/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/emergency-medicine/,

/clinical/cckm-tools/content/order-sets/inpatient/emergency-medicine/name-105389-en.cckm

201612340

page

100

UWHC,UWMF,

Tools,

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

ED - CLINICAL DECISION UNIT - ABDOMINAL PAIN - ADULT [6062]

ED - CLINICAL DECISION UNIT - ABDOMINAL PAIN - ADULT [6062] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


SmartSet: ED - CLINICAL DECISION UNIT - ABDOMINAL PAIN - ADULT
(ID:6062)
General Information
Display name: ED - Clinical Decision Unit - Abdominal Pain - Adult
Type: General
Merge priority:
Version comment:
Content source:
Synonyms: 1. ed cdu
2. observation
3. adult
4. ed
5. clinical decicion unit
SmartSet notes:
Description: Exclusion Criteria:
1. Patients with chronic abdominal pain or frequency Emergency Department
visits for abdominal pain
2. Patients unlikely to discharge home within 23 hours
3. Patients with acute periotonitis
4. Patients with unstable vital signs (SBP < 100, HR > 110)
5. Pregnancy
6. Immunocompromised patients
7. Patients with obstruction or partial obstruction (ileus)
8. Emergency Department staffing does not allow for frequent abdominal exams
Web information: Title URL
1.
Questionnaire:
Configuration
Admission Status
Admission Status
Page 1 of 6
Printed by STRAKA, KEVIN F [KFS1] at 11/30/2016 4:10:36 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Admit to CDU (ED Observation) Patient Class: Observation
Accommodation Code, if IMC request, please enter
Comments in field to the right: OSS/OBS
Will the patient require special placement due to
ISOLATION Precautions?
Could this patient have ACS/MI?
Does the patient require CARDIAC MONITORING for
transport?
Admitting Provider?
Attending Provider?
CDU Protocol: Abdominal Pain
Family History:
Expected Treatment/Procedures:
Intravenous Therapy
IV Fluids
sodium chloride 0.9 % infusion Intravenous, CONTINUOUS
dextrose 5%-NaCl 0.9% infusion Intravenous, CONTINUOUS
dextrose 5%-NaCl 0.45% with KCl 20 mEq/L
infusion
Intravenous, CONTINUOUS
Medications
Analgesics - Acetaminophen PRN
acetaMINOPHEN (TYLENOL) tab 325-650 mg, Oral, EVERY 4 HOURS PRN, pain/fever
Mild to moderate pain
Analgesics - NSAIDS - PRN
ibuprofen (MOTRIN) tab 200-400 mg, Oral, EVERY 6 HOURS PRN, pain
Mild to moderate pain
Analgesics - Opioid - Oral PRN
hydrocodone-acetaMINOPHEN (NORCO) 5-325
MG per tab
1-2 tab, Oral, EVERY 4 HOURS PRN, pain
Severe pain
oxycodone tab 5-10 mg, Oral, EVERY 4 HOURS PRN, pain
Severe pain
Analgesics - Opioid - Injection PRN
MORPHine PF injection 1-2 mg, Intravenous, EVERY 2 HOURS PRN, pain
Severe pain if unable to tolerate oral medications
HYDROmorphone PF (DILAUDID) injection 0.2-0.4 mg, Intravenous, EVERY 2 HOURS PRN,
pain
Severe pain if unable to tolerate oral medications
Antiemetics
ondansetron (ZOFRAN ODT) disintegrating tab 4 mg, Oral, EVERY 24 HOURS PRN,
nausea/vomiting
Administer first line as needed when able to tolerate
oral medications.
Page 2 of 6
Printed by STRAKA, KEVIN F [KFS1] at 11/30/2016 4:10:36 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

ondansetron (ZOFRAN) injection 4 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Administer first line as needed when unable to
tolerate oral medications.
prochlorperazine (COMPAZINE) tab 10 mg, Oral, EVERY 6 HOURS PRN, nausea
Administer second line if there is no response to first
line antiemetic within 30 minutes.
prochlorperazine (COMPAZINE) injection 10 mg, Intravenous, EVERY 6 HOURS PRN, nausea
Administer second line if there is no response to first
line antiemetic within 30 minutes.
promethazine (PHENERGAN) tab 12.5-25 mg, Oral, EVERY 6 HOURS PRN,
nausea/vomiting
promethazine (PHENERGAN) injection 12.5-25 mg, Intravenous, EVERY 6 HOURS PRN,
nausea/vomiting
Patient Care Orders
Vital Signs
Vital Signs SEE COMMENTS, Starting S, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every *** Hours, STAT
Activity
Activity CONTINUOUS, Routine
AD LIB:
AMBULATE:
CHAIR:
DANGLE:
BEDREST:
RESTRICTIONS:
UPPER LEFT EXTREMITY WEIGHT BEARING:
UPPER RIGHT EXTREMITY WEIGHT BEARING:
LOWER LEFT EXTREMITY WEIGHT BEARING:
LOWER RIGHT EXTREMITY WEIGHT BEARING:
Nutrition
Diet - Custom EFFECTIVE NOW, Starting S, Routine
Patient Type: Adult
Room Service Class:
Diet Type: Diet Modifications
Diet Modifications:
Bedside Meal Instructions:
Diet - General EFFECTIVE NOW, Starting S, Routine
Patient Type: Adult
Diet Type: General (no Modifications)
Bedside Meal Instructions:
Room Service Class:
Page 3 of 6
Printed by STRAKA, KEVIN F [KFS1] at 11/30/2016 4:10:36 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Diet - NPO Except Medications EFFECTIVE NOW, Starting S, Routine
Patient Type: Adult
Diet Type: NPO
NPO: NPO except Medications
Bedside Meal Instructions:
Room Service Class:
Diet - Adult Renal EFFECTIVE NOW, Starting S, Routine
Patient Type: Adult
Diet Type: Diet Modifications
Diet Modifications: Renal
Sodium:
Potassium:
Phosphorus:
Fluid Restriction Total mLs/24H (IV/PO):
Protein:
Bedside Meal Instructions:
Room Service Class:
Respiratory
Respiratory Therapy per Protocol CONTINUOUS, Routine
Protocol Type:
Oxygen Therapy CONTINUOUS, Routine
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Liter Flow:
Titrate oxygen to maintain O2 sat at (%):
O2 Delivery Device: Nasal Cannula
Attempt to Wean Off Oxygen?
Respiratory Therapy per Protocol CONTINUOUS, Routine
Protocol Type:
CPAP Overnight and Nap OVERNIGHT AND NAP, Routine
Therapy Settings: Per RT
CPAP Level (cm H2O):
Oxygen (LPM or %):
Self Administered (Only RT may document in this box
after patient assessment): RT Approval Required
Incentive Spirometry CONTINUOUS, Routine
Cough And Deep Breathe EVERY 4 HOURS, Routine
Patient Monitoring
Cardiac Rhythm Monitoring - Adult CONTINUOUS, Routine
Indication:
Notify Provider:
Functional Cardiac Defibrillator Present:
Pulse Oximetry CONTINUOUS, Routine
Contingency Parameters
Page 4 of 6
Printed by STRAKA, KEVIN F [KFS1] at 11/30/2016 4:10:36 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg): 180
If systolic blood pressure < (mmHg): 100
If diastolic blood pressure > (mmHg): 95
If diastolic blood pressure < (mmHg): 60
If temperature > (C): 38
If temperature < (C): 36
If heart rate > (bpm): 120
If heart rate < (bpm): 50
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL): 300
If blood glucose < (mg/dL): 80
If pain score >:
Pulse Oximetry < (%): 92
If urine output < (mL):
Other:
Diagnostic Tests & Imaging
Diagnostic Tests & Imaging
CT ABDOMEN PELVIS W IV CONTRAST ONCE-RAD NEXT AVAILABLE For 1 Occurrences,
Routine
Can pt be given oral contrast?
Current signs and symptoms?
What specific question(s) would you like answered by
this exam?
Relevant recent/past history?
Is patient pregnant?
Allergies to IV contrast or iodine?
Last creatinine value? (will auto pull in date and value
in comment):
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.
Last patient weight? (will auto pull in value and date
in comment):
Transport Method:
Disposition Criteria
Home
Disposition Criteria - Home CONTINUOUS, 1. Pain and/or tenderness resolved
or significantly improved.
2. Vital signs are acceptable.
Hospital
Page 5 of 6
Printed by STRAKA, KEVIN F [KFS1] at 11/30/2016 4:10:36 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

Disposition Criteria - Hospital CONTINUOUS, 1. Pain worsening or abdominal
exam becomes concerning
2. Positive testing or imaging that merits
hospitalization
3. Untstable vital signs
4. Persistent vomiting
Criteria
Suggestions: LOOKUP LOCATOR-ABDOMINAL PAIN DISCHARGE UWHC ED (RFV)[488]
UWIP C LOGIN DEPT UWH ED OR TAC ED[30001972]
Filter: RESTRICTION LOCATOR - UWHC ED[486]
Restrict SmartSet:
Settings
Discontinue action:
Deselect sections for
Pended/Held orders:
Pended/Held orders
display:
Release date: Use System Definitions Setting
Disallow user override:
Page 6 of 6
Printed by STRAKA, KEVIN F [KFS1] at 11/30/2016 4:10:36 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org