UMC Health System Patient Label Here PHYSICIAN ORDERS

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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 monitor, airway box, and suction equipment to bedside. SOB/CHF Exacerbation Patient Activity Bedrest, Bed Position: HOB >/= 30 degrees CBC Basic Metabolic Panel Arterial Blood Gas morphine 2 mg, IVPush, inj, ONE TIME Chest Pain Adult DX Chest Portable CBC Basic Metabolic Panel Troponin T Magnesium Level Page: 1 Rapid Response Plan Version: 3 Effective on: 04/30/14 Page 1 of 6

nitroglycerin (nitroglycerin sublingual) 0.4 mg, SL, tab, q5minx3, PRN chest pain aspirin USE FOR AMI, 324 mg, chewed, tab chew, ONE TIME This medication must be given immediately for AMI or STROKE. morphine 2 mg, IVPush, inj, q10min, PRN pain Administer until pain level is less than 4/10. Symptomatic Bradycardia Adult Place Device at Bedside DX Chest Portable Troponin T CK (Creatine Kinase) atropine 1 mg, IVPush, syringe, ONE TIME Symptomatic Tachycardia Adult DX Chest Portable Page: 2 Rapid Response Plan Version: 3 Effective on: 04/30/14 Page 2 of 6

Troponin T Symptomatic Hypotension Adult If the patient has received any narcotic medication in the last 24 hours: naloxone 0.4 mg, IVPush, inj, q2min, PRN bradypnea If patient has no cardiac history: NS (NS bolus) 500 ml, IVPB, ONE TIME, May repeat x1 if patient does not respond. 500 ml, IVPB, ONE TIME If the patient is actively bleeding and/or has had an Hgb less than 8 in the last four hours: ***To order Type and Crossmatch for 2 Units on Hold see...additional S category below*** Acute Seizures Adult LORazepam 1 mg, IVPush, inj, ONE TIME Phenytoin Level Free Perform Neurological Checks q15min, and Assess LOC. Accucheck Stat and repeat q30 min x 2 the q1h. If Blood Sugar < 70. If Blood Sugar less than 70 and patient is symptomatic: glucose (D50) 50 g, IVPush, syringe, ONE TIME, PRN glucose levels - see parameters Page: 3 Rapid Response Plan Version: 3 Effective on: 04/30/14 Page 3 of 6

Seizure Precautions Position patient on side. Altered Mental Status Urinalysis Urine, naloxone 0.4 mg, IVPush, inj, q2min, PRN bradypnea flumazenil 0.2 mg, IVPush, inj, ONE TIME Accucheck Stat and repeat q30 min x 2 the q1h. If Blood Sugar < 70. If Blood Sugar less than 70 and patient is symptomatic: glucose (D50) 50 g, IVPush, syringe, ONE TIME, PRN glucose levels - see parameters Perform Neurological Checks q15min, and assess LOC. Hematemesis Stat ***To order Type and Crossmatch for 2 Units on Hold see...additional S category below*** Acute Allergic Reaction Adult diphenhydramine 25 mg, IVPush, inj, ONE TIME Notify Nurse (DO NOT USE FOR MEDS) Closely monitor for signs of airway compromise. Suspected Sepsis Page: 4 Rapid Response Plan Version: 3 Effective on: 04/30/14 Page 4 of 6

Culture Blood Blood, Culture Blood Blood, Timed, T;N+0015 Arterial Blood Gas, Additional Tests: Lactate Lactic Acid Level...Additional Orders Page: 5 Rapid Response Plan Version: 3 Effective on: 04/30/14 Page 5 of 6

TYPE AND CROSS 2 UNITS PRBC ON HOLD PLAN Laboratory BB Blood Type (ABO/Rh) BB Antibody Screen BB Clot to Hold BB PRBCs on Hold Priority: On Hold, Quantity: 2 Page: 6 Rapid Response Plan Version: 3 Effective on: 04/30/14 Page 6 of 6