Unique Plan Description: ED Syncope
Plan Selection Display: ED Syncope
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-19 21:19:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-09-23 00:49:53
Available at all facilities: Yes

ED Syncope
Vital Signs
	BP and Pulse, Orthostatic
		Once, Now
Laboratory
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	Basic Metabolic Panel
		Stat, spec type = Blood
	hs Troponin T - MH/WH/JE
		Stat, spec type = Blood
	hs Troponin I - FH
		Stat, spec type = Blood
	Urinalysis
		T;N, Stat, Stat, spec type = Urine
	UA (Culture if Positive)
		Stat, Stat, Urine, spec type = Urine
	Thyroid Panel
		Stat, spec type = Blood
	INR - MH/WH/JE
		Stat, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N, Stat, spec type = Therapeutic Blood
	Ethanol Level
		Stat, spec type = Blood
	Toxicology Screen DAU - MH/WH/JE
		T;N, Stat, Urine Random, spec type = Urine
	Drug Screen Urine - FH
		T;N, Stat, Urine Random, spec type = Urine
	Lactate
		Stat, spec type = Blood
	hsCRP
		Stat, spec type = Blood
	D-Dimer - MH/WH/JE
		Stat, spec type = Blood
	D-Dimer Level - FH
		T;N, Stat, spec type = Blood
	Beta-HCG Quantitative - Pregnancy
		Stat, spec type = Blood
	Pregnancy Test Urine
		Stat, Stat, Urine, spec type = Urine
	PTT - MH/WH/JE
		Stat, spec type = Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
	Type and Screen (No Product on hold)
		Stat, spec type = Blood
	Glucose POC - RN
		Once
	Type and Crossmatch (Product Available)
		T;N, Stat, For Possible Transfusion
Diagnostic Tests
	ECG in ED
		Stat, Indication: Syncope
	Chest 1 View
		Stat
			Comment: At Bedside
	Chest 2 View
		Stat
	CT Head w/o Contrast
		Stat, Syncope
	CT Head w & w/o Contrast
		Stat, Syncope
	CTA Head
		Stat, Fainting/Syncope
	CTA Neck
		T;N, Stat, Syncope
	CT Head w Contrast
		Stat, Syncope
	CTA Chest
		T;N, Stat, Dissection of Aorta
	Venous Duplex Bil Upper or Lower
		T;N
		Stat
	CTA Chest Pulmonary Arteries
		T;N, Stat, SOB
	Venous Duplex Unilat Upper or Lower
		T;N
		Stat
IV Solutions
	Sodium Chloride 0.9%
		1,000 mL, IV, STAT, 999 ml/hr
		1,000 mL, IV, STAT, 500 ml/hr
		1,000 mL, IV, STAT, 125 ml/hr
		1,000 mL, IV, STAT, 100 ml/hr
		1,000 mL, IV, STAT, 75 ml/hr
	DOPamine 400 mg/D5W 250 mL Premix IV
		400 mg, EVERY BAG, 5 mcg/kg/min
		250 mL, IV, STAT, Start: T;N, Duration: 1 Dose(s)/Time(s), Increment Increase: 2.5 mcg/kg/min, Increment Decrease: 2.5 mcg/kg/min, Increment Freq: 10 min(s), Max Dose: 50 mcg/kg/min
			Comment: Concentration: 1600mcg/mL. .Notify MD if > 20mcg/kg/min.  If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
	Levophed 4mg/D5W 250mL Premix
		4 mg, EVERY BAG, 8 mcg/min
		250 mL, IV, STAT, Start: T;N, Duration: 1 Dose(s)/Time(s), Increment Increase: 1 mcg/min, Increment Decrease: 1 mcg/min, Increment Freq: 3 min(s), Max Dose: 30 mcg/min
			Comment: **LEVOPHED** Concentration: 16mcg/mL .  If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
	Levophed 8mg/D5W 250mL Premix
		250 mL, IV, STAT, Increment Increase: 1 mcg/min, Increment Decrease: 1 mcg/min, Increment Freq: 3 min(s), Max Dose: 30 mcg/min
			Comment: **LEVOPHED** Concentration: 32mcg/mL .  If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
		8 mg, EVERY BAG, 8 mcg/min
Patient Care
	Continuous Pulse Oximetry by Nurse
		Once
	Oxygen Therapy, Nurse to Administer
		
	Bladder Scan
		Once
	Foley Catheter
		Foley, Once
	Straight Catheter
		Straight, Once
	ED Cardiac Telemetry Monitoring
		NOW
Consults/Follow-up
	Consult Cardiologist
		Reason for Referral: Syncope
	Consult Hospitalist
		Reason for Referral: Syncope
	Consult Neurologist
		Reason for Referral: Syncope
	Consult Pulmonologist
		Reason for Referral: Syncope
	Consult Tele Neurology (JEFH)
		Reason for Referral: Syncope

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