***SPECIAL CONSIDERATION:

Similar documents
Bariatric Surgery Post Op Plan PACU Phase

IV Acetaminophen Pain Study for Neurosurgery Post Op Non ICU Admit Plan Begin Immediately/PACU

BARIATRIC SURGERY POST-OP PLAN - Phase: PACU Phase

ORTHO TOTAL KNEE REPLACEMENT POST-OP PLAN - Phase: PACU Ortho Phase

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post-Op Plan - PACU Ortho Phase

Gabapentin Research Pain Study for Ortho Total Knee Replacement Post Op Plan PACU Ortho Phase

PICU ADMIT DKA PLAN - Phase: Begin Immediately

ADMIT DIABETIC KETOACIDOSIS (DKA) PLAN - Phase: Begin Immediately/Emergency Center

THROMBOLYTIC THERAPY FOR PERIPHERAL OCCLUSION

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

ADMIT GENERAL MEDICINE PLAN - Phase: Begin Immediately

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase:.

GENERAL MEDICINE PLAN

ISCHEMIC STROKE/TIA PLAN

DONATION AFTER CARDIAC DEATH PLAN

NEUROSURGERY ICU PLAN

PEDIATRIC SPINE SURGERY POST-OP PLAN - Phase: Pediatric Spine Surgery General Orders

Pediatric Outpatient Surgery Plan - Diagnostic/Pre-Op Orders

PHYSICIAN ORDERS Diagnosis

PEDIATRIC CYSTIC FIBROSIS PLAN - Phase:.

EPIDURAL / INTRATHECAL POST-OP PLAN

GENERAL SURGERY POST-OP PLAN

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP ADMIT PLAN - Phase: Begin Immediately/PACU

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN

GENERAL SURGERY PLAN - Phase:.

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

Physician Orders ADULT: ANES Enhanced Recovery After Surgery (ERAS) Plan

Card Open Heart POD1 POD3 Plan Post Op Day 1

ISCHEMIC STROKE/TIA PLAN

ENT THYROIDECTOMY/PARATHYROIDECTOMY POST OP PLAN - Phase: Begin Immediately/PACU

INPATIENT INTERVENTIONAL RADIOLOGY PLAN - Phase: Pre-Procedure Orders

DRUG ALLERGIES WT: KG

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

ADMIT STROKE NEUROINTERVENTION PLAN - Phase: Begin Immediately

OB/GYN POSTPARTUM VAGINAL DELIVERY PLAN

PHYSICIAN S ORDERS Page 1 of 1 Providence Hospital ICU Insulin Drip Protocol

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

LYSIS OF ADHESIONS POST-OP PLAN - Phase: PACU Phase

CARD POST CARDIAC CATHETERIZATION PLAN

NEUROSURGERY ICU PLAN

CARD POST CARDIAC CATHETERIZATION PLAN

WHS POSTOPERATIVE POWERPLAN CHANGES

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PICU BRONCHIOLITIS PLAN

(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder

STROKE NEUROINTERVENTION PLAN - Phase:.

WRHA Surgery Program. Obstructive Sleep Apnea (OSA)

LIFEGIFT BRAIN DEATH PLAN

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

OB/GYN CESAREAN SECTION POST-OP PLAN - Phase: General Orders

Physician Orders PEDIATRIC: LEB Critical Care Respiratory Plan

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP ADMIT PLAN - Phase: Begin Immediately/PACU Phase

SEPSIS PLAN - Phase:.

CARD THORACOTOMY PRE-OP PLAN

OPEN AAA/MAJOR ABDOMINAL POST-OP PLAN - Phase:.

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

Physician Orders. PED Endocrine General Admit Plan [X or R] = will be ordered unless marked out. [ ] No known allergies

Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017

ADMIT CHEST PAIN PLAN - Phase: Begin Immediately

Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan

UMC Health System Patient Label Here PHYSICIAN ORDERS

SHINE Study PowerChart Order Set CONTROL

UMC Health System Patient Label Here. PHYSICIAN ORDERS Diagnosis

Physician Orders PEDIATRIC: LEB DKA Diabetes Mellitus Admit Plan

Physician Orders ADULT: Asthma and Bronchitis Plan

*111* attach patient label here

DRUG ALLERGIES WT: KG

TRAUMA AND SURGICAL ICU PLAN

DRUG ALLERGIES WT: KG

Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other

2019 Home Hemodialysis Standing Orders

Physician Orders ADULT: Head and Neck Postoperative Plan

PHYSICIAN ORDERS Diagnosis

TRANSCATHETER AORTIC VALVE REPLACEMENT POST- OP PLAN - Phase:.

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

1. Attending Physician: Dr Syn Pager: Cell: Co-Morbidities:

Physician Orders ADULT: Sickle Cell Inpatient Plan

DRUG ORDERING & DISPENSING:

Fairview Southdale Hospital Total Points: 50 RN/LPN Medication Assessment Passing: 45

OB/GYN ANTEPARTUM PLAN

CARD OPEN HEART PRE-OP PLAN

Physician Orders ADULT: Medical Response Team Standing Orders Protocol Plan

PEDIATRIC PICU TRAUMA PLAN EKM - Phase: PICU Trauma Plan

Physician Orders PEDIATRIC: LEB Oral Maxillofacial Post Op Plan

IR Central Venous Access [ ] Pre Procedure

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS

Physician Orders ADULT: LEB Asthma Admit Plan. Anticipated LOS: 2 midnights or more Patient Status Initial Outpatient T;N Attending Physician:

PEDIATRIC LIFEGIFT BRAIN DEATH PLAN

UMC Health System Patient Label Here PHYSICIAN ORDERS

Sample. Fractured Hip Post-Operative Orders. Legend < Mandatory fields o Optional fields. Height Allergies: List or o Up to date in electronic system

Subspecialty Rotation: Anesthesia

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

ALL orders are active unless: 1. Order is manually lined through to inactivate 2. Orders with check boxes ( ) are unchecked DRUG AND TREATMENT ORDERS

IDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015

Physician Orders LEB PICU Status Epilepticus Plan. [ ] No known allergies

CBC with Differential. PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

Transcription:

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 apnea (OSA) AND receive IV sedating medications intra-operative/intra-procedure (EXCLUDING case start sedating medications), or during Phase II recovery, should be, at the discretion of the anesthesia provider, transferred to a higher level of monitoring to PACU*** Convert IV to INT When tolerating PO liquids Deaccess Implanted Port Rapid Response Team or UMC credentialed staff to deaccess implanted port prior to discharge. heparin flush (heparin flush 100 units/ml injection) 3 ml, IVPush, inj, Prior to Discharge, Rapid Response Team or UMC credentialed staff to flush implanted port after deaccessing port. For administration Post-Op in OPS. Communication ***SPECIAL CONSIDERATION: Phase II (OPS) - Continuous Pulse Oximetry is mandatory for all patients with the following criteria: ASA Score of III or greater, prone positioning, obese patients and patients with a postive High Risk OSA Score*** Continuous Pulse Oximetry Notify Provider of VS Parameters SpO2 Less Than 92%, Notify anesthesia provider assigned to case Notify Provider (Misc) Notify Attending Anesthesiologist and Attending Surgeon, Reason: If unable to wean off O2 after two 15 min Room Air Trials Page: 1 of 9 Adult Anesthesia Post-Op Outpatient Surgery Plan Version: 1 Effective on: 08/01/15

ADULT ANESTHESIA POST-OP OUTPATIENT SURGERY PLAN PHYSICIAN S DETAILS If regional block performed by anesthesia: lower extremity non weight bearing, up with crutches only; if upper extremity block must use sling 24 hours for single injection and if catheter left in place then must use sling until catheter is removed. DISCHARGE: Patient may be discharged when Modified Post Anesthesia Recovery Score (MPAR) is 18 or above, per Department of Anesthesia Guidelines. DISCHARGE: Requires Anesthesiology Attending evaluation prior to discharge. DISCHARGE: Provide patient with discharge education for Regional Anesthesia (use the online education form under "depart, custom tab") DISCHARGE: With discharge phone call, specifically inquire about regional block and document patient report of numbness, pain, weakness, bruising. IV Solutions LR IV, 75 ml/hr IV, 100 ml/hr IV, 125 ml/hr IV, 150 ml/hr NS IV, 75 ml/hr IV, 100 ml/hr IV, 125 ml/hr IV, 150 ml/hr Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed..medication Management No IV narcotics or IV promethazine to be given Post-Op in OPS. ondansetron 4 mg, IVPush, soln, ONE TIME, PRN nausea/vomiting For administration Post-Op in OPS. Use surgeon preference for post-operative pain management. Laboratory POC Blood Sugar Check ONE TIME, on arrival Notify Provider (Misc) (Notify Provider of Results) Notify anesthesia provider assigned to case, Reason: blood sugar less than or greater than. Respiratory Page: 2 of 9 Adult Anesthesia Post-Op Outpatient Surgery Plan Version: 1 Effective on: 08/01/15

ADULT ANESTHESIA POST-OP OUTPATIENT SURGERY PLAN PHYSICIAN S DETAILS Oxygen Therapy 2-3 L/min, Via: Nasal cannula, Keep sats greater than: 92% Conduct a room air trial prior to discharge; If oxygen saturation is less than 92% resume oxygen therapy and re-trial prior to discharge. 8 L/min, Via: Simple mask, Keep sats greater than: 92% Conduct a room air trial prior to discharge; If oxygen saturation is less than 92% resume oxygen therapy and re-trial prior to discharge. 10 L/min, Via: Face tent, Keep sats greater than: 92% Conduct a room air trial prior to discharge; If oxygen saturation is less than 92% resume oxygen therapy and re-trial prior to discharge....additional Orders Page: 3 of 9 Adult Anesthesia Post-Op Outpatient Surgery Plan Version: 1 Effective on: 08/01/15

Dx PHYSICIAN S Weight Allergies DETAILS Patient Care POC Blood Sugar Check Per Sliding Scale Insulin Frequency AC & HS AC & HS 3 days TID BID q12h q6h q6h 24 hr q4h q2h Sliding Scale Insulin Protocol Follow SSI Reference Text Medications Medication sentences are per dose. You will need to calculate a total daily dose if needed. insulin regular () 0-10 units, subcut, inj, AC & nightly, PRN glucose levels - see parameters 0-10 units, subcut, inj, q6h, PRN glucose levels - see parameters 0-10 units, subcut, inj, q4h, PRN glucose levels - see parameters Continued on next page... TO Read Back Scanned Powerchart Scanned PharmScan Page: 4 of 9 Sliding Scale Insulin Protocol Plan Version: 3 Effective on: 08/27/14

PHYSICIAN S DETAILS 0-10 units, subcut, inj, q2h, PRN glucose levels - see parameters 0-10 units, subcut, inj, TID, PRN glucose levels - see parameters 0-10 units, subcut, inj, BID, PRN glucose levels - see parameters Page: 5 of 9 Sliding Scale Insulin Protocol Plan Version: 3 Effective on: 08/27/14

PHYSICIAN S DETAILS insulin regular () 0-12 units, subcut, inj, AC & nightly, PRN glucose levels - see parameters 0-12 units, subcut, inj, q6h, PRN glucose levels - see parameters 0-12 units, subcut, inj, q4h, PRN glucose levels - see parameters 0-12 units, subcut, inj, q2h, PRN glucose levels - see parameters Continued on next page... TO Read Back Scanned Powerchart Scanned. PharmScan Page: 6 of 9 Sliding Scale Insulin Protocol Plan Version: 3 Effective on: 08/27/14

PHYSICIAN S DETAILS 0-12 units, subcut, inj, TID, PRN glucose levels - see parameters 0-12 units, subcut, inj, BID, PRN glucose levels - see parameters insulin regular () 0-14 units, subcut, inj, AC & nightly, PRN glucose levels - see parameters minutes until BG is less than 300, then resume normal accucheck and sliding scale routine. Call physician 0-14 units, subcut, inj, q6h, PRN glucose levels - see parameters ; Continued on next page... To Read Back Scanned Powerchart Scanned PharmScan Order Take By Signature: Date Time Page: 7 of 9 Sliding Scale Insulin Protocol Plan Version: 3 Effective on: 08/27/14

PHYSICIAN S DETAILS 0-14 units, subcut, inj, q4h, PRN glucose levels - see parameters ; minutes until BG is less than 300, then resume normal accucheck and sliding scale routine. Call physician 0-14 units, subcut, inj, q2h, PRN glucose levels - see parameters ; minutes until BG is less than 300, then resume normal accucheck and sliding scale routine. Call physician 0-14 units, subcut, inj, TID, PRN glucose levels - see parameters ; minutes until BG is less than 300, then resume normal accucheck and sliding scale routine. Call physician 0-14 units, subcut, inj, BID, PRN glucose levels - see parameters. Continued on next page... TO Read Back Scanned Powerchart Scanned PharmScan Page: 8 of 9 Sliding Scale Insulin Protocol Plan Version: 3 Effective on: 08/27/14

PHYSICIAN S DETAILS insulin regular (Blank Insulin Sliding Scale) See Comments, subcut, inj, PRN glucose levels - see parameters Blood glucose is less than ; Initiate hypoglycemic protocol and Call physician; 70-110 - units; 111-150 - units subq; 151-200 - units subq; 201-250 - units subq; 251-300 - units subq; 301-350 - units subq; 351-400 - units subq; Greater than 400 - units IV now, repeat accucheck in 30 minutes; continue to repeat 10 units IV and accuchecks every 30 minutes until BG less than, then resume normal accucheck and sliding scale routine. Call physician HYPOglycemia Protocol HYPOglycemia Protocol If BS is less than 70 mg/dl, and patient SYMPTOMATIC, give 6 oz. of juice PO (if applicable) and/or follow HYPOglycemia Protocol meds. glucose (D50) 25 g, IVP, syringe, as needed, PRN glucose levels - see parameters Patient unable to swallow / NPO WITH IV access. Dextrose 50% 50 ml IV. Recheck BG in 15-20 minutes. Repeat treatment until blood glucose greater than 100 mg/dl. If not NPO provide additional snack once able to swallow. glucose 15 g, PO, gel, as needed, PRN glucose levels - see parameters glucagon 1 mg, IM, inj, as needed, PRN glucose levels - see parameters Patient UNABLE to swallow / NPO WITHOUT IV access. Administer Glucagon 1 mg IM or SubQ. Contact physician for further orders. Establish IV access with saline lock. Recheck BG every 15 to 20 minutes. Use aspiration precautions as glucagon may cause nausea and vomiting. Page: 9 of 9 Sliding Scale Insulin Protocol Plan Version: 3 Effective on: 08/27/14

2024 © healthdocbox.com Privacy Policy | Terms of Service | Feedback