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TSC – Vascular Surgery – Adult – Preoperative [4927]

TSC – Vascular Surgery – Adult – Preoperative [4927] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Ambulatory, Transformations Surgery Center


TSC - Vascular Surgery - Adult - Preoperative [4927]
Pre-op Day of Procedure
VTE Prophylaxis [129450]
· If low risk for development of VTE - select VTE Prophylaxis - Reason Not Ordered
· If requires VTE prophylaxis AND
o LOW bleed risk - select pharmacologic agent only
o ABSOLUTE bleed risk - select mechanical agents only
o HIGH bleed risk - weigh risk of bleed vs risk of VTE development and select drug OR mechanical agent
NOTE: Mechanical and pharmacologic agents should only be used together in patients with a very high risk of VTE
development
VTE Risk Factor Assessment Tool URL: https://uconnect.wisc.edu/clinical/references/medication-
use-manual/anticoagulation-resources/resources/name-
26461-en.file
Sequential Compression Device [EQP0023] CONTINUOUS, Starting today, Routine
Left/Right/Bilateral? Bilateral
Type: Knee High
Pre-Op Day Of Procedure
VTE Prophylaxis - Reason Not Ordered [COR0008] ONCE, Starting today For 1 Occurrences, Routine
Reason Not Ordered: Other (Comment Required)
Pre-Op Day Of Procedure
Vital Signs [193665]
Vital Signs [NURMON0013] EVERY 1 HOUR, Starting today, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Pre-Op Day Of Procedure
Patient Monitoring [193666]
Measure Weight [NURMON0015] ONCE, Starting today For 1 Occurrences, Routine
Weigh With?
Weigh when?
Pre-Op Day Of Procedure
Diet [132443]
NPO except medications [NURDIE0013] ONCE, Pre-Op Day Of Procedure
Non-categorized Patient Care Orders [132446]
Consent [NURCOM0022] ONCE, Starting today For 1 Occurrences, Consent to read:
***, Pre-Op Day Of Procedure
Premedications for Needle Insertion [129449]
Use lidocaine topical dressing kit for stable patient, no lidocaine allergies, have at least 30 minutes time prior to needing
to use IV
Sodium chloride (bacteriostatic) 0.9% intradermal: Useful for patients requiring urgent IV access; onset is within 1 minute.
Choice of medication should be based on patient’s previous experience/preference, history of lidocaine allergy and ease
of access.
lidocaine 1 % vial [39034] 0.1-0.4 mL, Intradermal, PRN, peripheral line insertion - see
Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge needle to
inject solution and create a wheal. Wait 30 seconds to 1
minute then insert IV catheter into center of wheal. Use if IV
is needed within 30 minutes. Choice of medication should be
based on patient’s previous experience/preference, history of
lidocaine allergy and ease of access
Pre-Op Day Of Procedure
sodium chloride (bacteriostatic) 0.9 % injection [50585] 0.05-0.1 mL, Intradermal, PRN, peripheral line insertion - see
Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge needle to
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inject solution and create a wheal. Wait 30 seconds to 1
minute then insert IV catheter into center of wheal. Use if IV
is needed within 30 minutes. Choice of medication should be
based on patient’s previous experience/preference, history of
lidocaine allergy and ease of access
Pre-Op Day Of Procedure
IV Fluids [131756]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Device:
Peripheral IV Location:
Peripheral IV Size:
Peripheral IV Status:
Does this need to be inserted/placed?
Pre-Op Day Of Procedure
lactated ringers infusion [38890] at 75 mL/hr, Intravenous, CONTINUOUS, Pre-Op Day Of
Procedure
dextrose 5%-lactated ringers 5 % IV soln - NOTE: order
if patient has Type I diabetes with blood sugar less than
199 AND receiving insulin [44897]
at 50 mL/hr, Intravenous, CONTINUOUS, Pre-Op Day Of
Procedure
Laboratory [128901]
GLUCOSE, POC [HCMGLUC] ONCE, Routine
If Conditional, What Condition?
Pre-Op Day Of Procedure
HEMOGLOBIN, POC [HCHGBPOC] ONCE, Routine
If Conditional, What Condition?
Pre-Op Day Of Procedure
HCG, QUAL, URINE, POC [HCPREGPOC] ONCE, Routine
If Conditional, What Condition?
Pre-Op Day Of Procedure
Surgical Prophylaxis
First Line (Single Response) [193829]
Cefazolin (Single Response) [193832]
cefazolin (ANCEF) - Patients who are 40-119 kg [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
cefazolin (ANCEF) - Patients who are 120 kg or greater
[35637]
3 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
MRSA/Document MRSA History (Single Response) [135177]
Patients who are 40-43 kg [193811]
cefazolin (ANCEF) [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 750 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
Patients who are 44-56 kg [193814]
cefazolin (ANCEF) [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 1,000 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
Patients who are 57-68 kg [193817]
cefazolin (ANCEF) [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 1,250 mg, Intravenous, ON CALL For 1 Doses
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See infusion guidelines
Pre-Op Day Of Procedure
Patients who are 69-81 kg [193820]
cefazolin (ANCEF) [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 1,500 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
Patients who are 82-93 kg [193823]
cefazolin (ANCEF) [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 1,750 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
Patients who are 94-120 kg [193826]
cefazolin (ANCEF) [35637] 2 g, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 2,000 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
Patients who are greater than 120 kg [193828]
cefazolin (ANCEF) [35637] 3 g, Intravenous, ONCE For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) [46836] 2,000 mg, Intravenous, ONCE For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
Immediate/Severe Reactions to Penicillin or Known Cephalosporin Allergies (Single Response) [193836]
vancomycin (VANCOCIN) - Patients who are 40-43 kg
[46836]
750 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) - Patients who are 44-56 kg
[46836]
1,000 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) - Patients who are 57-68 kg
[46836]
1,250 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) - Patients who are 69-81 kg
[46836]
1,500 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) - Patients who are 82-93 kg
[46836]
1,750 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
vancomycin (VANCOCIN) - Patients who are greater
than 93 kg [46836]
2,000 mg, Intravenous, ON CALL For 1 Doses
See infusion guidelines
Pre-Op Day Of Procedure
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Pr i nt ed by GUETZLAFF, SCOTT F [SFG091] at 10/7/2015 8:48:02 AM
Copyright © 2015 University of Wisconsin Hospitals and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison