Unique Plan Description: Dexmedetomidine (Precedex) protocol
Plan Selection Display: Dexmedetomidine (Precedex) protocol
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-03-01 13:43:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-07-06 11:40:50
Available at all facilities: Yes

Dexmedetomidine (Precedex) protocol
Vital Signs
	Vital Signs
		Q 15min upon initiation until RASS target achieved, or when titrating medication until RASS target achieved; then every 1hr and PRN
IV Solutions
	dexmedetomidine 400 mcg/NS 100 mL
		400 mcg, EVERY BAG, 0.2 mcg/kg/hr
		100 mL, IV, Routine, Start: T;N, RASS Goal: 0 to -1, Incremental Increase: 0.1 mcg/kg/hr, Incremental Decrease: 0.1 mcg/kg/hr, Incremental Freq: 30 min(s), Max Dose: 1.5 mcg/kg/hr
			Comment: Begin at 0.2mcg/kg/hr and titrate to goal RASS 0 to -1 OR BIS 45-60, Notify MD if target RASS OR BIS not met at 0.7mcg/kg/hr. Hold if HR<50, SBP<100mmHg or MAP<50 and notify MD.
	dexmedetomidine 400 mcg/NS 100 mL Premix IV
		100 mL, IV, Routine, Start: T;N, RASS Goal: 0 to -1, Incremental Increase: 0.1 mcg/kg/hr, Incremental Decrease: 0.1 mcg/kg/hr, Incremental Freq: 30 min(s), Max Dose: 1.5 mcg/kg/hr
			Comment: Begin at 0.2mcg/kg/hr and titrate to goal RASS 0 to -1 OR BIS 45-60, Notify MD if target RASS OR BIS not met at 0.7mcg/kg/hr. Hold if HR<50, SBP<100mmHg or MAP<50 and notify MD.
		400 mcg, EVERY BAG, 0.2 mcg/kg/hr
Medications
		To use this drug, patient must have one of the following: Delirium despite treatment, Alcohol withdrawal symptoms not controlled with Alcohol Withdrawal Protocol, failure of ventilator weaning due to agitation despite the use of propofol and/or benzodiaze(NOTE)*
		Contraindications to use include: Left ventricular ejection fraction <30%, Heart rate <50, Systolic blood pressure <100mmHg despite use of vasopressors and/or fluids, Heart block(NOTE)*
Patient Care
	Notify MD
		If HR<50, SBP<100mmHg or MAP<50 and hold dexmedotomidine infusion. If target RASS (0 to -1) OR BIS 45-60 not met at 0.7mcg/kg/hr, or if patient remains delirious at 24hr

*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