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/clinical/cckm-tools/content/order-sets/inpatient/hospital-wide/name-123239-en.cckm

201712341

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Hospital-wide

IP - Rapid Response Team Delegation Protocol - Adult - Procedure [1725]

IP - Rapid Response Team Delegation Protocol - Adult - Procedure [1725] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Hospital-wide


IP - Rapid Response Team Delegation Protocol - Adult - Procedure [1725]
Rapid Response Team Panels
Rapid Response Panels [150291]
Rapid Response Team - Basic [150292]
Oxygen Therapy [RT0032] CONTINUOUS, Routine
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? Yes
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Rapid Response Team - Acute Chest Pain Onset
[150152]
TROPONIN [GM2447] 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?
CBC WITHOUT DIFFERENTIAL [HEMO] 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?
BUN [BUN] 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?
CREATININE, WHOLE BLOOD [HCWBCRET] STAT For 1 Occurrences, STAT
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
ELECTROLYTES, WHOLE BLOOD
[HCWBLYTS]
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?
ECG - 12 Lead [EKG0008] ONCE 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.
Rapid Response Team - Acute Hypotension
[235298]
CBC WITHOUT DIFFERENTIAL [HEMO] 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?
BUN [BUN] 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 3
Printed by STRAKA, KEVIN F [KFS1] at 12/4/2017 1:48:21 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 12/2017CCKM@uwhealth.org

CREATININE, WHOLE BLOOD [HCWBCRET] STAT For 1 Occurrences, STAT
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
ELECTROLYTES, WHOLE BLOOD
[HCWBLYTS]
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?
ECG - 12 Lead [EKG0008] ONCE 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.
Lactate for Suspected Sepsis (Adults Only)
[207960]
LACTATE [GM2255] STAT For 1 Occurrences, STAT
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
LACTATE [GM2255] CONDITIONAL, 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? Repeat in 3 hours if
previous lactate >2
Cultrure, Blood, Bacteria/Yeast (2 Sites) [116728]
.Practices for Blood Culturing Best This order equals 2 sites (4 bottles). See link below for
CULTURE, BLOOD, BACTERIA AND YEAST
[GM4045]
NEXT DRAW, Routine, For optimum diagnosis of
sepsis, sample 3-4 sites only on the first day of a
septic episode. Cultures on subsequent days are
of minimal diagnostic value. Culture detects
bacteria, Candida and Cryptococcus. If filamentous
fungi are suspected see Culture, Blood,
Filamentous Fungi.
Patient's Active Lines:
No Active Lines Found.
If Conditional, What Condition?
CULTURE, BLOOD, BACTERIA AND YEAST
[GM4045]
NEXT DRAW, Routine, For optimum diagnosis of
sepsis, sample 3-4 sites only on the first day of a
septic episode. Cultures on subsequent days are
of minimal diagnostic value. Culture detects
bacteria, Candida and Cryptococcus. If filamentous
fungi are suspected see Culture, Blood,
Filamentous Fungi.
Patient's Active Lines:
No Active Lines Found.
If Conditional, What Condition?
sodium chloride 0.9% BOLUS [730003] 500 mL, Intravenous, ONCE For 1 Doses
Rapid Response Team - Acute Mental Status
Changes [150154]
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 12/4/2017 1:48:21 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org

CBC WITHOUT DIFFERENTIAL [HEMO] 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?
BUN [BUN] 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?
CREATININE, WHOLE BLOOD [HCWBCRET] STAT For 1 Occurrences, STAT
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
ELECTROLYTES, WHOLE BLOOD
[HCWBLYTS]
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?
Glucose, POC [IPGLUCOSE] STAT 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?
CALCIUM [CA] 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?
Rapid Response Team - Acute Respiratory
Distress [150155]
X-RAY CHEST AP VIEW [R71010] ONCE-RAD NEXT AVAILABLE For 1 Occurrences,
STAT
Current signs and symptoms?
What specific question(s) would you like answered
by this exam? Acute Respiratory Distress
Relevant recent/past history?
Is patient pregnant?
If being performed remotely, where? Bedside
Last patient weight? (will auto pull in value and date
in comment):
Transport Method: Floor Determined/Entered
BLOOD GASES [HCBGAS] 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?
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 12/4/2017 1:48:21 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org