Unique Plan Description: CT Surg Cardiac Surgery, ERA (MH) Pre-op diagnostic
Plan Selection Display: CT Surg Cardiac Surgery, ERA (MH) Pre-op diagnostic
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2018-01-31 08:36:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-08-07 09:10:07
Available at all facilities: Yes

CT Surg Cardiac Surgery, ERA (MH) Pre-op diagnosti
Laboratory
	Basic Metabolic Panel
		Stat, spec type = Blood
	CBC with Diff
		Stat, spec type = Blood
	Hemoglobin A1C
		Stat, spec type = Blood
	PF4 Assay Platelet Antibody Heparin Dependent
		Stat, spec type = Blood
	UA (Culture if Positive)
		Stat, Stat, spec type = Urine
			Comment: Valve Patients Only
	Lipid Panel
		Stat, spec type = Blood
	Type and Screen (No Product on hold)
		T;N, Stat, spec type = Blood
	Type and Crossmatch (Product Available)
		T;N, Stat, For Possible Transfusion
	INR - MH/WH/JE
		Stat, spec type = Blood
	Iron Panel - MH/WH/JE
		Stat, spec type = Blood
Diagnostic Tests
	Chest AP & Lat
		angina, Stat, Angina
			Comment: If not done in last 30 days
	Spirometry with diffusion study
		T;N
			Comment: If patient current smoker, has a history of smoking, or has a history of asthma or COPD, perform spirometry pre and post. If non smoker do spirometry pre op.
	Vein Mapping Bil Upper or Lower
		T;N, Routine, Indication: Evaluate for conduit feasibility, Location Lower Bilateral
	Segmental Arterial Pressures Upper
		T;N, Routine, Indication: Evaluate for conduit feasibility
			Comment: Upper bilateral
	Native Artery Duplex Bil Upper
		T;N, Routine, Indication: Evaluate for conduit feasibility
			Comment: Upper bilateral
Patient Care
	No ACE (angiotensin converting enzyme) inhibitors
		Stop Nephrotoxic medications day before and day of surgery
	No ARB (angiotensin receptor blocker)
		Stop Nephrotoxic medications day before and day of surgery
	No NSAIDS (non steroidal anti-inflamatory)
		Stop Nephrotoxic medications day before and day of surgery
	No Anticoagulants/antiplatelets/thrombolytics
		
	Surgical Prep
		T;N
			Comment: Send home with hibiclens for pre op bath
Consults/Follow-up
	Consult Cardiac Rehab: Inpatient
		T;N, Indications CABG
			Comment: Pre op Indications CABG - do preop 5 meter walk

*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