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IP – Dihydroergotamine (DHE) – Pediatric – Supplemental [1420]

IP – Dihydroergotamine (DHE) – Pediatric – Supplemental [1420] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Pain Management


IP - Dihydroergotamine (DHE) - Pediatric - Supplemental [1420]
Patient Care Orders
Vital Signs [19669]
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 and 20 minutes after each dose of
dihydroergotamine (DHE).
Non-Categorized Patient Care Orders [19670]
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.
Verify Patient is not Pregnant [NURCOM0022] ONCE, Starting today For 1 Occurrences
Contingency Parameters [19671]
Notify Provider [NURCOM0001] CONTINUOUS
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: 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 2/5.,Patient is
pregnant or is uncertain of pregnancy status.
Page 1 of 3
Printed by WILLIAMS, HEATHER R S [HRS0] at 6/1/2017 1:31:58 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 06/2017CCKM@uwhealth.org

Notify Pharmacist [NURCOM0001] CONTINUOUS
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 [19917]
sodium chloride 0.9% infusion [64367] Intravenous, CONTINUOUS
Medications
Treatment [19922]
lorazepam (ATIVAN) injection - NOTE:
Suggested dose 0.05 mg/kg/dose Maximum
Dose = 2 mg [800053]
0.05 mg/kg, Intravenous, EVERY 8 HOURS For 6
Doses
Give 30 minutes prior to each dose of
dihydroergotamine (DHE). Discontinue when
dihydroergotamine discontinued
If ordered IV: push rate 2 mg/minute
NOTE: Suggested dose 0.05 mg/kg/dose
ondansetron (ZOFRAN) injection - NOTE -
Maximum Dose = 8 mg [800202]
0.1 mg/kg, Intravenous, EVERY 8 HOURS For 6
Doses
Give 30 minutes prior to each dose of
dihydroergotamine (DHE). Discontinue when
dihydroergotamine discontinued.
Dihydroergotamine (Single Response) [192758]
dihydroergotamine (DHE) injection - NOTE:
Order for patients 6-9 years of age [44969]
0.1 mg, Intravenous, EVERY 8 HOURS For 6 Doses
Discontinue if headache score is less than 2/5 and
satisfactorily controlled (Maximum 6 doses/week)
for 3 Minutes
NOTE: Order for patients 6-9 years of age
dihydroergotamine (DHE) injection - NOTE:
Order for patients 10-12 years of age [44969]
0.2 mg, Intravenous, EVERY 8 HOURS For 6 Doses
Discontinue if headache score is less than 2/5 and
satisfactorily controlled (Maximum 6 doses/week)
for 3 Minutes
NOTE: Order for patients 10-12 years of age
dihydroergotamine (DHE) injection - NOTE:
Order for patients 13-16 years of age (Suggested
dose 0.3-0.5 mg) [44969]
Intravenous, EVERY 8 HOURS For 6 Doses
Discontinue if headache score is less than 2/5 and
satisfactorily controlled (Maximum 6 doses/week)
for 3 Minutes
NOTE: Order for patients 13-16 years of age
(Suggested dose 0.3-0.5 mg)
Side Effect Management [19923]
Page 2 of 3
Printed by WILLIAMS, HEATHER R S [HRS0] at 6/1/2017 1:31:58 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 06/2017CCKM@uwhealth.org

lorazepam (ATIVAN) injection - NOTE:
Suggested dose 0.05 mg/kg/dose. (Maximum
0.5 mg/dose, 10 mg/day) [800053]
0.05 mg/kg, Intravenous, EVERY 20 MINUTES PRN,
nausea/vomiting following each dose of
dihydroergotamine (Maximum 10 mg/day)
Discontinue when dihydroergotamine discontinued.
NOTE: Suggested dose 0.05 mg/kg/dose.
(Maximum 0.5 mg/dose, 10 mg/day)
If ordered IV: push rate 2 mg/minute
Page 3 of 3
Printed by WILLIAMS, HEATHER R S [HRS0] at 6/1/2017 1:31:58 PM
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 06/2017CCKM@uwhealth.org