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/clinical/cckm-tools/content/order-sets/inpatient/pain-management/name-98075-en.cckm

201707191

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IP – Dihydroergotamine (DHE) – Adult – Supplemental [1421]

IP – Dihydroergotamine (DHE) – Adult – Supplemental [1421] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Pain Management


IP - Dihydroergotamine (DHE) - Adult - Supplemental [1421]
for Adult Patients OnlyIntended
Patient Care Orders
Vital Signs [190226]
Vital Signs [NURMON0013] SEE COMMENTS, Starting today, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
60 minutes prior to each dose of dihydroergotamine
(DHE) and 20 minutes after each dose of
dihydroergotamine (DHE).
Non-Categorized Patient Care Orders [189552]
Assess Patient [NURCOM0022] SEE COMMENTS, Starting today with First
Occurrence As Scheduled, Assess nausea, vomiting,
headache/pain rating, photophobia and phonophobia
before and after any medication administration.
Document all assessments.
Observe Patient [NURCOM0022] SEE COMMENTS, Starting today with First
Occurrence As Scheduled, Observe patient closely for
20 minutes after each dose of dihydroergotamine
(DHE).
Verify Patient is Not Pregnant or Breastfeeding
[NURCOM0022]
ONCE
Contingency Parameters [19675]
Notify Neurology Provider [NURCOM0001] Provider to Notify: Other (Comment)
If systolic blood pressure > (mmHg): 160
If systolic blood pressure < (mmHg): 80
If diastolic blood pressure > (mmHg): 110
If diastolic blood pressure < (mmHg): 50
If temperature > (C): 38 Oral
If temperature < (C):
If heart rate > (bpm): 110
If heart rate < (bpm): 60
If respiratory rate >: 8
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Patient has taken any triptan or ergot-type
medications within 24 hours of dihydroergotamine
(DHE),Patient experiences numbness, tingling or
jitteriness after each dose of dihydroergotamine
(DHE),Headache score is less than 3/10,Patient is
pregnant or is uncertain of pregnancy status.
Page 1 of 2
Printed by WILLIAMS, HEATHER R [HRS0] at 7/7/2017 8:57:28 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2017CCKM@uwhealth.org

Notify Pharmacist [NURCOM0001] Provider to Notify: Other (Comment)
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C):
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: Dihydroergotamine (DHE) has been
discontinued, so that antiemetics can be discontinued.
Intravenous Therapy
IV Fluids [190225]
sodium chloride 0.9% infusion [64367] at 125 mL/hr, Intravenous, CONTINUOUS
Medications
Premedications [225710]
lorazepam (ATIVAN) injection [800053] 0.5 mg, Intravenous, 2 X DAILY PRN
Give 30 minutes prior to each dose of
dihydroergotamine (DHE). Discontinue when
dihydroergotamine discontinued
If ordered IV: push rate 2 mg/minute.
haloperidol lactate (HALDOL) injection 0.5 mg
[800108]
0.5 mg, Intravenous, 2 X DAILY PRN, other,
Premedication for DHE
Give 30 minutes prior to each dose of
dihydroergotamine (DHE). Discontinue when
dihydroergotamine discontinued
Treatment [19918]
dihydroergotamine (DHE) injection [44969] 1 mg, Intravenous, ONCE For 1 Doses
Discontinue if headache pain satisfactorily controlled.
Maximum 2 mg per 24 hour period. Maximum 6 mg
per week
for 3 Minutes
dihydroergotamine (DHE) injection [44969] 1 mg, Intravenous, PRN For 5 Doses, Headache. Do
not administer within 1 hour of the previous dose.
Max dose is 2 mg/day
Discontinue if headache pain satisfactorily controlled.
Maximum 2 mg per 24 hour period. Maximum 6 mg
per week
for 3 Minutes
Side Effect Management [19919]
lorazepam (ATIVAN) injection [800053] 0.25 mg, Intravenous, EVERY 20 MINUTES PRN,
agitation, nausea/vomiting following each dose of
dihydroergotamine (Maximum 3 mg/day)
Discontinue when dihydroergotamine discontinued
If ordered IV: push rate 2 mg/minute.
haloperidol lactate (HALDOL) injection 0.25 mg
[800108]
0.25 mg, Intravenous, EVERY 20 MINUTES PRN,
agitation, nausea/vomiting following each dose of
dihydroergotamine (Maximum 1.5 mg/day)
Discontinue when dihydroergotamine discontinued
Page 2 of 2
Printed by WILLIAMS, HEATHER R [HRS0] at 7/7/2017 8:57:28 AM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2017CCKM@uwhealth.org