Unique Plan Description: GI POEM Pre-op
Plan Selection Display: GI POEM Pre-op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2026-03-03 12:34:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2026-03-03 12:34:00
Available at all facilities: No

GI POEM Pre-op
IV Solutions
	Sodium Chloride 0.9%
		500 mL, IVPB, T;N, 1 Dose(s)/Time(s), 999 ml/hr
Medications
	Unasyn IVPB
		3,000 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
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	Levaquin IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
	Flagyl IVPB
		500 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis, T;N
	methylene blue
		5 mg, Injection, INJ Soft Tissue, Once, T;N, duration: 1 Dose(s)/Time(s)
			Comment: soft tissue injection during procedure
Patient Care
	Obtain Consent/Permit for:
		T;N, esophagogastroduodenoscopy with possible biopsies and/or dilation and possible per oral endoscopic myotomy

*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