Unique Plan Description: ED BURN CARE
Plan Selection Display: ED BURN CARE
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-14 22:30:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-02-21 09:02:48
Available at all facilities: Yes

ED BURN CARE
Laboratory
	CBC with Diff
		T;N, Stat, spec type = Blood
	Basic Metabolic Panel
		T;N, Stat, spec type = Blood
	Carboxyhemoglobin
		T;N, Stat, spec type = Blood
	Lactate
		T;N, Stat, spec type = Blood
	Myoglobin Urine Random
		T;N, Stat, Stat, Urine Random, spec type = Urine
	Urinalysis
		T;N, Stat, Stat, spec type = Urine
	UA (Culture if Positive)
		T;N, Stat, Stat, spec type = Urine
			Comment: change the indwelling catheter prior to obtaining specimen if catheter in place greater than 2 weeks, or unknown.
	hs Troponin I - FH
		T;N, Stat, spec type = Blood
	hs Troponin T - MH/WH/JE
		T;N, Stat, spec type = Blood
	CK
		T;N, Stat, spec type = Blood
	Myoglobin
		T;N, Stat, spec type = Blood
Diagnostic Tests
	ECG in ED
		T;N, Stat, Indication: Dyspnea on Exertion
	Chest 1 View
		T;N, Stat, Dyspnea
IV Solutions
	Lactated Ringers Injection
		1,000 mL, IV
			Comment: Parkland Formula Adults is 2-4ml LR X kg body weight X % TBSA burn. One-half of this volume is to be administered in the first 8 hours, the remainder over the next 16 hours post burn. Rule of 9's for Adults: 9% for each arm, 18% for each leg, 9% for head, 18% for front torso, and 18% for back torso. Rule of 9's for Children: 9% for each arm, 14% for each leg, 18% for head, 18% for front torso, and 18% for back torso. Refer to the Parkland Formula in the calculator on the Patient Summary page.
Medications
	ondansetron
		4 mg, Injection, IV PUSH, Once, STAT
		8 mg, Injection, IV PUSH, Once, STAT
		4 mg, Tablet-Disintegrating, By Mouth, Once, STAT
		8 mg, Tablet-Disintegrating, By Mouth, Once, STAT
	tetanus-diphth toxoids (Td) adult/adol
		0.5 mL, Injection, IM-Intramuscular, Once, STAT
		For patients >= 11 years of age and has not received Adacel previously or if previous 		Td/Tdap history is unknown select the below order:(NOTE)*
	Adacel (Tdap) intramuscular suspension
		0.5 mL, Suspension-Injection, IM-IntraMUSCULAR, Once, STAT
	Boostrix (Tdap) intramuscular suspension
		0.5 mL, Suspension-Injection, IM-Intramuscular, Once, STAT
		Should be given to all patient for all wounds other than clean minor wounds if the immune 		status is uncertain or the last known tetanus immunization was greater than 5 years prior 		to the event.(NOTE)*
	tetanus immune globulin
		250 units, Injection, IM-IntraMUSCULAR, Once, STAT
Antibiotics
	Ancef IVPB
		1,000 mg, Injection-Premix, IVPB, Once, STAT
		2,000 mg, Injection-Premix, IVPB, Once, STAT
	Ancef IVPB (FH)
		1,000 mg, INT, IVPB, Once, STAT
		2,000 mg, INT, IVPB, Once, STAT
	Ancef
		1,000 mg, Injection, IM-Intramuscular, Once, STAT
	silver sulfADIAZINE 1% topical cream
		1 appl, Cream, TOPICAL, Once, STAT
			Comment: Apply topically to affected area. (if not sulfa allergic)
	Neosporin
		1 appl, TOPICAL, Once, STAT
			Comment: Apply topically to affected area
	Polysporin
		1 appl, TOPICAL, Once, STAT
			Comment: Apply topically to affected area
Pain Meds
	Dilaudid Injectable
		0.5 mg, Injection, IV PUSH, Once, STAT, T;N
		1 mg, Injection, IM-Intramuscular, Once, STAT
		1 mg, Injection, IV PUSH, Once, STAT
	morphine  IV
		1 mg, Syringe, IV PUSH, Once, STAT, T;N
		2 mg, Syringe, IV PUSH, Once, STAT, T;N
		3 mg, Syringe, IV PUSH, Once, STAT, T;N
		5 mg, Syringe, IV PUSH, Once, STAT, T;N
		6 mg, Syringe, IV PUSH, Once, STAT, T;N
		10 mg, Syringe, IV PUSH, Once, STAT, T;N
	Tylenol Extra Strength
		500 mg, Tab, By Mouth, Once, STAT
		1,000 mg, Tab, By Mouth, Once, STAT
	Tylenol pediatric oral syringe
		15 mg/kg, Syringe, Oral, By Mouth, Once, STAT
	acetaminophen 325 mg/10.15 mL elixir
		15 mg/kg, Elixir, By Mouth, Once, STAT
	acetaminophen 160 mg/5 mL oral liquid
		15 mg/kg, Elixir, By Mouth, Once, STAT
	Percocet 5 mg-325 mg oral tablet
		1 TAB, Tab, By Mouth, Once, STAT, T;N
		2 TAB, Tab, By Mouth, Once, STAT, T;N
	acetaminophen-hydrocodone 325 mg-5 mg oral tablet
		1 TAB, Tab, By Mouth, Once, STAT
		2 TAB, Tab, By Mouth, Once, STAT
	ketamine 100 mg/mL injectable solution
		0.3 mg/kg, Solution, IM-Intramuscular, Once, STAT
			Comment: Max dose 50mg
		0.5 mg/kg, Solution, IM-Intramuscular, Once, STAT
			Comment: Max dose 50mg
		0.5 mg/kg, Solution, NASAL, Once, STAT
			Comment: max dose 50mg; use 100mg/ml concentration via the nasal atomizer device as rapidly as possible by RN; administer half dose in each nostril
	ketamine 50 mg/mL injectable solution
		0.3 mg/kg, Solution, IM-Intramuscular, Once, STAT
			Comment: Max dose 50mg
		0.5 mg/kg, Solution, IM-Intramuscular, Once, STAT
			Comment: Max dose 50mg
		0.5 mg/kg, Solution, NASAL, Once, STAT
			Comment: Max dose 50mg
	ketamine
		0.1 mg/kg, INT, IVPB, Once, STAT
			Comment: Max 20mg
		0.3 mg/kg, INT, IVPB, Once, STAT
			Comment: Max 20mg
	Valium Injectable
		5 mg, Injection, IV Push, Once, STAT
		10 mg, Injection, IV Push, Once, STAT
Patient Care

	ED Cardiac Telemetry Monitoring
		T;N
	Continuous Pulse Oximetry by Nurse
		T;N, Once
	Oxygen Therapy, Nurse to Administer
		T;N
	Glucose POC - RN
		T;N, Once
	Wound Care
		T;N, Once
			Comment: Apply cool sterile saline compresses to burn area
		T;N, Once
			Comment: Apply clean dry, loose fitting, non-adherent dressing

ED Peripheral Lock Insert with Flush
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush, 4 hr
Patient Care
	Peripheral Lock-Insert
		T;N, Once

*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