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/clinical/cckm-tools/content/order-sets/inpatient/neurosciences/name-116578-en.cckm

201705138

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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Neurosciences

ED-IP - Pediatric Status Epilepticus - Supplemental [6361]

ED-IP - Pediatric Status Epilepticus - Supplemental [6361] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Neurosciences


ED/IP - Pediatric Status Epileptius - Supplemental [6361]
CriteriaInclusion
> 2 monthsAge
lasting > 5 minutes Seizures
seizures without return to baseline mental statusRecurrent
Goals
Stop seizure as soon as possible
need for next medication Anticipate
continue medications < 60 minutes if seizures different three Administer
ABCsMaintain continuous support of
Status Epilepticus - Pediatric - Emergency
Department/Inpatient
URL: https://uconnect.wisc.edu/clinical/cckm-
tools/content/cpg/neurology/related/name-
100991-en.cckm
Patient Care Orders
Patient Monitoring [222512]
Pulse Oximetry [NURMON0009] CONTINUOUS, Routine
Video EEG [EEG0008] ONCE For 1 Occurrences, Routine
Reason for Monitoring:
Sleep deprived?
Duration:
Has a Neurology Consult been obtained? (If no,
obtain a Neurology Consult prior to ordering the
procedure):
Non-categorized Patient Care Orders [222513]
Insert and Maintain Peripheral IV [NURVAD0013] CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed?
Cardio-Respiratory Monitor - Pediatric - Without
Rhythm [139420]
Cardio-Respiratory Monitor - Pediatric - Without
Rhythm [NURMON0074]
ONCE, Routine, Please complete the Notify
Provider order below, including specification for
apnea > *** seconds. If indicated, order pulse
oximetry separately.
Device Present:
Device Mode:
Device Low Rate Limit (BPM):
Notify Provider:
Notify [NURCOM0001] CONTINUOUS
Provider to Notify: Provider
Notify based on:
Notify provider for apnea > 20 seconds
Medications - Hypoglycemia
Patient Unable to Eat/Swallow Safely and Has IV Access [143431]
dextrose injection - NOTE: Maximum Dose = 25
g [800233]
0.5-1 g/kg, Intravenous, PRN, For blood glucose less
than or equal to 69 mg/dL AND patient is unable to
eat/swallow safely, NPO or unconscious AND has IV
access.
Repeat every 15 minutes until blood glucose greater
than 70 mg/dL
Medications - Seizure Treatment
Presentation [221906]
Page 1 of 4
Printed by STRAKA, KEVIN F [KFS1] at 5/16/2017 3:42:05 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2017CCKM@uwhealth.org

sodium chloride 0.9% BOLUS [730003] 20 mL/kg, Intravenous, ONCE For 1 Doses
Emergent Therapy - First Medication - 5 minutes of seizure (Single Response) [221927]
lorazepam (ATIVAN) injection - Maximum Dose =
4 mg [800053]
0.1 mg/kg, Intravenous, ONCE For 1 Doses
lorazepam (ATIVAN) injection - Maximum Dose =
4 mg [800053]
0.1 mg/kg, Other, ONCE For 1 Doses
Admission intraosseously
midazolam (VERSED) 5 MG/ML intraNASAL soln
= Maximum Dose = 10 mg [785196]
0.5 mg/kg, Nasal, ONCE For 1 Doses
midazolam (VERSED) syrup [60487] 0.5 mg/kg, Other, ONCE For 1 Doses
Administer between the gums and checks
midazolam (VERSED) injection - Maximum Dose
= 10 mg [800197]
0.2 mg/kg, Intramuscular, ONCE For 1 Doses
Emergent Therapy - Second medication - 10 minutes of seizure (Single Response) [221104]
Lorazepam IV [221892]
lorazepam (ATIVAN) injection - Maximum Dose =
4 mg [800053]
0.1 mg/kg, Intravenous, EVERY 5 MINUTES PRN
For 1 Doses, Urgent AED
Administer at the direction of the provider
Note: RN or HUC to notify pharmacist to prepare
urgent therapy [950018]
ONCE For 1 Doses
Note: RN or HUC to notify pharmacist to prepare
urgent therapy
Lorazepam IO [221895]
lorazepam (ATIVAN) injection - Maximum Dose =
4 mg [800053]
0.1 mg/kg, Other, EVERY 5 MINUTES PRN,
Urgent AED
Administer intraosseously at the direction of the
provider
Note: RN or HUC to notify pharmacist to prepare
urgent therapy [950018]
ONCE For 1 Doses
Note: RN or HUC to notify pharmacist to prepare
urgent therapy
Midazolam intraNASAL - If No IV/IO access
[221898]
midazolam (VERSED) 5 MG/ML intraNASAL soln
- Maximum Dose = 10 mg [785196]
0.5 mg/kg, Nasal, EVERY 5 MINUTES PRN For 1
Doses, Urgent AED
Administer at the direction of the provider
Note: RN or HUC to notify pharmacist to prepare
urgent therapy [950018]
ONCE For 1 Doses
Note: RN or HUC to notify pharmacist to prepare
urgent therapy
Midazolam Buccal - If No IV/IO access [221901]
midazolam (VERSED) syrup - Maximum Dose =
10 mg [60487]
0.5 mg/kg, Other, EVERY 5 MINUTES PRN,
Urgent AED
Administer between the gums and cheek at the
director of the provider
Note: RN or HUC to notify pharmacist to prepare
urgent therapy [950018]
ONCE For 1 Doses
Note: RN or HUC to notify pharmacist to prepare
urgent therapy
Midazolam IM - If No IV/IO accees [221904]
midazolam (VERSED) injection - Maxumum
Dose = 10 mg [800197]
0.2 mg/kg, Intramuscular, EVERY 5 MINUTES
PRN, sedation, Urgent AED
Administer at the direction of the provider
Note: RN or HUC to notify pharmacist to prepare
urgent therapy [950018]
ONCE For 1 Doses
Note: RN or HUC to notify pharmacist to prepare
urgent therapy
URGENT THERAPY - 20 minutes of seizure - NOTE: Request RN or HUC to notify pharmacist to prepare
medication for Urgent Therapy (Single Response) [221947]
Page 2 of 4
Printed by STRAKA, KEVIN F [KFS1] at 5/16/2017 3:42:05 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2017CCKM@uwhealth.org

fosphenytoin (CEREBYX) intraVENOUS -
Maximum Dose = 1000 mg PE - Avoid in patients
with cardiac [800124]
Intravenous, PRN - NOTIFY PHARMACY WHEN
NEEDED
phenobarbital injection - Maximum Dose = 1000
mg [800070]
20 mg/kg, Intravenous, ONCE For 1 Doses
levetiracetam (KEPPRA) intraVENOUS -
Recommended dose 30-60 mg/kg - Maximum
Dose = 2500 mg [800051]
Intravenous, ONCE For 1 Doses
valproate (DEPACON) intraVENOUS - Not
recommended for patients less than 2 years old.
Recommended dose 20-40 mg/kg. Maximum
Dose - 1000 mg [800082]
Intravenous, ONCE For 1 Doses
Refractory Therapy - Seizure between 30-60 minutes (Single Response) [221966]
phenobarbital injection - Maximum Dose = 1000
mg [800070]
20 mg/kg, Intravenous, ONCE For 1 Doses
Laboratory
Laboratory [222515]
Glucose, POC [IPGLUCOSE] STAT - RN COLLECT 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 WITH DIFFERENTIAL [CBC] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
ELECTROLYTES [LYTE] STAT - RN COLLECT 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 - RN COLLECT 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 [CRET] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
PHENOBARBITAL [PHEN] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
LEVETIRACETAM [HCKEPPRA] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
VALPROATE [DEP] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
OXCARBAZEPINE METABOLITE [HCOXCARB] STAT - RN COLLECT 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 3 of 4
Printed by STRAKA, KEVIN F [KFS1] at 5/16/2017 3:42:05 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2017CCKM@uwhealth.org

PHENYTOIN [DIL] STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Consults
Consults [222516]
Consult Pediatric Neurology (Inpatient)
[CON0097]
ONCE
Intent:
Concern or Specific Question or Task to be
Addressed (Symptom, Sign, or Diagnosis):
Can this consult be done via video?
Call back number:
Consult Pediatric Neurosurgery (Inpatient)
[CON0192]
ONCE
Intent:
Concern or Specific Question or Task to be
Addressed (Symptom, Sign, or Diagnosis):
Can this consult be done via video?
Call back number:
Page 4 of 4
Printed by STRAKA, KEVIN F [KFS1] at 5/16/2017 3:42:05 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 05/2017CCKM@uwhealth.org