/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/pain-management/,

/clinical/cckm-tools/content/order-sets/inpatient/pain-management/name-123020-en.cckm

201711332

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UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Pain Management

IP - PICU - Pain/Agitation Protocol - Pediatrics [5568]

IP - PICU - Pain/Agitation Protocol - Pediatrics [5568] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Pain Management


IP - PICU - Pain/Agitation Protocol - Pediatrics [5568]
UW Health Pain and Agitation Continuous
Infusion Titration - Pediatric - Inpatient Practice
Protocol
URL: https://uconnect.wisc.edu/clinical/cckm-
tools/content/delegationpractice-
protocols/practice-protocols/name-97447-en.cckm
Opioids
FENTanyl (Single Response) [184964]
Patient weight less than 40 kg [195953]
FENTanyl infusion PEDS [800143] 1-5 mcg/kg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol.
Initiate at 1 mcg/kg/hr or current rate and titrate to
control pain
FENTanyl PF injection RANGE - Maximum Dose
= 50 mcg [750047]
0.5-2 mcg/kg, Intravenous, EVERY 15 MINUTES
PRN For 2 Hours, Initiation Phase: May give up to 3
doses within first 2 hours of infusion Pain/Agitation
Initiation Phase: Do NOT administer more than 3
doses.
for 1 Minutes
FENTanyl PF injection RANGE - Maximum Dose
= 50 mcg [750047]
0.5-2 mcg/kg, Intravenous, EVERY 1 HOUR PRN,
Titration Phase: Start 2 hours after initiation.
Pain/Agitation
Start 2 hours after initiation of infusion
for 1 Minutes
Patient weight equal to or greater than 40 kg
[195953]
FENTanyl infusion PEDS [800143] 25-200 mcg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol.
Initiate at 1 mcg/kg/hr or current rate and titrate to
control pain
FENTanyl PF injection RANGE - Maximum Dose
= 50 mcg [750047]
50 mcg, Intravenous, EVERY 15 MINUTES PRN For
2 Hours, Initiation Phase: May give up to 3 doses
within first 2 hours of infusion Pain/Agitation
Initiation Phase: Do NOT administer more than 3
doses.
for 1 Minutes
FENTanyl PF injection RANGE - Maximum Dose
= 50 mcg [750047]
50 mcg, Intravenous, EVERY 1 HOUR PRN,
Titration Phase: Start 2 hours after initiation.
Pain/Agitation
Start 2 hours after initiation of infusion
for 1 Minutes
MORPHine (Single Response) [195954]
Patient weight less than 40 kg [184965]
MORPHine infusion PEDS [800156] 0.05-0.3 mg/kg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol.
Initiate at 0.05 mg/kg/hr or current rate and titrate to
control pain
MORPHine PF injection RANGE - Maximum
Dose = 4 mg [750057]
0.05-0.1 mg/kg, Intravenous, EVERY 15 MINUTES
PRN For 4 Hours, pain, Initiation Phase: May give
up to 3 doses within first 2 hours of infusion.
Pain/Agitation
Initiation Phase: Do NOT administer more than 3
doses
for 4 Minutes
Page 1 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:55:10 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2017CCKM@uwhealth.org

MORPHine PF injection RANGE - Maximum
Dose = 4 mg [750057]
0.05-0.1 mg/kg, Intravenous, EVERY 1 HOUR PRN,
pain, Start 2 hours after initiation after infusion
started. Pain/Agitation
Titration Phase: Start 2 hours after initiation of
infusion.
for 4 Minutes
Patient weight equal to or greater than 40 kg
[184965]
MORPHine infusion PEDS [800156] 1-10 mg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol.
Initiate at 0.05 mg/kg/hr or current rate and titrate to
control pain
MORPHine PF injection RANGE - Maximum
Dose = 4 mg [750057]
4 mg, Intravenous, EVERY 15 MINUTES PRN For 4
Hours, pain, Initiation Phase: May give up to 3
doses within first 2 hours of infusion. Pain/Agitation
Initiation Phase: Do NOT administer more than 3
doses
for 4 Minutes
MORPHine PF injection RANGE - Maximum
Dose = 4 mg [750057]
4 mg, Intravenous, EVERY 1 HOUR PRN, pain,
Start 2 hours after initiation after infusion started.
Pain/Agitation
Titration Phase: Start 2 hours after initiation of
infusion.
for 4 Minutes
Sedatives
Midazolam (Single Response) [184966]
Patient weight less than 40 kg [195955]
midazolam (VERSED) infusion PEDS [800154] 0.025-0.2 mg/kg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol.
Initiate at 0.025 mg/kg/hr or current rate and titrate to
Sedation goal.
midazolam (VERSED) injection RANGE -
Maximum Dose = 4 mg [750056]
0.025-0.05 mg/kg, Intravenous, EVERY 15
MINUTES PRN For 4 Hours, shortness of breath,
Agitation, Initiation Phase: May give up to 3 doses
within the first 2 hours of infusion.
If orderd IV: push rate 1 mg/minute.
Initiation Phase: Do NOT administer more than 3
doses.
midazolam (VERSED) injection RANGE -
Maximum Dose = 4 mg [750056]
0.025-0.05 mg/kg, Intravenous, EVERY 1 HOUR
PRN, Agitation, Titration Phase: Start 2 hours after
infusion started.
If orderd IV: push rate 1 mg/minute.
Start 2 hours after initiation of infusion.
Patient weight equal to or greater than 40 kg
[195955]
midazolam (VERSED) infusion PEDS [800154] 1-10 mg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol.
Initiate at 0.025 mg/kg/hr or current rate and titrate to
Sedation goal.
midazolam (VERSED) injection RANGE -
Maximum Dose = 4 mg [750056]
4 mg, Intravenous, EVERY 15 MINUTES PRN For 4
Hours, shortness of breath, Agitation, Initiation
Phase: May give up to 3 doses within the first 2
hours of infusion.
If orderd IV: push rate 1 mg/minute.
Initiation Phase: Do NOT administer more than 3
doses.
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:55:10 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org

midazolam (VERSED) injection RANGE -
Maximum Dose = 4 mg [750056]
4 mg, Intravenous, EVERY 1 HOUR PRN, Agitation,
Titration Phase: Start 2 hours after infusion started.
If orderd IV: push rate 1 mg/minute.
Start 2 hours after initiation of infusion.
Dexmedetomidine [184967]
dexmedetomidine (PRECEDEX) 4 MCG/mL
loading dose [760353]
Intravenous, ONCE For 1 Doses, for 10 Minutes
dexmedetomidine (PRECEDEX) infusion PEDS
[800135]
0.5-1.5 mcg/kg/hr, Intravenous, CONTINUOUS
Titrate per PICU Sedation/Analgesia Protocol Initiate
at 0.5 mcg/kg/hr or current rate and titrate to Sedation
goal.
midazolam (VERSED) injection RANGE -
Maximum Dose = 4 mg [750056]
0.025-0.05 mg/kg, Intravenous, EVERY 15 MINUTES
PRN For 4 Hours, Agitation, Initiation Phase: May give
up to 3 doses within the first 2 hours of infusion.
If orderd IV: push rate 1 mg/minute. Initiation Phase:
Do NOT administer more than 3 doses.
midazolam (VERSED) injection RANGE -
Maximum Dose = 4 mg [750056]
0.025-0.05 mg/kg, Intravenous, EVERY 1 HOUR
PRN, Agitation, Titration Phase: Start 2 hours after
infusion started.
If orderd IV: push rate 1 mg/minute. Agitation, Titration
Phase: Start 2 hours after infusion started.
Sedation Goal [195993]
Sedation Goal [NURMON0096] CONTINUOUS, Starting today, Routine
Sedation Goal (State Behavioral Scale):
Order WAT Score if SBS Goal >= 0
[NURMON0099]
EVERY 12 HOURS, Routine
Neuromuscular Blocker Patients [NURCOM0022] CONTINUOUS, Starting today, For patients on
neuromuscular blockers, titrate if vital signs increase
by greater than 20% with stimulation and other causes
for a change in vital signs are ruled out or cerebral
regional saturations decrease by less than or equal to
20%.
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/4/2017 1:55:10 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2017CCKM@uwhealth.org