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/clinical/cckm-tools/content/order-sets/inpatient/emergency-medicine/name-101161-en.cckm

201711326

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Emergency Medicine

ED - Nuclear Medicine Chest Pain Treatment - Adult [2556]

ED - Nuclear Medicine Chest Pain Treatment - Adult [2556] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Nuclear Medicine Chest Pain Treatment - Adult [2556]
Laboratory
Troponin - 2 Hours after initial Troponin [82730]
TROPONIN [GM2447] SPECIFIC TIME, 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?
2 Hours after initial Troponin
Diagnostic Tests and Imaging
EKG - 2 Hours after initial EKG [82729]
ECG (Repeat) [EKG0008] ONCE, Starting today For 1 Occurrences, STAT
Reason for exam: Chest Pain
Disclaimer for University Hospital Only: A Stat status
for an ECG is in reference to the timing of the ECG.
The goal is to perform a STAT ECG within 10 minutes
of the order being placed. It is the responsibility of the
ordering provider to review the STAT ECGs. All ECGs
(stat or routine) will be formally reviewed within one
business day.
2 hours after first Troponin
General Radiology [81715]
NM Myocardial Perfusion Rest and Stress
[117122]
Stress Test order. Nuclear routine This panel is the IP Level II Chest Pain and
Both orders are required for stress testing. Do not remove the orders.
NM MYOCARDIAL PERFUSION REST &
STRESS (SPECT) W WALL MOTION &
EJECTION FRACTION [R78452]
ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, STAT
Current signs and symptoms?
Reason for exam:
What specific question(s) would you like answered
by this exam?
Relevant recent/past history?
Is patient pregnant or breastfeeding?
What form of stress is to be performed?
Is the patient ready for discharge today, pending the
results of the stress test?
For scheduling purposes, does the patient require
general anesthesia, sedation or anxiolytics? Note:
ordering provider is responsible for prescribing oral
anxiolytics or arranging peds anesthesia / sedation
services. See reference link above.
For Scheduling purposes, is the patient
claustrophobic or require any form of sedation?
Note: ordering provider is responsible for prescribing
oral anxiolytic or ordering sedation services.
Last patient weight? (will auto pull in value and date
in comment):
Last patient height? (will auto pull in value and date
in comment):
BMI (will auto pull in value):
Transport Method:
Page 1 of 2
Printed by STRAKA, KEVIN F [KFS1] at 11/20/2017 3:18:10 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2017CCKM@uwhealth.org

Exercise or Drug Stress Test (with Nuclear
Medicine) [EKG0007]
ONCE, Routine
Current signs and symptoms?
Reason for exam:
What specific question(s) would you like answered
by this exam?
Relevant recent/past history?
Is patient pregnant or breastfeeding?
What form of stress is to be performed?
Is the patient ready for discharge today, pending the
results of the stress test?
For scheduling purposes, does the patient require
general anesthesia, sedation or anxiolytics? Note:
ordering provider is responsible for prescribing oral
anxiolytics or arranging peds anesthesia / sedation
services. See reference link above.
For Scheduling purposes, is the patient
claustrophobic or require any form of sedation?
Note: ordering provider is responsible for prescribing
oral anxiolytic or ordering sedation services.
Last patient weight? (will auto pull in value and date
in comment):
Last patient height? (will auto pull in value and date
in comment):
BMI (will auto pull in value):
Transport Method:
Bring comfortable shoes and wear pants.
NPO 4 hours; no caffeine or tobacco 12 hours
Patient Care Orders
Nutrition [81719]
No or Minimal Food [NURCOM0052] ONCE, Starting today For 1 Occurrences, STAT
Order Name (Only necessary if something other than
"Nursing Communcation" is preferred.):
No or Minimal Food
No Caffeine or Decaffeinated Beverages or Food
[NURCOM0052]
ONCE, Starting today For 1 Occurrences, STAT
Order Name (Only necessary if something other than
"Nursing Communcation" is preferred.):
No Caffeine or Decaffeinated Beverages or Food
Non-Categorized Patient Care Orders [136712]
Note: Discontinue Any Nitroglycerin Infusion or
Cream [950057]
ONCE For 1 Doses
Discontinue Any Nitroglycerin Infusion or Cream
Patient will need shoes for excercise portion of
the test [NURCOM0052]
ONCE, Starting today For 1 Occurrences, STAT
Order Name (Only necessary if something other than
"Nursing Communcation" is preferred.):
Patient will need shoes for excercise portion of the test
Inform patient they will be in Nuclear Medicine for
at least 2 hours [NURCOM0052]
ONCE, Starting today For 1 Occurrences, STAT
Order Name (Only necessary if something other than
"Nursing Communcation" is preferred.):
Inform patient they will be in Nuclear Medicine for at
least 2 hours
Page 2 of 2
Printed by STRAKA, KEVIN F [KFS1] at 11/20/2017 3:18:10 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2017CCKM@uwhealth.org