/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-98368-en.cckm

201606176

page

100

UWHC,UWMF,

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

ED – Headache – Adult [631]

ED – Headache – Adult [631] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Headache - Adult [631]
Laboratory
Labs [6615]
CBC WITH DIFFERENTIAL [CBC] 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?
BASIC METABOLIC PANEL [BMET] STAT - RN COLLECT For 1 Occurrences, Routine, 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?
PROTHROMBIN TIME/INR [PT] 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?
ESR [HCERWEST] 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?
HCG, QUALITATIVE, URINE [UPREG] 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?
URINALYSIS WITH MICROSCOPY [UA] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
CSF Labs [131379]
CELL COUNT, CSF, TUBE 1 [HCCCTUB1] 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?
CELL COUNT, CSF, TUBE 4 [HCCCTUB4] 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?
CULTURE, CSF, AER WITH GRAM STAIN [HCSFC] 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?
GLUCOSE, CSF [GM2740] 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?
PROTEIN, CSF [GM2745] 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?
Page 1 of 3
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 2:29:50 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org

If Conditional, What Condition?
HERPES SIMPLEX VIRUS BY PCR [HCHSVPCR] STAT - RN COLLECT 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
General Radiology [6565]
CT HEAD W/ O IV CONTRAST [R70450] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, STAT
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:
CT ANGIO HEAD & NECK [R07032] ONCE-RAD NEXT AVAILABLE, Starting today For 1
Occurrences, STAT
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:
IV Fluids
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
Migraine Medications [133254]
diphenhydramine (BENADRYL) cap [36791] 25 mg, Oral, ONCE For 1 Doses
diphenhydramine (BENADRYL) injection 50 mg
[800106]
25 mg, Intravenous, ONCE For 1 Doses
droperidol (INAPSINE) injection 0.625 mg [800117] 0.625 mg, Intravenous, ONCE For 1 Doses
prochlorperazine (COMPAZINE) tab [41372] 10 mg, Oral, ONCE For 1 Doses
prochlorperazine (COMPAZINE) injection [41369] 10 mg, Intravenous, ONCE For 1 Doses
promethazine (PHENERGAN) injection [800112] 12.5 mg, Intravenous, ONCE For 1 Doses
Page 2 of 3
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 2:29:50 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org

Analgesics [133200]
acetaMINOPHEN (TYLENOL) tab [34149] 650 mg, Oral, ONCE For 1 Doses
ibuprofen (MOTRIN) tab [38353] 600 mg, Oral, ONCE For 1 Doses
ketOROLAC (TORADOL) injection [800050] 30 mg, Intravenous, ONCE For 1 Doses
ketOROLAC (TORADOL) injection [800050] 60 mg, Intramuscular, ONCE For 1 Doses
MORPHine PF injection [800122] 4 mg, Intravenous, ONCE For 1 Doses
MORPHine PF injection [800122] 8 mg, Intravenous, ONCE For 1 Doses
HYDROmorphone PF (DILAUDID) injection [800120] 0.5 mg, Intravenous, ONCE For 1 Doses
HYDROmorphone PF (DILAUDID) injection [800120] 1 mg, Intravenous, ONCE For 1 Doses
Antiemetics [133253]
ondansetron (ZOFRAN ODT) disintegrating tab [64224] 4 mg, Oral, ONCE For 1 Doses
ondansetron (ZOFRAN) injection [800202] 4 mg, Intravenous, ONCE For 1 Doses
metoclopramide (REGLAN) injection [800059] 10 mg, Intravenous, ONCE For 1 Doses
Patient Care Orders
Vital Signs [6728]
Vital Signs [NURMON0013] EVERY 1 HOUR, Starting today, STAT
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Nutrition [140757]
Diet Order (ED Only) [NURDIE0012] CONTINUOUS, Routine
Diet: NPO,Other (Comment) (except medications)
Supplies [133252]
Please Bring Lumbar Puncture Tray [NURCOM0022] ONCE For 1 Occurrences
Please Bring 22g Whitacre "Dull Tip" needle to room
[NURCOM0022]
ONCE
Please Bring 22g Quincke "Cutting Tip" needle to room
[NURCOM0022]
ONCE
Page 3 of 3
Printed by GUETZLAFF, SCOTT F [SFG091] at 1/14/2016 2:29:50 PM

Copyright © 2015 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:



















 
01/2016Lee Vermeulen, CCKM@uwhealth.org