Unique Plan Description: Acute Alcohol Withdrawal (lorazepam/diazepam)
Plan Selection Display: Acute Alcohol Withdrawal (lorazepam/diazepam)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2024-03-26 16:09:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-04-08 14:41:36
Available at all facilities: Yes

Acute Alcohol Withdrawal (lorazepam/diazepam)
Vital Signs
	Vital Signs
		every 4 hours if alcohol withdrawal score is 1-5, every 2 hours if alcohol withdrawal score is 6-10, every 1 hour if alcohol withdrawal score >11. Reassess alcohol withdrawal score with each set of vital signs.
Laboratory
Today's Lab
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	CBC with Diff
		Stat, spec type = Blood
	GGT
		Stat, spec type = Blood
	Magnesium Level
		Stat, spec type = Blood
	Phosphorus
		Stat, spec type = Blood
	Ethanol Level
		Stat, spec type = Blood
		T;N+720, Routine, spec type = Blood
	Toxicology Screen DAU - MH/WH/JE
		Stat, spec type = Urine
	Drug Screen Urine - FH
		Stat, Stat, spec type = Urine
IV Solutions

	Banana Bag IV
		100 mg, EVERY BAG
		1,000 mL, EVERY BAG
		10 mL, IVPB, Once, Routine, 125 ml/hr, T;N, duration: 1 Dose(s)/Time(s)
		1 mg, EVERY BAG
Medications
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	chlordiazePOXIDE
		25 mg, Capsule, By Mouth, QID, duration: 3 Day(s)
		10 mg, Capsule, By Mouth, QID, T+3;N, duration: 3 Day(s)
		5 mg, Capsule, By Mouth, QID, T+6;N, duration: 3 Day(s)
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	LORazepam
		2 mg, Tab, By Mouth, Q6HAWAKE, T;N, duration: 3 Day(s)
			Comment: Hold if sleeping
		1 mg, Tab, By Mouth, Q6HAWAKE, T+3;N, duration: 3 Day(s)
			Comment: Hold if sleeping
		0.5 mg, Tab, By Mouth, Q6HAWAKE, T+6;N, duration: 3 Day(s)
			Comment: Hold if sleeping
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		1 mg, Tab, By Mouth, Once, NOW
		2 mg, Tab, By Mouth, Once, NOW
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		1 mg, Tab, By Mouth, Q4H, PRN AWS score of 1-5
			Comment: Do Not Give if AWS score ONLY caused by tremors or nausea/vomiting.
		1 mg, Injection, IV Push, Q4H, PRN AWS score of 1-5
			Comment: Do Not Give if AWS score ONLY caused by tremors or nausea/vomiting
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		2 mg, Tab, By Mouth, Q2H, PRN AWS score of 6-10
			Comment: Watch for delierium; monitor respiratory status.
		2 mg, Injection, IM-Intramuscular, Q2H, PRN AWS score of 6-10
			Comment: Watch for delierium; monitor respiratory status.
		2 mg, Injection, IV Push, Q2H, PRN AWS score of 6-10
			Comment: Watch for delierium; monitor respiratory status.
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		2 mg, Tab, By Mouth, Q1H, PRN AWS score >10
			Comment: Watch for delirium; monitor respiratory status.
		2 mg, Injection, IM-Intramuscular, Q1H, PRN AWS score >10
			Comment: Watch for delirium; monitor respiratory status.
		2 mg, Injection, IV Push, Q1H, PRN AWS score >10
			Comment: Watch for delirium; monitor respiratory status.
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	diazePAM
		2.5 mg, Injection, IV Push, Q4H, PRN AWS score of 1-5
			Comment: Do Not Give if AWS score ONLY caused by tremors or nausea/vomiting, May be used when lorazepam is not available
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		5 mg, Injection, IV Push, Q2H, PRN AWS score of 6-10
			Comment:  Watch for delirium; monitor respiratory status. May be used when lorazepam is not available
		5 mg, Injection, IM-Intramuscular, Q2H, PRN AWS score of 6-10
			Comment: Watch for delirium; monitor respiratory status. May be used when lorazepam is not available, if IV route not available.
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		5 mg, Injection, IV Push, Q1H, PRN AWS score >10
			Comment: Watch for delierium; monitor respiratory status. May be used when lorazepam is not available.
		5 mg, Injection, IM-Intramuscular, Q1H, PRN AWS score >10
			Comment: Watch for delierium; monitor respiratory status. May be used when lorazepam is not available, if IV route not available.
	Notify MD
		Notify Provider if Lorazepam dose exceeds 12mg in 12hr or 24mg in 24hr
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	risperiDONE
		0.5 mg, Tab, By Mouth, TID, PRN agitation
	haloperidol  Injectable
		2 mg, Injection, IV Push, Q4H, PRN agitation
			Comment: If unable to administer antipsychotic by mouth
		5 mg, Injection, IV Push, Q4H, PRN agitation
			Comment: If unable to administer antipsychotic by mouth
		2 mg, Injection, IM-Intramuscular, Q4H, PRN agitation
			Comment: If unable to administer antipsychotic by mouth or IV
		5 mg, Injection, IM-Intramuscular, Q4H, PRN agitation
			Comment: If unable to administer antipsychotic by mouth or IV
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	famotidine
		20 mg, Tab, By Mouth, BID, PRN indigestion
	cloNIDine
		0.1 mg, Tab, By Mouth, Q1H, PRN see comment
			Comment: For SBP>150 mmHg to a maximum of 0.6 mg/24 hours. Contact MD if ineffective
	folic acid
		1 mg, Tab, By Mouth, DAILY, duration: 30 Day(s)
	thiamine
		100 mg, Tab, By Mouth, DAILY, duration: 5 Day(s)
		100 mg, Injection, IV Push, DAILY, duration: 5 Day(s)
	multivitamin Oral Tablet
		1 TAB, Tab, By Mouth, DAILY
	ondansetron
		4 mg, Injection, IV Push, Q6H, PRN nausea and/or vomiting
			Comment: use if patient unable to take PO
		4 mg, Tablet-Disintegrating, By Mouth, Q6H, PRN nausea and/or vomiting
	traZODone
		100 mg, Tab, By Mouth, QHS, PRN insomnia
			Comment: Do Not Give after 3:00am or during patient's normal wake hours
	nicotine
		2 mg, Gum, By Mouth, Q1H, PRN smoking cessation
		4 mg, Gum, By Mouth, Q1H, PRN smoking cessation
		7 mg, Patch, TOPICAL, DAILY
		14 mg, Patch, TOPICAL, DAILY
		21 mg, Patch, TOPICAL, DAILY
	nicotine Patch Removal
		Patch Removal, Patch, TOPICAL, DAILY, T;N+1440
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Patient Care
	Cardiac Telemetry Monitoring
		Telemetry Indications: Other
	Medication patch site check
		T;N+720, Q12H-Sch

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase