/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-98379-en.cckm

201709272

page

100

UWHC,UWMF,

Tools,

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

ED - Stroke Code - Adult [632]

ED - Stroke Code - Adult [632] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Stroke Code - Adult [632]
Laboratory
Labs [9235]
Glucose, POC [IPGLUCOSE] ONCE, Starting today For 1 Occurrences, Routine,
Glucose, POC should always be ordered in
conjunction with orders for hypoglycemia management
and monitoring as indicated in the Hypoglycemia
Management (Adult) panel.
If Conditional, What Condition?
CBC WITHOUT DIFFERENTIAL [HEMO] 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?
PROTHROMBIN TIME/INR [PT] 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?
Collection time for this lab must be within 20 minutes
of the patient arrival to the ED
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?
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?
DIFFERENTIAL [DIFF] STAT, Starting today For 1 Occurrences, STAT, Test
is only available as an Add-On to a previously ordered
WBC or CBC without Differential.
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
ESR [HCERWEST] 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?
TSH [TSH] 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?
Diagnostic Tests and Imaging
Cardiology [136334]
ECG - 12 Lead [EKG0008] ONCE, Starting today For 1 Occurrences, STAT
Reason for exam: STROKE/TIA
General Radiology [6566]
Page 1 of 4
Printed by STRAKA, KEVIN F [KFS1] at 9/27/2017 9:55:38 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
09/2017CCKM@uwhealth.org

STROKE MRI/MRA FAST ED SCREEN
[R07054A]
ONCE-RAD NEXT AVAILABLE, Routine
Current signs and symptoms?
What specific question(s) would you like answered by
this exam?
Relevant recent/past history?
Study Needed Within:
Is patient pregnant?
Does patient have a pacemaker or defibrillator?
Allergy to Gadolinium (MRI) contrast?
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.
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.
Relevant Surgical History (Select all applicable or
None):
Implanted Devices? (Select all applicable or None):
History of Metal in Body? (Select all applicable or
None):
Has patient had a colonoscopy/endoscopy in the last 8
weeks?
Last creatinine value? (will auto pull in date and value
in comment):
Last e-GFR value? (will auto pull in value and date in
comment):
Last patient weight? (will auto pull in value and date in
comment):
Last patient height? (will auto pull in value and date in
comment):
Transport Method:
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
Page 2 of 4
Printed by STRAKA, KEVIN F [KFS1] at 9/27/2017 9:55:38 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
09/2017CCKM@uwhealth.org

STROKE CODE- CT ANGIO HEAD, NECK W
PERFUSION [R07001A]
ONCE-RAD NEXT AVAILABLE, Routine
Current signs and symptoms? Stroke
What specific question(s) would you like answered by
this exam? Stroke
Relevant recent/past history? Stroke
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:
Intravenous Therapy
IV Fluids [9792]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
sodium chloride 0.9 % infusion BOLUS [730003] 500 mL, Intravenous, ONCE For 1 Doses
sodium chloride 0.9 % infusion BOLUS [730003] 1,000 mL, Intravenous, ONCE For 1 Doses
Medications
Medications [6823]
labetalol injection [800192] 10 mg, Intravenous, ONCE For 1 Doses
Patient Care Orders
Vital Signs [136337]
Vital Signs [NURMON0013] EVERY 30 MINUTES, Starting today, STAT
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Patient Monitoring [136338]
Assess Neurologic Status [NURMON0006] EVERY 30 MINUTES, Starting today, STAT
Measure Weight [NURMON0015] ONCE, Starting today For 1 Occurrences, STAT
Weigh With?
Weigh when?
Cardiac Rhythm Monitoring - Adult
[NURMON0010]
CONTINUOUS, Routine
Indication:
Notify Provider: Symptomatic Change in
Rhythm,Serious Arrhythmia
Functional Cardiac Defibrillator Present:
Activity [136340]
Activity - Bedrest [NURACT0008] CONTINUOUS, Starting today, Routine
Location:
Nutrition [136341]
Diet Order (ED Only) - NPO (No Oral Meds)
[NURDIE0012]
CONTINUOUS, Starting today, STAT
Diet: NPO
Respiratory [136343]
Pulse Oximetry [NURMON0009] CONTINUOUS, Starting today, STAT
Page 3 of 4
Printed by STRAKA, KEVIN F [KFS1] at 9/27/2017 9:55:38 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
09/2017CCKM@uwhealth.org

Contingency Parameters [6729]
Notify - Neurology Resident (CSC) or Provider
(TAC) if temperature is greater than 38.0 degrees
Celsius [NURCOM0022]
CONTINUOUS, Starting today
Notify - Neurology Resident (CSC) or Provider
(TAC) if requires more than 1 labetalol dose
within 1 hour [NURCOM0022]
CONTINUOUS, Starting today
Notify - Neurology Resident (CSC) or Provider
(TAC) if any change in neurological status
[NURCOM0022]
CONTINUOUS, Starting today
Page 4 of 4
Printed by STRAKA, KEVIN F [KFS1] at 9/27/2017 9:55:38 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
09/2017CCKM@uwhealth.org