/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/order-sets/,/clinical/cckm-tools/content/order-sets/inpatient/,/clinical/cckm-tools/content/order-sets/inpatient/anesthesiology/,

/clinical/cckm-tools/content/order-sets/inpatient/anesthesiology/name-112917-en.cckm

20170247

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Anesthesiology

Anesthesiology - Intraoperative [2711]

Anesthesiology - Intraoperative [2711] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Anesthesiology


Anesthesiology - Intraoperative [2711]
Patient Care Orders
Patient Care Orders [149343]
Glucose, POC [IPGLUCOSE] ONCE, Starting today For 1 Occurrences, Routine, Glucose,
POC should always be ordered in conjunction with orders for
hypoglycemia management and monitoring as indicated in
the Hypoglycemia Management (Adult) panel.
If Conditional, What Condition?
IntraOp
Laboratory
ABG Syringe Tests (CSC lab) [84899]
BLOOD GASES AND O2 SATURATION [HCBGASOS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BLOOD GASES [HCBGAS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
O2 SATURATION [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CARBON MONOXIDE [GM2350] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
POTASSIUM, WHOLE BLOOD [HCWBK] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
SODIUM, WHOLE BLOOD [HCWBNA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HEMOGLOBIN, WHOLE BLOOD [HCWBHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CALCIUM, IONIZED, WHOLE BLOOD [HCWBICA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
Page 1 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2016CCKM@uwhealth.org

previous specimen?
If Conditional, What Condition?
IntraOp
LACTATE [GM2255] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CHLORIDE, WHOLE BLOOD [HCWBCL] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
GLUCOSE, WHOLE BLOOD [HCWBGLU] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CREATININE, WHOLE BLOOD [HCWBCRET] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
ABG Syringe Tests (TAC lab) [194252]
BLOOD GASES AND O2 SATURATION [HCBGASOS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BLOOD GASES [HCBGAS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
O2 SATURATION [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CARBON MONOXIDE [GM2350] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
POTASSIUM, WHOLE BLOOD [HCWBK] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Page 2 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

IntraOp
SODIUM, WHOLE BLOOD [HCWBNA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HEMOGLOBIN, WHOLE BLOOD [HCWBHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CALCIUM, IONIZED, WHOLE BLOOD [HCWBICA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
LACTATE [GM2255] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CHLORIDE, WHOLE BLOOD [HCWBCL] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
GLUCOSE, WHOLE BLOOD [HCWBGLU] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CREATININE [CRET] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
ABG Syringe Tests - TO BE ANALYZED IN AFCH OR [124431]
BLOOD GASES AND O2 SATURATION [HCBGASOS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
BLOOD GASES [HCBGAS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
Page 3 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

IntraOp
O2 SATURATION [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
POTASSIUM, WHOLE BLOOD [HCWBK] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
SODIUM, WHOLE BLOOD [HCWBNA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
HEMOGLOBIN, WHOLE BLOOD [HCWBHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
CALCIUM, IONIZED, WHOLE BLOOD [HCWBICA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
LACTATE [GM2255] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
GLUCOSE, WHOLE BLOOD [HCWBGLU] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
HEMOGLOBIN, PUMP PRIME [HCWBHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
BLOOD GASES, PUMP PRIME [HCBGAS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Pump Prime, STAT
Indicate FIO2:
Page 4 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
SODIUM, PUMP PRIME [HCWBNA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
POTASSIUM, PUMP PRIME [HCWBK] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
CALCIUM, IONIZED, PUMP PRIME [HCWBICA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
Will this specimen be analyzed in the AFCH OR? Yes
IntraOp
ABG Syringe Tests - ONLY use this in AFCH PAVILION [128274]
BLOOD GASES AND O2 SATURATION [HCBGASOS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, RIGHT ATRIUM [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, INNOMINATE VEIN [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, SVC [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, SVC, LEFT [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Page 5 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, SVC, RIGHT [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, PULMONARY ARTERY [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, LEFT PULMONARY ARTERY
[HCOSAT]
STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, RIGHT PULMONARY ARTERY
[HCOSAT]
STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, FONTAN [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, IVC [HCOSAT] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, LEFT UPPER PULMONARY VEIN
[HCOSAT]
STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, RIGHT UPPER PULMONARY VEIN
[HCOSAT]
STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, LEFT LOWER PULMONARY VEIN
[HCOSAT]
STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
Page 6 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
O2 SATURATION, RIGHT LOWER PULMONARY VEIN
[HCOSAT]
STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
BLOOD GASES [HCBGAS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Arterial, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
POTASSIUM, WHOLE BLOOD [HCWBK] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
CALCIUM, IONIZED, WHOLE BLOOD [HCWBICA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
LACTATE [GM2255] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
HEMOGLOBIN, WHOLE BLOOD [HCWBHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
SODIUM, WHOLE BLOOD [HCWBNA] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
GLUCOSE, WHOLE BLOOD [HCWBGLU] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
Page 7 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

If Conditional, What Condition?
Will this specimen be analyzed in AFCH PAVILION? Yes
IntraOp
Heme [84900]
Specimen Collection, Container Types and Processing URL: https://uconnect.wisc.edu/clinical/references/clinical-
laboratories/specimen/
CBC WITHOUT DIFFERENTIAL [HEMO] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
WHITE CELL COUNT [WBC] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PROTHROMBIN TIME/INR [PT] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HEMOGLOBIN [HGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HEMATOCRIT [HCT] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PTT [PTT] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PLATELET COUNT [PLT] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
FIBRINOGEN [GM1320] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
D-DIMER, QUANT [GM1332] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Page 8 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

IntraOp
ACTIVATED CLOTTING TIME, POC [HCACTPOC] CONDITIONAL, Starting today For 1 Days, Routine
If Conditional, What Condition? Monitor heparin IntraOp
IntraOp
Chemistry (CSC lab) [84907]
Specimen Collection, Container Types and Processing URL: https://uconnect.wisc.edu/clinical/references/clinical-
laboratories/specimen/
ALBUMIN [ALB] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
AMMONIA [GM2200] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
AST/SGOT [AST] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HCG, QUANTITATIVE [BHCG] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine, This test is not intended for aiding in the diagnosis of
cancer or for monitoring the treatment of cancer patients.
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BILIRUBIN, DIRECT [DBIL] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BILIRUBIN, TOTAL [TBIL] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BUN [BUN] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CHLORIDE, WHOLE BLOOD [HCWBCL] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CK, TOTAL [CPK] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
Page 9 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

previous specimen?
If Conditional, What Condition?
IntraOp
CREATININE, WHOLE BLOOD [HCWBCRET] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
GLUCOSE [GLU] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
LACTATE [GM2255] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
MAGNESIUM [MAG] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PHOSPHATE [PHOS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
POTASSIUM [K] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HEMOGLOBIN, PLASMA [HCPHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PTH [HCPTHIN] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
SODIUM [NA] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
TROPONIN [GM2447] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
Page 10 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
Chemistry (TAC lab) [193915]
Specimen Collection, Container Types and Processing URL: https://uconnect.wisc.edu/clinical/references/clinical-
laboratories/specimen/
ALBUMIN [ALB] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
AMMONIA [GM2200] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
AST/SGOT [AST] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HCG, QUANTITATIVE [BHCG] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine, This test is not intended for aiding in the diagnosis of
cancer or for monitoring the treatment of cancer patients.
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BILIRUBIN, DIRECT [DBIL] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BILIRUBIN, TOTAL [TBIL] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
BUN [BUN] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CHLORIDE, WHOLE BLOOD [HCWBCL] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
CREATININE [CRET] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
Page 11 of 16
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Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

previous specimen?
If Conditional, What Condition?
IntraOp
GLUCOSE [GLU] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
LACTATE [GM2255] STAT - RN COLLECT, Starting today For 1 Occurrences,
STAT
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
MAGNESIUM [MAG] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PHOSPHATE [PHOS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
POTASSIUM [K] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
PTH [HCPTHIN] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
SODIUM [NA] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
TROPONIN [GM2447] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
Urine [84909]
Specimen Collection, Container Types and Processing URL: https://uconnect.wisc.edu/clinical/references/clinical-
laboratories/specimen/
MYOGLOBIN, URINE [GM1540] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine, Urine myoglobin testing will be performed only on
inpatients who have had a positive heme result on a
urinalysis within the previous 12 hours. Following a positive
urine myoglobin, subsequent requests during the same
Page 12 of 16
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Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

admission will be canceled.
Urine Myoglobin may be useful in suspected skeletal muscle
injury or acute kidney failure without obvious cause. Urine
Myoglobin is not useful for monitoring cardiac injury. For
suspected cardiac injury see Troponin.
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
HEMOGLOBIN, URINE [HCUHGB] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
IntraOp
Blood Bank
Transfusion orders to be placed using one of the following order sets
IP - Blood Transfusion - Adult - Supplemental [996]
IP - Blood Transfusion - Pediatric - Supplemental [1267
Tests [100542]
TYPE AND SCREEN [HCTS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine, As good clinical practice and for patient safety, the
Transfusion Service will automatically crossmatch 2 packed
RBCs on all patients with antibodies to ensure blood would be
available in the event it is needed. If you would like to opt out
of this automatic order for this patient please contact the
UWHC Blood Bank at (608) 263-8367 or The American
Center Lab at (608) 234-6600 as appropriate.
Blood Products [12026]
Red Blood Cells (Adult) [BLB0006] 1 UNIT, Starting today For 1 Occurrences, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Uncrossmatched **WARNING** Requesting MD verifies that
the clinical situation is sufficiently urgent to require release of
blood before completion of compatibility testing and agrees to
hold UWHC harmless for any and all liability for any injuries
resulting from release of blood before such testing:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Consent Status:
Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe)
1 Red Blood Cell Unit ~ 350 mL.
Plasma (Adult) [BLB0003] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Consent Status:
Patient Weight
Page 13 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

No data found for Wt
1 Plasma Unit ~ 200 mL.
NURSING REMINDER: Call UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes before transfusion to prepare
products.
Platelets (Adult) [BLB0004] 1 SINGLE, Starting today For 1 Occurrences, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Consent Status:
Patient Weight
No data found for Wt
For refractory patients, call UWHC Blood Back at (608) 263-
8307 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes (at UWHC) or 2-3 hours (at The
American Center) before transfusion to prepare products.
1 Single Donor Unit ~ 200-250 mL.
All platelet products are leukocyte-reduced (CMV safe).
NURSING REMINDER: Call UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes (at UWHC) or 2-3 hours (at The
American Center) before transfusion to prepare products.
Cryoprecipitate (Adult) [BLB0005] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Consent Status:
Fibrin Glue, mLs Needed:
Patient Weight
No data found for Wt
Cryoprecipitate is stored frozen as 5 pooled units (approx
120mL). Standard adult dose = 10 units. Suggested dose =
1 unit/10 kg.
Individual cryoprecipitate units are also available for fibrin
glue (approx 10-15 mL each).
NURSING REMINDER: Call UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes before transfusion to prepare
products.
Blood Product [12027]
Red Blood Cells (Pediatric) [BLB0013] 1 UNIT, Starting today For 1 Occurrences, Routine
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Page 14 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

Date Product Needed:
Uncrossmatched **WARNING** Requesting MD verifies that
the clinical situation is sufficiently urgent to require release of
blood before completion of compatibility testing and agrees to
hold UWHC harmless for any and all liability for any injuries
resulting from release of blood before such testing:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Volume-Reduced (May be pre-selected based on history):
Consent Status:
Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe).
1 Red Blood Cell Unit ~ 350 mL. Suggested dose: 10 mL/kg
body weight.
Plasma (Pediatric) [BLB0010] Starting today, Routine
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Consent Status:
Patient Weight
No data found for Wt
1 Plasma Unit ~ 200 mL. Suggested dose: 10-15 mL/kg body
weight.
NURSING REMINDER: Call UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes before transfusion to prepare
products.
Platelets (Pediatric) [BLB0011] Starting today, Routine
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Volume-Reduced (May be pre-selected based on history):
Consent Status:
Patient Weight
No data found for Wt
For refractory patients, call UWHC Blood Back at (608) 263-
8307 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes (at UWHC) or 2-3 hours (at The
American Center) before transfusion to prepare products.
Suggested dose = 10-20 mL/kg body weight for neonatal and
Page 15 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org

pediatric patients. For patients greater than 40 kg, suggested
dose is 1 Single Donor Unit. 1 Single Donor Unit = 200-250
mL. All platelet products are leukocyte-reduced (CMV safe).
NURSING REMINDER: Call UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes (at UWHC) or 2-3 hours (at The
American Center) before transfusion to prepare products.
Cryoprecipitate (Pediatric) [BLB0012] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Consent Status:
Patient Weight
No data found for Wt
1 Cryoprecipitate Unit ~ 10-20 mL. Suggested dose: 1 Unit/10
kg body weight. If patient weighs less than 10 kg, give 1 Unit.
NURSING REMINDER: Call UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes before transfusion to prepare
products.
Diagnostic Tests and Imaging
Radiology [84908]
X-RAY CHEST AP VIEW [R71010] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, ASAP
Current signs and symptoms?
What specific question(s) would you like answered by this
exam?
Relevant recent/past history?
Is patient pregnant?
If being performed remotely, where? Bedside
Transport Method: Floor Determined/Entered
IntraOp
FLUOROSCOPY <= 1 HOUR (Spine) [R76000] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, Routine
Which body area is to be imaged?
Radiology Specialty Area: GENERAL IMAGING
Current signs and symptoms?
What specific question(s) would you like answered by this
exam?
Relevant recent/past history?
Is patient pregnant?
If being performed remotely, where?
Last patient weight? (will auto pull in value and date in
comment):
Transport Method: Floor Determined/Entered
IntraOp
Page 16 of 16
Printed by GUETZLAFF, SCOTT F [SFG091] at 5/18/2016 3:19:11 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
05/2016CCKM@uwhealth.org