBG, Special (DEF)* T;N Stat once, Test Select CBG Lactate, Special T;N Stat once, Test Select CBG Electrolytes Glucose Hct and Hgb Ionized calcium, Special T;N Stat, Test Select CBG Electrolytes Hct and Hgb Lactate Glucose Ionized calcium, Special T;N Stat, Special Instructions: SVOT Co-oximetry (RT Collect) Routine q12h Continuous Infusion 1,000 ml, Intra-ARTERIAL, Routine, ml/hr, Infuse via ART line, To be performed by RT 1,000 ml, IV, Routine, ml/hr, Infuse via CVP line, To be performed by RT Heparin 2 Units/ml in 500 ml NS (Pediatric) 500 ml, IV, STAT, Infuse via central line Heparin 2 Units/ml in 500 ml NS (Pediatric) 500 ml, Intra-ARTERIAL, STAT, ml/hr, Infuse via arterial line +1 Hours 1/4NS + 1 unit/ml Heparin (Pediatric) (IVS)* sterile water 150 ml, IV, STAT, ml/hr Comments: Infuse via central or arterial line sodium chloride 5.8 meq Heparin 1000 units/ml Inj (additive) 150 units Medications Respiratory Medications LEB Critical Care Respiratory Plan QM0209 PP Page 2 of 5 *065*
3 Continuous Nebulization(NOTE)* 100 mg, 7.5 mg/hr 100 mg, 12.5 mg/hr 100 mg, 15 mg/hr Intermittent Nebulization(NOTE)* 2.5 mg, Inh Soln, NEB, q6h, PRN, Routine, (3 ml = 2.5 mg) 2.5 mg, Inh Soln, NEB, q6h, PRN Wheezing, Routine, (3 ml = 2.5 mg) Comments: (3 ml = 2.5 mg) 1.25 mg, Inh Soln, NEB, q6h, PRN, Routine, ( 1.5 ml = 1.25 mg) 1.25 mg, Inh Soln, NEB, q6h, PRN Wheezing, Routine, ( 1.5 ml = 1.25 mg) +1 Hours albuterol (MDI) puff, MDI, INH, q6h, Routine, (180 mcg = 2 puffs) +1 Hours albuterol (MDI) puff, MDI, INH, q6h, PRN Wheezing, Routine, (180 mcg = 2 puffs) +1 Hours ipratropium mg, Inh Soln, NEB, q8h, Routine, ( ml = mg) (DEF)* 0.25 mg, Inh Soln, NEB, q8h, Routine, ( 1.25 ml = 0.25 mg) 0.5 mg, Inh Soln, NEB, q8h, Routine, ( 2.5 ml = 0.5 mg) +1 Hours fluticasone CFC free 44 mcg/inh inhalation aerosol 88 mcg, MDI, INH, bid, Routine, (2 puffs = 88 mcg) +1 Hours fluticasone CFC free 110 mcg/inh inhalation aerosol 220 mcg, MDI, INH, bid, Routine, (2 puff = 220 mcg) +1 Hours fluticasone CFC free 220 mcg/inh inhalation aerosol LEB Critical Care Respiratory Plan QM0209 PP Page 3 of 5 *065*
4 440 mcg, MDI, INH, bid, Routine, (2 puff = 440 mcg) +1 Hours budesonide 0.25 mg, Inh Soln, NEB, bid, Routine, ( 2 ml = 0.25 mg) (DEF)* 0.5 mg, Inh Soln, NEB, bid, Routine, (2 ml = 0.5 mg) +1 Hours racepinephrine 2.25% inhalation solution 0.25 ml, Inh Soln, NEB, q4h, PRN Stridor, Routine +1 Hours sodium chloride 7% inh sol 2 ml, Inh Soln, NEB, bid, Routine, give after bronchodilator and before airway clearance (DEF)* 4 ml, Inh Soln, NEB, bid, Routine, give after bronchodilator and before airway clearance +1 Hours dornase alfa 2.5 mg, Inh Soln, NEB, QDay, Routine (DEF)* Comments: via PARI nebulizer (after hypertonic saline and before airway clearance) 2.5 mg, Inh Soln, NEB, bid, Routine Comments: via PARI nebulizer (after hypertonic saline and before airway clearance) +1 Hours sodium bicarbonate 4.2% inhalation solution 1 ml, Inh Soln, INH, q2h, PRN Other, specify in Comment, Routine, Secretions Comments: Mix each ml of 4.2% sodium bicarbonate with 2.25 ml sterile water. For ET suctioning. +1 Hours acetylcysteine 20% inhalation solution 1 ml, Inh Soln, NEB, q6h, PRN Other, specify in Comment, Routine, Secretions Comments: Mix each ml of acetylcysteine with 0.083% albuterol inhalation soln Inhaled Antibiotics(NOTE)* +1 Hours tobramycin inhalation soln 300 mg, Inh Soln, NEB, bid, Routine Laboratory Methemoglobin Time Study, q12h, Type: Blood Comments: if patient on nitric oxide Diagnostic Tests Chest 1VW Frontal T;N, Routine, Portable Chest PA & Lateral T;N, Routine, Portable Echocardiogram Pediatric (0-18 yrs) Start at: T;N, Priority: Routine, Transport: Portable Consults/Notifications/Referrals Notify Physician-Continuing Notify For: O2 sats less than or = 92% LEB Critical Care Respiratory Plan QM0209 PP Page 4 of 5 *065*
5 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 LEB Critical Care Respiratory Plan QM0209 PP Page 5 of 5 *065*
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 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
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 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 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 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 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 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 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
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,
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
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: 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
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 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 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
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
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 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 SIGNATURE DATE TIME
DRUG AND TREATMENT Condition/Status Patient Status (WCH) Patient Status: Inpatient Update Resident Team C (DEF)* A B X Vital Signs Vital Signs Q4H, Do not wake for vitals 2300-0700 (DEF)* DAILY Q4H Blood
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 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 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
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
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
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
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 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
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
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
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. 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
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 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 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
MASTER SYLLABUS
MASTER SYLLABUS 2018-2019 A. Academic Division: Health Science B. Discipline: Respiratory Care C. Course Number and Title: RESP 2490 Practicum IV D. Course Coordinator: Tricia Winters, BBA, RRT, RCP Assistant
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 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: 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:
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
***SPECIAL CONSIDERATION:
ADULT ANESTHESIA POST-OP OUTPATIENT SURGERY PLAN Dx PHYSICIAN S Weight Allergies DETAILS Admit/Discharge/Transfer Return Patient to PACU Patient Care ***Patients who are at high risk for obstructive sleep
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)
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: 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,
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
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
DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES
DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES DISCLAIMER: This Clinical Practice Guideline (CPG) generally describes a recommended course of treatment for patients with the identified health
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
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. 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
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 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,
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
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,
(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
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
THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION
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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***
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
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
Gabapentin Research Pain Study for Ortho Total Knee Replacement Post-Op Plan - PACU Ortho Phase
Total Knee Replacement Post-Op Plan - PACU Ortho Phase Diagnosis Weight Allergies Admit/Discharge/Transfer Patient Status Requested Location: 3W, Pt Status: Inpatient (LOS > 2 midnights) Patient Condition
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Patient: Becky Smith DOB: 01/26/XXXX Age: 5 y/o Attending: Dr. D. Miles Allergies: NKA MR#: 203. Patient Chart #203 Becky Smith
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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
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
Provide guidelines for the management of mechanical ventilation in infants <34 weeks gestation.
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Asthma Care in the Emergency Department Clinical Practice Guideline
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Division of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Admission Criteria Clinical Practice Policy
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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
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
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
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
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
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:
Airway Clearance Devices
Print Page 1 of 11 Wisconsin.gov home state agencies subject directory department of health services Search Welcome» August 2, 2018 5:18 PM Program Name: BadgerCare Plus and Medicaid Handbook Area: Durable
Objectives. Case Presentation. Respiratory Emergencies
Respiratory Emergencies Objectives Describe how to assess airway and breathing, including interpreting information from the PAT and ABCDEs. Differentiate between respiratory distress, respiratory failure,
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
Steven Berkowitz, DVM Chief, Emergency and Critical Care Saint Francis Veterinary Center
Steven Berkowitz, DVM Chief, Emergency and Critical Care Saint Francis Veterinary Center Outline Anatomy Common Diseases Interventions Oxygen Therapy Medications Nebulization Coupage Respiratory Tract
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
BPD. Neonatal/Pediatric Cardiopulmonary Care. Disease. Bronchopulmonary Dysplasia. Baby Jane
1 Neonatal/Pediatric Cardiopulmonary Care Disease 2 Bronchopulmonary Dysplasia 3 is a 33-day-old prematurely born girl who weighs 1420 g. At birth, her estimated gestational age was 28 weeks. Her initial
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***
Guidelines and Best Practices for Vapotherm High Velocity Nasal Insufflation (Hi-VNI ) NICU POCKET GUIDE
Guidelines and Best Practices for Vapotherm High Velocity Nasal Insufflation (Hi-VNI ) TM NICU POCKET GUIDE Patient Selection Diagnoses Patient presents with one or more of the following symptoms: These
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
DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Available at: BMC-B BMC-D BMC-N BMC-S Vital Signs Vital Signs Q4H (DEF)* Q2H Q1H Vital Signs Orthostatic Activity Activity Bedrest, for 12 hours then Up ad lib (DEF)* Bedrest, for 24
Protocol Update 2019
Protocol Update 2019 There have been several questions revolving around protocol updates and how they are to be conducted. As many of you are aware there is a protocol submission process in the appendix
Card Open Heart POD1 POD3 Plan Post Op Day 1
Day 1 PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Transfer Patient Transfer to: Floor, Pt Status: Inpatient (LOS > 2 midnights) Vital Signs q2h, POD 1 Vital Signs q2h for 24 hours then per unit
Management of acute asthma in children in emergency department. Moderate asthma
152 Moderate asthma SpO2 92% No clinical features of severe asthma NB: If a patient has signs and symptoms across categories, always treat according to their most severe features agonist 2-10 puffs via
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
(PLACE PATIENT LABEL HERE) Date: Time: Assessment nurse: Sign: STOP!
ASTHMA BEST CARE BUNDLE P A T H W A Y ADULT ASTHMA Date: Time: Assessment nurse: Sign: INCLUSION CRITERIA Known asthmatic Shortness of breath and / or wheeze EXCLUSION CRITERIA Chronic lung disease other
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
COMMISSION ON ACCREDITATION FOR RESPIRATORY CARE TMC DETAILED CONTENT OUTLINE COMPARISON
A. Evaluate Data in the Patient Record I. PATIENT DATA EVALUATION AND RECOMMENDATIONS 1. Patient history e.g., admission data orders medications progress notes DNR status / advance directives social history
I. Subject: Continuous Aerosolization of Bronchodilators
I. Subject: Continuous Aerosolization of Bronchodilators II. Indications: A. Acute airflow obstruction in which treatment with an aerosolized bronchodilator is desired for an extended period of time, i.e.
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
Adjunct Therapies for Pediatric ARDS: Where are the Data?
Adjunct Therapies for Pediatric ARDS: Where are the Data? Alexandre T. Rotta, MD, FCCM Professor of Pediatrics, Linsalata Family Endowed Chair in Pediatric Critical Care and Emergency Medicine Rainbow
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
NEUROSURGERY ICU PLAN
NEUROSURGERY ICU PLAN PHYSICIAN S Diagnosis Weight Allergies DETAILS Patient Care Vital Signs Per Unit Standards Per Unit Standards, including cerebral perfusion pressure (CPP) and end tidal CO2. Perform