Unique Plan Description: Circumcision EKM
Plan Selection Display: Circumcision
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-19 12:25:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-04-01 15:21:32
Available at all facilities: No

Circumcision EKM
Medications
	Tylenol pediatric oral syringe
		15 mg/kg, Syringe-Oral, By Mouth, Once, PRN, see comment
			Comment: Give immediately prior to or after the procedure.
		15 mg/kg, Syringe-Oral, By Mouth, Q6H, 4 Dose(s)/Time(s)
	Tylenol 325 mg/10.15 mL elixir (JE)
		15 mg/kg, Elixir, BY MOUTH, Once, PRN for see comment
			Comment: Give immediately prior to or after the procedure.
	acetaminophen 160 mg/5 mL oral liquid
		15 mg/kg, Elixir, By Mouth, Once, PRN for see comment
			Comment: Give immediately prior to or after the procedure.
	Xylocaine-MPF 1% preservative-free injectable solution
		1 mL, Injection, SUBCUTANEOUS, Once, PRN for see comment
			Comment: Given pre-procedure
		0.5 mL/kg, Injection, SUBCUTANEOUS, Once, PRN for see comment
			Comment: Given pre-procedure for patients under 2 kg
	lidocaine-prilocaine 2.5%-2.5% topical cream
		1 appl, Cream, TOPICAL, Once, T;N
			Comment: To Penis one hour prior to procedure
	bacitracin ointment
		1 appl, Packet, TOPICAL, Q30MIN, PRN for see comment
			Comment: to circumcision area as needed with every diaper change
Patient Care
	Circumcision scheduled for:
		Date/Time T;N
	Obtain Consent/Permit for:
		T;N, Circumcision
	Administer Oral Sucrose
		T;N, Once
			Comment: orally, by pacifier or by syringe. On call for circumcision.
	Dressing Care
		T;N, bleeding
			Comment: Apply Surgicel as needed for bleeding
		T;N, bleeding
			Comment: Apply Vaseline to circumcision with each diaper change

*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