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UWHC,UWMF,

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

ED - Overdose - Adult [641]

ED - Overdose - Adult [641] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Overdose - Adult [641]
Laboratory
Labs [6623]
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 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?
BILIRUBIN, TOTAL [TBIL] 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?
AST/SGOT [AST] 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?
ALT/SGPT [ALT] 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?
ALKALINE PHOSPHATASE [ALKP] 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, 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?
ACETAMINOPHEN [GM2485] ONCE, 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?
SALICYLATE [HCSAL] 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?
ALCOHOL [GM2440] 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?
DRUG SCREEN, URINE [HCUPNL] STAT, Starting today For 1 Occurrences, STAT, 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?
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?
Page 1 of 6
Printed by STRAKA, KEVIN F [KFS1] at 12/8/2017 2:30:49 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2017CCKM@uwhealth.org

HCG, QUALITATIVE, URINE [UPREG] 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?
CK, TOTAL [CPK] 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?
MAGNESIUM [MAG] 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?
PHOSPHATE [PHOS] 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?
OSMOLALITY [GM2215] 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?
TROPONIN [GM2447] 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?
BLOOD GASES AND O2 SATURATION
[HCBGASOS]
STAT, Starting today 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?
PROTHROMBIN TIME/INR [PT] NEXT AM For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
BETA-HYDROXYBUTYRATE [XBOH] NEXT AM For 1 Occurrences, Routine
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 [140172]
ECG - 12 Lead [EKG0008] ONCE, Starting today For 1 Occurrences, STAT
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 [133199]
Page 2 of 6
Printed by STRAKA, KEVIN F [KFS1] at 12/8/2017 2:30:49 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

X-RAY CHEST AP VIEW [R71010] 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?
If being performed remotely, where?
Last patient weight? (will auto pull in value and date in
comment):
Transport Method: Floor Determined/Entered
CT HEAD W/ O IV CONTRAST [R70450] ONCE-RAD NEXT AVAILABLE, 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:
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
Overdose Medications
Overdose Medications [7028]
NOTE: Discontinue any acetaminophen orders when ordering N-acetylcysteine.
NOTE: Enteral is the preferred route of administration in all patients able to tolerate.
The IV formulation is restricted to acetaminophen toxicity, non-acetaminophen acute liver failure
(NAALF), or alcohol-induced liver failure (ALF) in the following patient populations:
1. Has inability to tolerate enteral medications despite antiemetic therapy,
2. Is receiving GI decontamination,
3. Has suspected or confirmed GI bleed,
4. Has possible obstruction,
OR
5. Has surgical conditions that preclude enteral administration
naloxone (NARCAN) injection [800199] 0.4 mg, Intravenous, PRN, opioid overdose
Start at 0.4 mg, repeat up to a total of 2 mg. Notify
MD if naloxone administered
activated charcoal (EZ CHAR) susp [69638] 50 g, Oral, ONCE For 1 Doses
sodium bicarbonate injection [800214] 50 mEq, Intravenous, ONCE For 1 Doses
sodium bicarbonate injection [800214] 100 mEq, Intravenous, ONCE For 1 Doses
Page 3 of 6
Printed by STRAKA, KEVIN F [KFS1] at 12/8/2017 2:30:49 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

lorazepam (ATIVAN) injection [800053] 1 mg, Intravenous, ONCE For 1 Doses
N-acetylcysteine Administration
NOTE: Discontinue any acetaminophen orders when ordering N-acetylcysteine.
NOTE: Enteral is the preferred route of administration in all patients able to tolerate.
The IV formulation is restricted to acetaminophen toxicity, non-acetaminophen acute liver failure
(NAALF), or alcohol-induced liver failure (ALF) in the following patient populations:
1. Has inability to tolerate enteral medications despite antiemetic therapy,
2. Is receiving GI decontamination,
3. Has suspected or confirmed GI bleed,
4. Has possible obstruction,
OR
5. Has surgical conditions that preclude enteral administration
Acetaminophen Toxicity - PEDIATRIC / ADULT (Single Response) [150594]
ENTERAL Regimen - Acetaminophen Overdose -
Pediatrics / Adults [235198]
acetylcysteine 20% soln(ORAL) CUSTOM -
NOTE: Loading dose [780005]
140 mg/kg, Oral, ONCE For 1 Doses
NOTE: Loading dose
acetylcysteine 20% soln(ORAL) CUSTOM -
NOTE: Maintenance dose [780005]
70 mg/kg, Oral, EVERY 4 HOURS For 17 Doses
Administer 4 hours following administration of
loading dose
NOTE: Maintenance dose
Acetaminophen Level [GM2485] 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?
Acetaminophen Level [GM2485] CONDITIONAL, Routine
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Draw 4 hours post-
acetaminophen ingestion. If time of ingestion is
unknown, draw 2 hours after first draw.
INTRAVENOUS Regimen - Acetaminophen
Overdose - Pediatrics / Adults [148970]
acetylcysteine (ACETADOTE) 150mg/kg in
dextrose 5% 200 mL bag [700129]
150 mg/kg, Intravenous, ONCE For 1 Doses
Bag #1.Administer entire bag over 60 minutes
NOTE: Loading dose.
acetylcysteine (ACETADOTE) 50 mg/kg in
dextrose 5 % 500 mL bag [700129]
100 mg/kg, Intravenous, ONCE For 1 Doses
Administer entire bag over 4 hours
NOTE: Second dose
acetylcysteine (ACETADOTE) 6,000 mg in
dextrose 5 % 530 mL infusion [700900]
6.25 mg/kg/hr, Intravenous, CONTINUOUS For 16
Hours
Infuse at 6.25mg/kg/hr for 16 hours
Note: Third dose
acetylcysteine (ACETADOTE) 6,000 mg in
dextrose 5 % 530 mL infusion [700900]
4.17 mg/kg/hr, Intravenous, CONTINUOUS For 4
Days
Infuse at 4.17mg/kg/hr for 4 days
Note: Fourth dose
Page 4 of 6
Printed by STRAKA, KEVIN F [KFS1] at 12/8/2017 2:30:49 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

Acetaminophen Level [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?
Acetaminophen Level [GM2485] CONDITIONAL, Routine
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Draw 4 hours post-
acetaminophen ingestion. If time of ingestion is
unknown, draw 2 hours after first draw.
Non-acetaminohpen Acute Liver Failure - Adults (Single Response) [150597]
N-acetylcysteine - Enteral Regimen - Non-
acetaminophen/Alcohol-Induced - Adults
[148971]
acetylcysteine 20% soln(ORAL) CUSTOM -
NOTE: Loading dose [780005]
140 mg/kg, Oral, ONCE For 1 Doses
NOTE: Loading dose
acetylcysteine 20% soln(ORAL) CUSTOM -
NOTE: Maintenance dose [780005]
70 mg/kg, Oral, EVERY 4 HOURS For 17 Doses
Administer 4 hours following administration of
loading dose
NOTE: Maintenance dose
N-acetylcysteine - Intravenous Regimen - Non-
acetaminophen - Adults [235202]
acetylcysteine (ACETADOTE) 150mg/kg in
dextrose 5% 200 mL bag - NOTE: Loading dose
[700129]
150 mg/kg, Intravenous, ONCE For 1 Doses
Bag #1. Administer over 60 minutes.
NOTE: Loading dose
acetylcysteine (ACETADOTE) in dextrose 5 %
200 mL bag [700129]
50 mg/kg, Intravenous, ONCE
Administer entire bag over 4 hours
NOTE: Second dose
acetylcysteine (ACETADOTE) 6,000 mg in
dextrose 5 % 530 mL infusion [700900]
12.5 mg/kg/hr, Intravenous, ONCE For 1 Doses
Run at 12.5mg/kg/hr for 4 hours, then decrease to
6.25mg/kg/hour See separate order for
acetylcysteine
NOTE: Third dose
Alcohol-Induced Liver Failure - Adults (Single Response) [150617]
N-acetylcysteine - Enteral Regimen - Non-
acetaminophen/Alcohol-Induced - Adults
[148971]
acetylcysteine 20% soln(ORAL) CUSTOM -
NOTE: Loading dose [780005]
140 mg/kg, Oral, ONCE For 1 Doses
NOTE: Loading dose
acetylcysteine 20% soln(ORAL) CUSTOM -
NOTE: Maintenance dose [780005]
70 mg/kg, Oral, EVERY 4 HOURS For 17 Doses
Administer 4 hours following administration of
loading dose
NOTE: Maintenance dose
N-acetylcysteine - Intravenous Regimen - Alcohol
induced - Adults [235208]
acetylcysteine (ACETADOTE) 150mg/kg in
dextrose 5% 200 mL bag - NOTE: Loading dose
[700129]
150 mg/kg, Intravenous, ONCE For 1 Doses
Bag #1. Administer over 60 minutes.
NOTE: Loading dose.
acetylcysteine (ACETADOTE) 50 mg/kg in
dextrose 5 % 500 mL bag [700129]
50 mg/kg, Intravenous, ONCE For 1 Doses
Administer entire bag over 4 hours
Note: Second dose
acetylcysteine (ACETADOTE) 6,000 mg in
dextrose 5 % 530 mL infusion [700900]
12.5 mg/kg/hr, Intravenous, ONCE For 1 Doses
Run at 12.5 mg/kg/hr x 4 hours, then decrease to
6.25 mg/kg/hour. See separate order for
acetylcysteine
NOTE: Third dose
Page 5 of 6
Printed by STRAKA, KEVIN F [KFS1] at 12/8/2017 2:30:49 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

acetylcysteine (ACETADOTE) 6,000 mg in
dextrose 5 % 530 mL infusion [700900]
6.25 mg/kg/hr, Intravenous, CONTINUOUS
Administer over 16 hours.
NOTE: Fourth dose
Patient Care Orders
Vital Signs [140197]
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 [198627]
Cardiac Rhythm Monitoring - Adult
[NURMON0010]
CONTINUOUS, Starting today, Routine
Notify Provider: Symptomatic Change in
Rhythm,Serious Arrhythmia
Functional Cardiac Defibrillator Present:
Constant Supervision in ED by ED staff
[PRECAU0018]
CONTINUOUS, Routine
Constant Supervision Ratio:
Respiratory [6719]
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?
Page 6 of 6
Printed by STRAKA, KEVIN F [KFS1] at 12/8/2017 2:30:49 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org