PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

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PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

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Transcription:

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 Orders(SUB)* ***The above suphase is available at the end of the plan*** ED Rainbow Tubes(SUB)* ***Reminder: Order ED Rainbow Tubes (SUB) as a separate form*** Orthostatic Nursing Orders Pelvic Exam ED Cardiac Monitor Indwelling Urinary Catheter (Foley)(SUB)* ***Reminder: Order Indwelling Urinary Catheter (Foley)(SUB) as a separate form*** Medications acetaminophen (Tylenol) 650 mg tab PO ED_ONCE (DEF)* 650 mg supp PR ED_ONCE ranitidine (Zantac) 50 mg inj IV PUSH ED_ONCE pantoprazole (Protonix) 40 mg inj IV PUSH ED_ONCE Al hydroxide/mg hydroxide/simethicone (Maalox Plus Extra Strength) 30 ml PO susp ED_ONCE, Clinical Instructions: GI Cocktail Substitution Comments: P&T approved substitution of Maalox Plus Extra Strength for GI Cocktail Antiemetics promethazine (Phenergan) 12.5 mg inj IV PUSH ED_ONCE Comments: If the patient has an IV infusing, the promethazine should be mixed in 20 ml of saline and administered slowly over at least 3 minutes at the port furthest away from the IV insertion site. If the patient does not have an IV infusing, the promethazine should be mixed in 50 ml bag of saline and administered over 15 minutes. Unless otherwise specified, ondansetron (Zofran) serves as the first line anti-emetic. ondansetron (Zofran) 4 mg inj IV PUSH ED_ONCE Comments: Unless otherwise specified, ondansetron (Zofran) serves as the first line anti-emetic. ondansetron (Zofran ODT) 4 mg tab soluble SUBLING ED_ONCE Comments: Unless otherwise specified, ondansetron (Zofran) serves as the first line anti-emetic. metoclopramide (Reglan) 10 mg inj IV PUSH ED_ONCE Page 1 of 5

DRUG AND TREATMENT Analgesics: Opioids hydromorphone (Dilaudid) 0.5 mg inj IV PUSH ED_ONCE (DEF)* 1 mg inj IV PUSH ED_ONCE morphine 2 mg inj IV PUSH ED_ONCE (DEF)* 4 mg inj IV PUSH ED_ONCE ketorolac (Toradol) 15 mg inj IV PUSH ED_ONCE (DEF)* 30 mg inj IV PUSH ED_ONCE 15 mg inj IM ED_ONCE 30 mg inj IM ED_ONCE 60 mg inj IM ED_ONCE IV Solutions Sodium Chloride 0.9% (Normal Saline Bolus) 1,000 ml IVPB bag ED_ONCE (DEF)* 500 ml IVPB bag ED_ONCE 250 ml IVPB bag ED_ONCE Sodium Chloride 0.9% (NS) IV bag 250 ml/hour (DEF)* IV bag 150 ml/hour IV bag 100 ml/hour ***(NOTE)***If the extra blood tubes have been ordered use the add on blood in lab order below ED Add on Blood in Lab Amylase, Specimen in Lab ***(NOTE)***If Labs or extra blood tubes have not been ordered use this subphase SUB ED Abdominal Pain Lab Orders(SUB)* ***The above subphase is available at the end of the plan*** ***(NOTE)***If the protocol lab tests have been ordered use the subphase below SUB ED Abdominal Pain Additional Labs(SUB)* ***The above suphase is available at the end of the plan*** HCG Screen Urine URINE, ED_ONCE Comments: Pregnancy Screen Urine Urine Culture URINE, CLEANCATCH, ED_ONCE (DEF)* URINE, CATHETER Comments: Females - cath if vaginal bleeding or discharge Page 2 of 5

DRUG AND TREATMENT GC CH Screen by PCR ED_ONCE Radiology XR Abd 2 view with Chest Abdominal Pain, Pending Discharge - No, ED_ONCE, Obstructive Series CT ABD w/ Contrast CT ABD Limited w/o Contrast CT ABD Limited w/ Contrast CT ABD w/o Contrast CT ABD w/wo Contrast CT Abd/Chest w/o Contrast CT Abd/Pelvis w/o Con CT Abd/Pelvis w/con CT Renal w/ Contrast CT Renal w/o Contrast CT Renal w/wo Contrast CT Renal/Pel w/o Con US Abdomen Limited Abdominal Pain, Pending Discharge - No, ED_ONCE US Abdomen Complete Abdominal Pain, Pending Discharge - No, ED_ONCE US Pelvis (Non-Obstetric) Limited OB Us Comments: If unable to view ovarian flow, perform US Transvaginal if needed US Transvaginal Page 3 of 5

DRUG AND TREATMENT SUB ED Abdominal Pain Protocol Q2H, 1 day Diet NPO ED Nursing Orders Initiate Protocol SUB ED Abdominal Pain Protocol ***(NOTE)***ED Urine Pregnancy POC for females of child-bearing age and capacity ED Urine Pregnancy POC ED_ONCE Start IV/INT ED Notify Provider Temperature > 101.5, Temperature < 98, HR > 110, HR < 60, SBP > 180, SBP < 90, RR > 20, RR < 8, SpO2 < 94 Urinalysis with Microscopic URINE, ED_ONCE Comments: Females-cath if vaginal bleeding or discharge. Obtain urines within 1 hour of arrival Respiratory Pulse Oximetry (Continuous) Special Instructions: If oxygen saturation less than 94%, initiate O2 Therapy order, 1, day Comments: Q8H sensor site must be inspected. IF circulatory condition or skin integrity has changed, the sensor should be applied to a different site. O2 Therapy. Nasal Cannula, 2, Titrate to maintain oxygen saturation equal to or greater than 94% SUB ED Abdominal Pain Protocol Lab Order Complete Blood Count Basic Metabolic Panel Liver Profile Amylase Level Page 4 of 5

DRUG AND TREATMENT SUB ED Abdominal Pain Lab Orders Complete Blood Count Basic Metabolic Panel Liver Profile Amylase Level CMP Cardiac Enzymes Creatine Kinase Total STAT, Creatine Kinase MB STAT, Troponin STAT, SUB ED Abdominal Pain Additional Labs CMP Cardiac Enzymes Creatine Kinase Total STAT, Creatine Kinase MB STAT, Troponin STAT, Page 5 of 5

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