/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-98363-en.cckm

20180108

page

100

UWHC,UWMF,

Tools,

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

ED - Altered Mental Status - Adult [4929]

ED - Altered Mental Status - Adult [4929] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Altered Mental Status - Adult [4929]
Laboratory
Labs [132092]
CBC WITH DIFFERENTIAL [CBC] STAT, 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?
BASIC METABOLIC PANEL [BMET] STAT, Starting today For 1 Occurrences, STAT, Test
includes Sodium; Potassium; Chloride; Carbon
Dioxide, Total; Anion Gap; Glucose; BUN; Creatinine;
and Calcium.
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
BILIRUBIN, TOTAL [TBIL] STAT, 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?
AST/SGOT [AST] STAT, 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?
ALT/SGPT [ALT] STAT, 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?
ALKALINE PHOSPHATASE [ALKP] STAT, 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?
URINALYSIS WITH MICROSCOPY [UA] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
LIPASE [LIPS] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
ACETAMINOPHEN [GM2485] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
SALICYLATE [HCSAL] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
ALCOHOL [GM2440] STAT 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 1 of 4
Printed by STRAKA, KEVIN F [KFS1] at 1/3/2018 4:26:35 PM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

DRUG SCREEN, URINE [HCUPNL] STAT For 1 Occurrences, Routine, Test includes:
Amphetamines/Methamphetamines, Barbiturates,
Benzodiazepine, Cocaine, and Opiates (primarily
targets morphine, codeine, and heroin).
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
HCG, QUALITATIVE, URINE [UPREG] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
BLOOD GASES AND O2 SATURATION,
ARTERIAL [HCBGASOS]
STAT For 1 Occurrences, STAT
Indicate FIO2:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
CK, TOTAL [CPK] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
MAGNESIUM [MAG] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
PHOSPHATE [PHOS] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
PROTHROMBIN TIME/INR [PT] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
TROPONIN [GM2447] STAT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Labs CSF [132098]
CELL COUNT, CSF, TUBE 1 [HCCCTUB1] STAT, 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?
CELL COUNT, CSF, TUBE 4 [HCCCTUB4] STAT, 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?
CULTURE, CSF, AER WITH GRAM STAIN
[HCSFC]
STAT, 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?
GLUCOSE, CSF [GM2740] STAT, 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?
PROTEIN, CSF [GM2745] STAT, 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 2 of 4
Printed by STRAKA, KEVIN F [KFS1] at 1/3/2018 4:26:35 PM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

HERPES SIMPLEX VIRUS BY PCR
[HCHSVPCR]
STAT For 1 Occurrences, Routine
Indicate specimen source if other:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Diagnostic Tests and Imaging
Cardiology [140486]
ECG - 12 Lead [EKG0008] ONCE, Routine
Reason for exam:
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.
General Radiology [133206]
CT HEAD W/ O IV CONTRAST [R70450] ONCE-RAD NEXT AVAILABLE For 1 Occurrences,
Routine
Current signs and symptoms?
What specific question(s) would you like answered by
this exam? Please include relevant recent/past
history.
Last creatinine value? (will auto pull in date and value
in comment):
Last patient weight? (will auto pull in value and date in
comment):
Transport Method:
X-RAY CHEST SINGLE VIEW [R71045] ONCE-RAD NEXT AVAILABLE For 1 Occurrences,
Routine
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
Intravenous Therapy
IV Fluids [133198]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Starting today, STAT
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
sodium chloride 0.9 % infusion BOLUS [730003] 1,000 mL, Intravenous, ONCE For 1 Doses
sodium chloride 0.9 % infusion [64367] at 125 mL/hr, Intravenous, CONTINUOUS
Medications
Miscellaneous [135443]
dextrose injection [800233] 25 g, Intravenous, ONCE For 1 Doses
naloxone (NARCAN) injection [800199] 0.4 mg, Intravenous, PRN, opioid overdose
Patient Care Orders
Vital Signs [140489]
Page 3 of 4
Printed by STRAKA, KEVIN F [KFS1] at 1/3/2018 4:26:35 PM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org

Vital Signs [NURMON0013] EVERY 1 HOUR, Starting today, STAT
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Patient Monitoring [140488]
Cardiac Rhythm Monitoring - Adult
[NURMON0010]
CONTINUOUS, Routine
Indication:
Notify Provider: Symptomatic Change in
Rhythm,Serious Arrhythmia
Functional Cardiac Defibrillator Present:
Respiratory [140487]
Pulse Oximetry on Room Air - Once
[NURMON0009]
ONCE, Starting today For 1 Occurrences, STAT
Pulse Oximetry [NURMON0009] CONTINUOUS, Starting today, STAT
Oxygen Therapy [RT0032] CONTINUOUS, Starting today, STAT
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Liter Flow:
Titrate oxygen to maintain O2 sat at (%): 93
O2 Delivery Device: Nasal Cannula
Attempt to Wean Off Oxygen?
Supplies [133205]
Please bring Lumbar Puncture Tray to room
[NURCOM0022]
ONCE
Please bring 22g Whitacre "Dull Tip" needle to
room [NURCOM0022]
ONCE
Please bring 22g Quincke "Cutting Tip" needle to
room [NURCOM0022]
ONCE
Page 4 of 4
Printed by STRAKA, KEVIN F [KFS1] at 1/3/2018 4:26:35 PM
Copyright © 2018 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 01/2018CCKM@uwhealth.org