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*** Q15MINS Int, 1 hour Q30MINS Int Diet ED NPO Nursing Orders Neurovascular Check Monitoring With vital signs Start IV/INT ED Communication Order Indwelling Urinary Catheter (Foley)(SUB)* ***Reminder: Order Indwelling Urinary Catheter (Foley) (SUB) as a separate form*** GEN Nasogastric/Orogastric Tube Insertion(SUB)* ***Reminder: Order GEN Nasogastric/Orogastric Tube Insertion (SUB) as a separate form*** Orthopedic Device Cervical Collar Medications acetaminophen (Tylenol) 650 mg tab PO ibuprofen (Motrin) 800 mg tab PO acetaminophen-hydrocodone (Norco 325 mg-5 mg oral tablet) 1 tab PO tab acetaminophen-oxycodone (Percocet 5 mg/325 mg) 1 tab PO tab ketorolac (Toradol) 15 mg inj IV PUSH (DEF)* 30 mg inj IV PUSH diphtheria/pertussis acel/tetanus ped (Dtap (tetanus/diphtheria/pertussis less than 7 years of age)) 0.5 ml IM inj diphtheria-tetanus toxoid adult 0.5 ml IM inj Page 1 of 6
DRUG AND TREATMENT Antiemetics promethazine (Phenergan) 12.5 mg inj IV PUSH 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 Comments: Unless otherwise specified, ondansetron (Zofran) serves as the first line anti-emetic. metoclopramide (Reglan) 10 mg inj IV PUSH Analgesics: Opioids hydromorphone (Dilaudid) 0.5 mg inj IV PUSH (DEF)* 1 mg inj IV PUSH morphine 2 mg inj IV PUSH (DEF)* 4 mg inj IV PUSH IV Solutions Sodium Chloride 0.9% (Normal Saline Bolus) 1,000 ml IVPB bag (DEF)* 500 ml IVPB bag 250 ml IV bag Sodium Chloride 0.9% (NS) IV bag 100 ml/hour (DEF)* IV bag 150 ml/hour IV bag 250 ml/hour ***(NOTE)***If extra blood tubes have been sent use the add on blood order below ED Add on Blood in Lab Specimen in Lab, CBC BMP (Chem 7) ***(NOTE)***If labs or extra blood tubes have not been sent use the subphase below SUB Lab Orders(SUB)* ***(NOTE)***If the protocol labs have been ordered use the subphase below SUB Additional Labs(SUB)* Page 2 of 6
DRUG AND TREATMENT Toxicology Screen 12 - Urine URINE, Urinalysis with Microscopic URINE, Radiology XR Chest *1 view AP Portable XR Spine Cervical 1 view LAT Portable XR SPine Cervical 4 view XR Pelvis 1 view Portable Pending Discharge - No, AP View XR Humerus L XR Humerus R XR Forearm L XR Forearm R XR Femur L XR Femur R XR Tibia Fibula L XR Tibia Fibula R CT Chest/Abd/Pelvis w/ Con CT Spine Cervical w/o Contrast CT Head w/o Contrast CT Chest Limited w/o Contrast CT Chest/Abd w/wo Contrast CT Chest/Abd w/o Contrast CT Abd/Pelvis w/o Con Chest Tube Placement In Sp Proc CT Abd/Pelvis w/con Respiratory ABG/VBG Notification istat Creatinine Consults Insert Arterial Line SUB Protocol Q15MINS Int, 1 hour +60 Minutes Q30MINS Int Page 3 of 6
DRUG AND TREATMENT Nursing Orders Initiate Protocol SUB Protocol Start IV/INT Communication Order See comment Comments: If patient presents with C-spine immobilized, maintain immobilization until cleared by MD. If patient presents ambulatory with a high risk of mechanism injury and complains of neck or back pain notify MD. ED Capillary Glucose POC ***(NOTE)***ED Urine Pregnancy POC for females of child-bearing age and capacity ED Urine Pregnancy POC ED Notify Provider Temperature > 101.5, Temperature < 98, HR > 110, HR < 60, SBP > 180, SBP < 90, RR > 20, RR < 8, SpO2 < 94 Urinalysis URINE, 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 Protocol Lab Orders CBC. BMP SUB Lab Orders CBC. BMP Liver Profile Page 4 of 6
DRUG AND TREATMENT HCG Screen Qualitative Serum Comments: For females of childbearing age and capacity PT INR PTT Amylase Level Alcohol Serum Cardiac Enzymes Creatine Kinase Total STAT, Creatine Kinase MB STAT, Troponin STAT, SUB Additional Labs Liver Profile HCG Screen Qualitative Serum Comments: For females of childbearing age and capacity PT INR PTT Troponin Amylase Level Alcohol Serum Page 5 of 6
DRUG AND TREATMENT Cardiac Enzymes Creatine Kinase Total STAT, Creatine Kinase MB STAT, Troponin STAT, Page 6 of 6