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/clinical/cckm-tools/content/order-sets/inpatient/orthopedicsrehab/name-110309-en.cckm

201611333

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Orthopedics/Rehab

IP - Orthopedics - Bone and Joint Infectious - Supplemental [6004]

IP - Orthopedics - Bone and Joint Infectious - Supplemental [6004] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Orthopedics/Rehab


IP - Orthopedics - Bone and Joint Infectious - Supplemental [6004]
Laboratory
Adult OR Specimens [206805]
operative tissue specimens.-6 intra-3Recommend
AFB and Fungal testing should be reserved for immunocompromised patients or unique clinical
concern.
See additional orders below.
Adult OR Specimens [214538]
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
Page 1 of 6
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Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 11/2016CCKM@uwhealth.org

SURGICAL PATHOLOGY [HCPATHS] ONCE For 1 Occurrences, Routine, This order is to
be used for fresh or formalin-fixed (for gross and
micro evaluation) tissues.
Slides and/or paraffin-embedded blocks coming
from outside institutions needing second opinion
pathology review should be ordered as Surgical
Pathology Consult [HCPATHSP].
Specimen Source Description:
Number of containers:
Clinical Diagnosis:
Reason for procedure:
Other pertinent information:
Frozen section call back number:
Type of procedure:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
Pediatric OR Specimens [214529]
operative tissue specimens.-6 intra-3Recommend
those with and Fungal testing should be reserved for immunocompromised patients or AFB
unique clinical concern.
Pediatric OR Specimens [214531]
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
Page 2 of 6
Printed by O'BRIEN, RYLEY P [RPO249] at 11/17/2016 11:11:05 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2016CCKM@uwhealth.org

CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
CULTURE, TISSUE, AER/ANA WITH GRAM
STAIN [HCWANC]
ONCE, Starting today For 1 Occurrences, Routine
Indicate source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition? Acquisition of
intraoperative cultures.
Discuss appropriate timing for culture sendoff with
surgeon.
SURGICAL PATHOLOGY [HCPATHS] ONCE For 1 Occurrences, Routine, This order is to
be used for fresh or formalin-fixed (for gross and
micro evaluation) tissues.
Slides and/or paraffin-embedded blocks coming
from outside institutions needing second opinion
pathology review should be ordered as Surgical
Pathology Consult [HCPATHSP].
Specimen Source Description:
Number of containers:
Clinical Diagnosis:
Reason for procedure:
Other pertinent information:
Frozen section call back number:
Type of procedure:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
Consult Pediatric Inf Disease (Inpatient)
[CON0096]
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:
Joint Aspirations [214507]
CELL COUNT, BODY FLUID [CCNT] ONCE For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
CULTURE, BODY FLUID, AER/ANA WITH
GRAM STAIN [HCWABF]
ONCE For 1 Occurrences, Routine, UWHC Only:
Use blood culture bottles for peritoneal, pericardial,
pleural, synovial and dialysate fluids.
Indicate source if other:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
CRYSTALS, SYNOVIAL FLUID [FCR] ONCE 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 6
Printed by O'BRIEN, RYLEY P [RPO249] at 11/17/2016 11:11:05 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2016CCKM@uwhealth.org

CULTURE, BLOOD, BACTERIA/YEAST (2
SITES) [116728]
This order equals 2 sites (4 bottles). See link below for Best Practices for Blood Culturing.
Best Practices for Blood Culturing URL: https://uconnect.wisc.edu/clinical/references/clinical-
laboratories/blood/
Lab Test Directory URL: https://uconnect.wisc.edu/clinical/tools-
resources/lab-test-directory/microbiology/name-
67798-en.labtest
CULTURE, BLOOD, BACTERIA AND YEAST
[GM4045]
STAT - RN COLLECT For 1 Occurrences, 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]
STAT - RN COLLECT For 1 Occurrences, 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?
Lyme Disease Panel [214635]
LYME AB, TOTAL [LYM] ADD ON For 1 Occurrences, Routine
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
LYME DISEASE, PCR [XBBURG] ONCE For 1 Occurrences, Routine
Indicate specimen source if other:
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
PROTEIN, BODY FLUID [GM2810] ONCE, Routine
Indicate specimen source if other:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
GLUCOSE, BODY FLUID [GM2790] ONCE, Routine
Indicate specimen source if other:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Laboratory [214522]
CULTURE, BLOOD, BACTERIA/YEAST (2
SITES) [116728]
This order equals 2 sites (4 bottles). See link below for Best Practices for Blood Culturing.
Best Practices for Blood Culturing URL: https://uconnect.wisc.edu/clinical/references/clinical-
laboratories/blood/
Lab Test Directory URL:
Page 4 of 6
Printed by O'BRIEN, RYLEY P [RPO249] at 11/17/2016 11:11:05 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2016CCKM@uwhealth.org

https://uconnect.wisc.edu/clinical/tools-
resources/lab-test-directory/microbiology/name-
67798-en.labtest
CULTURE, BLOOD, BACTERIA AND YEAST
[GM4045]
STAT - RN COLLECT For 1 Occurrences, 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]
STAT - RN COLLECT For 1 Occurrences, 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?
CBC WITH DIFFERENTIAL [CBC] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
C REACTIVE PROTEIN [CRPN] ADD ON For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen? Add to next scheduled draw
for this pt today
If Conditional, What Condition?
ESR [ESR] ADD ON For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen? Add to next scheduled draw
for this pt today
If Conditional, What Condition?
CREATININE [CRET] NEXT DRAW For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
ALT/SGPT [ALT] ADD ON For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen? Add to next scheduled draw
for this pt today
If Conditional, What Condition?
CK, TOTAL [CPK] ADD ON For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test
to previous specimen? Add to next scheduled draw
for this pt today
If Conditional, What Condition?
Immunocompromised / Immunodeficiency / Chronic Bone or Joint Lesion [214537]
AFB and Fungal testing should be reserved for immunocompromised patients or unique clinical
concern.
Page 5 of 6
Printed by O'BRIEN, RYLEY P [RPO249] at 11/17/2016 11:11:05 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2016CCKM@uwhealth.org

CULTURE, FUNGAL, WITH SMEAR
[HCFCULTS]
ONCE For 1 Occurrences, Routine, Smears not
routinely performed on CSF. If CSF, order Culture,
Fungal.
Indicate source if other:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
AFB SMEAR AND CULTURE [191443]
A smear and culture are performed on all non-blood specimens. For blood specimens only a
culture should be requested.
Lab Test Directory URL: https://uconnect.wisc.edu/clinical/tools-
resources/lab-test-directory/wslh/name-67931-
en.labtest
AFB SMEAR [AFBSMR] ONCE For 1 Occurrences, Routine
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
AFB CULTURE [AFBCX] ONCE For 1 Occurrences, Routine, Smear and
culture should be ordered for diagnostic specimens.
M. avium complex PCR is performed on the first
smear positive respiratory specimen from patients
not previously diagosed with tuberculosis.
Susceptibility testing is performed automatically on
all initial M. tuberculosis isolates. Susceptibility
testing for some non-tuberculous mycobacteria is
available.
The initial M. tuberculosis isolate from each patient
is also genotyped as part of the CDC Universal
Genotyping Program.
If add on test, what should lab do if unable to add
test to previous specimen?
If Conditional, What Condition?
SURGICAL PATHOLOGY [HCPATHS] ONCE For 1 Occurrences, Routine, This order is to
be used for fresh or formalin-fixed (for gross and
micro evaluation) tissues.
Slides and/or paraffin-embedded blocks coming from
outside institutions needing second opinion pathology
review should be ordered as Surgical Pathology
Consult [HCPATHSP].
Specimen Source Description:
Number of containers:
Clinical Diagnosis:
Reason for procedure:
Other pertinent information:
Frozen section call back number:
Type of procedure:
If add on test, what should lab do if unable to add test
to previous specimen?
If Conditional, What Condition?
Page 6 of 6
Printed by O'BRIEN, RYLEY P [RPO249] at 11/17/2016 11:11:05 AM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2016CCKM@uwhealth.org