Unique Plan Description: Anes OB Epidural Analgesia Labor
Plan Selection Display: Anes OB Epidural Analgesia Labor
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2022-03-17 09:11:02
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-10-24 09:09:20
Available at all facilities: Yes

Anes OB Epidural Analgesia Labor
Laboratory
	Platelet Count
		T;N, Stat, spec type = Blood
Medications
	ePHEDrine
		10 mg, Solution, IV PUSH, Q10MIN, PRN for systolic blood pressure < ...., T;N, duration: 24 hr
			Comment: 90 or symptomatic hypotension and HR<60
		15 mg, Solution, IV PUSH, Q10MIN, PRN for systolic blood pressure < ...., T;N, duration: 24 hr
			Comment: 90 or symptomatic hypotension and HR<60.
	Neo-Synephrine (JE/WH)
		80 mcg, Syringe, IV PUSH, Q10MIN, PRN for systolic blood pressure < ...., duration: 24 hr
			Comment: < 90 and symptoms of hypotension. and HR > = 60bpm
		40 mcg, Syringe, IV PUSH, Q10MIN, PRN for systolic blood pressure < ...., duration: 24 hr
			Comment: < 90 and symptoms of hypotension. and HR > = 60bpm
	Neo-Synephrine (NMH)
		80 mcg, Injection, IV Push, Q10MIN, PRN for systolic blood pressure < (see comment), duration: 24 hr
			Comment: < 90 and symptoms of hypotension. and HR > = 60bpm
		40 mcg, Injection, IV Push, Q10MIN, PRN for systolic blood pressure < (see comment), duration: 24 hr
			Comment: < 90 and symptoms of hypotension. and HR > = 60bpm
	fentaNYL
		100 mcg, Injection, Epidural, Once
			Comment: Via syringe pushed into epidural catheter.  Given by anesthesia
	Naropin 0.2% injectable solution
		40 mL, Injection, Epidural, Once, T;N
	epinephrine-lidocaine 1:200,000-2% preservative-free injectable solution
		20 mL, Injection, Epidural, Once, T;N
	Benadryl
		25 mg, Injection, IV PUSH, Q6H, PRN, itching, 24 hr
		50 mg, Injection, IV PUSH, Q6H, PRN, itching-severe, 24 hr
	nalbuphine
		5 mg, Injection, IV Push, Q4H, PRN for itching, duration: 24 hr
		2.5 mg, Injection, IV Push, Q4H, PRN for itching, duration: 24 hr
Epidural Medications
	fentaNYL 200 mcg/ropivacaine 0.1% 100 mL epidural
		Rate(ml/hr) = 0, Init. Loading Dose (mL)= 10, Pt. Contolled Dose (mL)= 10, Lockout Interval (min) = 15, 1-hour limit (mL) 35, Provide Admin. Bolus(mL) 10mL Q40Min, Bag Volume = 100 mL, Epidural
	fentaNYL 4 mcg/mL-bupivacaine 1/8% NS 100 mL
		Rate(ml/hr) = 10, Bag Volume = 100 mL, Epidural, EPIDURAL
			Comment: fentanyl conc:  4 mcg/mL.  Change Every 24 Hours.  If 3 PCEA doses are requested and pain not controlled, contact Anesthesia provider.
	fentaNYL-ropivacaine 2 mcg/mL-0.2% Epidural 100mL (FH)
		100 mL, Epidural, STAT
Patient Care

	No Anticoagulants/antiplatelets/thrombolytics
		T;N, While epidural catheter in place; refer to guidelines for timing of AC/antiplatelet dose administration post epidural
	Continuous Pulse Oximetry by Nurse
		T;N
			Comment: Continuous monitoring- apply at time of epidural insertion and monitor for 1 hour. May discontinue after 1 hr if stable
	Discontinue Epidural Catheter
		T;N, Once
			Comment: discontinue epidural infusion and remove epidural catheter after vaginal delivery
	Notify Anesthesia if:
		T;N
			Comment: Marked change in sedation or CMS status; Persistent pain; Persistent side effect despite treatment
	Do Not
		Shower or Bathe with epidural in place

*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