Unique Plan Description: ED Cellulitis (FH)
Plan Selection Display: ED Cellulitis (FH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2022-04-05 14:15:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-03-27 10:54:58
Available at all facilities: Yes

ED Cellulitis (FH)
Laboratory
Today's Lab
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	hsCRP
		Stat, spec type = Blood
	Sed Rate
		Stat, spec type = Blood
	Procalcitonin
		
Diagnostic Tests

	Venous Duplex Unilat Upper or Lower
		T;N, Routine, Indication: Pain, Location Left Upper
		T;N, Routine, Indication: Pain, Location Left Lower
		T;N, Routine, Indication: Pain, Location Right Upper
		T;N, Routine, Indication: Pain, Location Right Lower
	Venous Duplex Bil Upper or Lower
		Indication: Pain, Location Upper Bilateral
		Indication: Pain, Location Lower Bilateral
Medications
Non-purulent
		**ORAL ANTIBIOTICS**(NOTE)*
		(Cellulitis/ Facial cellulitis/Erysipelas)(NOTE)*
		Mild: Select one of the following(NOTE)*
	cephalexin
		500 mg, Capsule, By Mouth, Once, Indication: Skin soft tissue
	Cleocin HCl
		300 mg, Capsule, By Mouth, Once, Indication: Skin soft tissue
Purulent
		(Furuncle/Carbuncle/Abcess), Incision and drainage plus:(NOTE)*
		Mild: Consider incision and drainage(NOTE)*
		Moderate: choose one of the following(NOTE)*
	Bactrim DS
		1 TAB, Tab, By Mouth, Once, Indication: Skin soft tissue
	doxycycline
		100 mg, Tab, By Mouth, Once, Indication: Skin soft tissue
	amoxicillin-clavulanate  875 mg-125 mg oral tablet
		1 TAB, Tab, By Mouth, Once, Indication: Skin soft tissue
Animal Bite
	amoxicillin-clavulanate  875 mg-125 mg oral tablet
		1 TAB, Tab, By Mouth, Once, Indication: Skin soft tissue
		Penicillin allergy(NOTE)*
	doxycycline
		100 mg, Tab, BY MOUTH, Once, Indication: Skin soft tissue
	metroNIDAZOLE
		500 mg, Tab, By Mouth, Once, Indication: Skin soft tissue
Human Bite
	amoxicillin-clavulanate  875 mg-125 mg oral tablet
		1 TAB, Tab, By Mouth, Once, Indication: Skin soft tissue
		Penicillin allergy(NOTE)*
	doxycycline
		100 mg, Tab, BY MOUTH, Once, Indication: Skin soft tissue
	clindamycin
		300 mg, Capsule, BY MOUTH, Once, Indication: Skin soft tissue
Non Purulent
	Ancef IVPB (FH)
		1,000 mg, INT, IVPB, Once, Indication: Skin soft tissue
	Cleocin IVPB
		900 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue
			Comment: If allergic to penicillins
	Rocephin IVPB (FH)
		2,000 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue
			Comment: If allergic to penicillins
	vancomycin IVPB (FH)
		15 mg/kg, INT, IVPB, PHARMACY TO DETERMINE, Indication: Skin soft tissue
Purulent:
		(Furuncle/Carbuncle/Abcess), Incision and drainage plus:(NOTE)*
		Mild: Consider incision and drainage(NOTE)*
		Moderate: choose one of the following(NOTE)*
	Ancef IVPB (FH)
		2,000 mg, INT, IVPB, Once, Indication: Skin soft tissue
	vancomycin IVPB (FH)
		15 mg/kg, INT, IVPB, PHARMACY TO DETERMINE, Indication: Skin soft tissue
			Comment: If risk factors present for MRSA
	DAPTOmycin IVPB
		6 mg/kg, INT, IVPB, Q24H, Indication: Skin soft tissue
			Comment: If allergic to vancomycin
Necrotizing Fasciitis
		(Empiric therapy) (Consider surgical and ID consults)(NOTE)*
	Unasyn IVPB (FH)
		3,000 mg, INT, IVPB, Once, Indication: Skin soft tissue
	Cleocin IVPB
		900 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue
	INVanz IVPB
		1,000 mg, INT, IVPB, Once, Indication: Skin soft tissue, STAT
	Cleocin IVPB
		900 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue, STAT
	Zosyn IVPB (FH)
		4.5 gm, Injection-Premix, IVPB, Once, Indication: Skin soft tissue, STAT
	Cleocin IVPB
		900 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue, STAT
Animal Bite/Human Bite:
		(Choose one), If beta-lactam allergic, consider ID consult(NOTE)*
	Unasyn IVPB (FH)
		3,000 mg, INT, IVPB, Once, Indication: Skin soft tissue
	Rocephin IVPB (FH)
		2,000 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue
		Choose one of two below with Rocephin(NOTE)*
	Cleocin IVPB
		900 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue, STAT
	metroNIDAZOLE IVPB
		500 mg, Injection-Premix, IVPB, Once, Indication: Skin soft tissue, STAT
	INVanz IVPB
		1,000 mg, INT, IVPB, Once, Indication: Skin soft tissue, STAT
Patient Care

	Edema Wear-apply
		
Consults/Follow-up
	Notify Fremont Infusion Therapy
		T;N, Patient to be scheduled for further IV antibiotic treatment of cellulitis

ED Blood Culture with Lactate
Laboratory
	Lactate
		T;N, Stat, spec type = Blood
	.Culture Blood
		T;N, Stat, spec type = Blood
	.Blood Culture.
		T;N, Stat, spec type = Blood

*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