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/clinical/cckm-tools/content/order-sets/inpatient/emergency-medicine/name-98385-en.cckm

201711334

page

100

UWHC,UWMF,

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

ED - NSTE - ACS Treatment - Adult [5563]

ED - NSTE - ACS Treatment - Adult [5563] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - NSTE - ACS Treatment - Adult [5563]
Laboratory
Labs [190283]
BASIC METABOLIC PANEL [BMET] STAT, Starting today 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?
MAGNESIUM [MAG] 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?
TROPONIN [GM2447] 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?
PTT [PTT] 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?
PROTHROMBIN TIME/INR [PT] 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?
PHOSPHATE [PHOS] 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?
HEMATOCRIT [HCT] 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?
PLATELET COUNT [PLT] 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?
Diagnostic Tests and Imaging
General Radiology [190284]
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? Question mediastinal width. Question
pneumothroax.
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
Premedications for Needle Insertion [106310]
Page 1 of 3
Printed by STRAKA, KEVIN F [KFS1] at 11/27/2017 5:18:02 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2017CCKM@uwhealth.org

Use lidocaine topical dressing kit for stable patient, no lidocaine allergies, have at least 30
minutes time prior to needing to use IV
Sodium chloride (bacteriostatic) 0.9% intradermal: Useful for patients requiring urgent IV
access; onset is within 1 minute. Choice of medication should be based on patient’s previous
experience/preference, history of lidocaine allergy and ease of access.
lidocaine (LMX) 4% topical dressing kit [66882] Topical, EVERY 1 HOUR PRN, peripheral line
insertion - see Admin Instructions
Do NOT apply to area greater than 200 square
centimeters (maximum 2.5 g/site; maximum 4 sites
per hour, 6 times per day). Do NOT leave on longer
than 2 hours. Use for stable patient, no allergies to
lidocaine, with at least 30 minutes time prior to IV use
lidocaine (XYLOCAINE) 1% injection [39034] 0.1-0.4 mL, Intradermal, PRN, peripheral line insertion
- see Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge
needle to inject solution and create a wheal. Wait 30
seconds to 1 minute then insert IV catheter into center
of wheal. Use if IV is needed within 30 minutes.
Choice of medication should be based on patient’s
previous experience/preference, history of lidocaine
allergy and ease of access
sodium chloride (bacteriostatic) 0.9 % injection
[50585]
0.05-0.1 mL, Intradermal, PRN, peripheral line
insertion - see Admin Instructions
Use an insulin or TB syringe with a 25-30 gauge
needle to inject solution and create a wheal. Wait 30
seconds to 1 minute then insert IV catheter into center
of wheal. Use if IV is needed within 30 minutes.
Choice of medication should be based on patient’s
previous experience/preference, history of lidocaine
allergy and ease of access
Intravenous Therapy [190273]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Starting today, STAT
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Check and document patency, tubing change, site
assessment, and dressing change per policy.
Medications
Medications [190274]
Enoxaparin: 1st Line Treatment unless chronic kidney disease or other contraindications for ●
-Adult -Heparin Anticoagulation -enoxaparin which then order heparin via the IP/ED
Supplemental [4373] order set .
Aspirin: Administer first dose STAT, and avoid all other NSAIDs●
5 inhibitors (i.e. 24 hours since - nitroglycerin: Do NOT order if recent use of PDE●
sildenafil/vardenafil dose, or 48 hours since tadalafil dose). If HTN, heart failure or pain persists,
consider IV
Morphine: Order if ischemic pain persists despite maximum tolerated nitrates ●
enoxaparin (LOVENOX) subcutaneous injection -
NOTE: Recommended as 1st line treatment
unless chronic kidney disease or other
contraindications for enoxaparin [800040]
1 mg/kg, Subcutaneous, ONCE For 1 Doses
aspirin chew tab [34786] 324 mg, Oral, ONCE For 1 Doses
clopidogrel (PLAVIX) tab [720168] 600 mg, Oral, ONCE For 1 Doses
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 11/27/2017 5:18:02 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2017CCKM@uwhealth.org

nitroglycerin (NITROSTAT) sublingual tab 0.4 mg
- NOTE: If hypertension, heart failure or pain
persists consider IV [40283]
0.4 mg, Sublingual, EVERY 5 MINUTES PRN For 3
Doses, chest pain
Hold if SBP less than 120 mmHg
nitroglycerin 50 mg in dextrose 5% 250 mL
infusion [51611]
Intravenous, CONTINUOUS
MORPHine PF injection - NOTE: Order if
ischemic pain persists despite maximum tolerated
nitrates [800122]
4 mg, Intravenous, ONCE For 1 Doses
Patient Care Orders
Vital Signs [136369]
Measure Weight For Dose Calculations
[NURMON0054]
ONCE, Starting today For 1 Occurrences, STAT
Vital Signs [NURMON0013] EVERY 1 HOUR, STAT
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Patient Monitoring [136371]
Cardiac Rhythm Monitoring - Adult
[NURMON0010]
CONTINUOUS, Routine
Indication:
Notify Provider:
Functional Cardiac Defibrillator Present:
Respiratory [190286]
Pulse Oximetry on Room Air - Once
[NURMON0009]
ONCE, Starting today For 1 Occurrences, STAT
Pulse Oximetry [NURMON0009] CONTINUOUS, STAT
Oxygen Therapy [RT0032] CONTINUOUS, Starting today, STAT
FiO2 (%) Titrate to Keep Sats >/= to ___%:
Liter Flow:
Titrate oxygen to maintain O2 sat at (%): 90
O2 Delivery Device: Nasal Cannula
Attempt to Wean Off Oxygen?
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 11/27/2017 5:18:02 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2017CCKM@uwhealth.org