/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-98389-en.cckm

201710289

page

100

UWHC,UWMF,

Tools,

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

ED – Neuro-Endovascular Stroke (NES) – Adult [5968]

ED – Neuro-Endovascular Stroke (NES) – Adult [5968] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Emergency Medicine


ED - Neuro-Endovascular Stroke (NES) - Adult [5968]
Surgical Case Request
Surgical Case Request [229086]
Surgical Case Request [ORP9999] Note: If this case needs to be scheduled within 24
hours, please call the OR schedulers or the OR
control station., Patient Class: Emergency, Location:
UWHC ANESTHESIA OTHER OUT, Provider:
ANESTHESIA RESOURCE, Date: S, Procedure:
Neuro angiogram with acute stroke treatment,
Provider: ANESTHESIA RESOURCE, Laterality: N/A,
Anesthesia Type: General
Diagnostic Tests and Imaging
General Radiology [200633]
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:
STROKE CODE LIMITED - CT ANGIO HEAD
PERFUSION ONLY [R07034A]
ONCE-RAD NEXT AVAILABLE, Routine
Current signs and symptoms? Stroke
What specific question(s) would you like answered by
this exam? Please include relevant recent/past
history. Stroke
Can Patient be given oral contrast? No
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:
Page 1 of 3
Printed by O'BRIEN, RYLEY P [RPO249] at 10/13/2017 2:50:21 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 10/2017CCKM@uwhealth.org

ANGIOGRAM INTERNAL CAROTID CEREBRAL
[R36224]
ONCE-RAD NEXT AVAILABLE, Routine
Current signs and symptoms? Stroke
What specific question(s) would you like answered by
this exam? Treat Stroke
Relevant recent/past history? Stroke
Is patient pregnant? Unknown
Is patient on anticoagulation therapy? If yes, specify
coagulation disorder and current medications in
comments box at bottom.
Last creatinine value? (will auto pull in date and value
in comment):
Last patient weight? (will auto pull in value and date in
comment):
Last e-GFR value? (will auto pull in value and date 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.
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 [201261]
labetalol injection - NOTE: order if patient DID
RECEIVE tPA at an outside facility [800192]
10 mg, Intravenous, EVERY 10 MINUTES PRN, SBP
> 180 mmHg, or DBP > 105 mmHg
Hold if heart rate less than 52 beats per minute
NOTE: order if patient DID RECEIVE tPA at an
outside facility
labetalol injection - NOTE: order if patient did
NOT RECEIVE tPA at an outside facility [800192]
10 mg, Intravenous, EVERY 10 MINUTES PRN, SBP
> 220 mmHg, or DBP > 120 mmHg
Hold if heart rate less than 52 beats per minute
NOTE: order if patient did NOT RECEIVE tPA at an
outside facility
Patient Care Orders
Vital Signs [201218]
Vital Signs [NURMON0013] SEE COMMENTS, Starting today, STAT
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Every 15 minutes times 4, then every 30 minutes
times 12, then every hour.
Patient Monitoring [201219]
Page 2 of 3
Printed by O'BRIEN, RYLEY P [RPO249] at 10/13/2017 2:50:21 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
10/2017CCKM@uwhealth.org

Assess Neurologic Status using UWHC
Abbreviated NIHSS Flowsheet [NURMON0006]
SEE COMMENTS, Starting today, STAT, Assess
neurologic status using "UWHC Abbreviated NIHSS
Flowsheet" - Every 15 minutes times 4, then every 30
minutes times 12, then every hour.
Measure Weight [NURMON0015] ONCE, Starting today For 1 Occurrences, STAT
Weigh With?
Weigh when?
Cardiac Rhythm Monitoring - Adult
[NURMON0010]
CONTINUOUS, Starting today, Routine
Notify Provider: Symptomatic Change in
Rhythm,Serious Arrhythmia
Functional Cardiac Defibrillator Present:
Indication: Post stroke
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
Contingency Parameters [230519]
Notify - Neurology Resident if temperature is
greater than 38.0 degrees Celsius
[NURCOM0022]
CONTINUOUS, Starting today
Notify - Neurology Resident if requires more than
1 labetalol dose within 1 hour [NURCOM0022]
CONTINUOUS, Starting today
Notify - Neurology Resident if any change in
neurological status [NURCOM0022]
CONTINUOUS, Starting today
Page 3 of 3
Printed by O'BRIEN, RYLEY P [RPO249] at 10/13/2017 2:50:21 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
10/2017CCKM@uwhealth.org