Unique Plan Description: HN ONC Bivalirudin for Flap Perfusion
Plan Selection Display: HN ONC Bivalirudin for Flap Perfusion
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2026-02-06 15:54:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2026-02-06 15:54:00
Available at all facilities: Yes

HN ONC Bivalirudin for Flap Perfusion
Laboratory
	CBC with Diff
		T;N, Stat, spec type = Blood
		T+1;0400, Routine, Q24H, spec type = Blood
	PTT - MH/WH/JE
		T;N, Stat, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	INR - MH/WH/JE
		T;N, Stat, spec type = Blood
	Creatinine
		T;N, Stat, spec type = Blood
	Creatinine for Flap Perfusion
		T+1;0400, Routine, Q24H, spec type = Blood
Medications
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.10570.1001(NOTE)*
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.10570.1001(NOTE)*
	bivalirudin syringe
		0.3 mg/kg, Injection, IntraDermal, Q6H
			Comment: Syringe #1. dose(s) to be injected directly into flap by H&N provider ONLY. Pharmacy to prepare using 250mg/5ml vial (conc: 50mg/ml).
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.10570.1001(NOTE)*
		0.3 mg/kg, Injection, IntraDermal, Q6H
			Comment: Syringe #2. dose(s) to be injected directly into flap by H&N provider ONLY. Pharmacy to prepare using 250mg/5ml vial (conc: 50mg/ml).
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.10570.1001(NOTE)*
		0.3 mg/kg, Injection, IntraDermal, Q6H
			Comment: Syringe #3. dose(s) to be injected directly into flap by H&N provider ONLY. Pharmacy to prepare using 250mg/5ml vial (conc: 50mg/ml).
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.10570.1001(NOTE)*
		0.3 mg/kg, Injection, IntraDermal, Q6H
			Comment: Syringe #4. dose(s) to be injected directly into flap by H&N provider ONLY. Pharmacy to prepare using 250mg/5ml vial (conc: 50mg/ml).
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY margin:0; P margin:0 </STYLE><META name=GENERATOR content="MSHTML 11.00.10570.1001(NOTE)*
		0.3 mg/kg, Injection, IntraDermal, Q6H
			Comment: Syringe #5. dose(s) to be injected directly into flap by H&N provider ONLY. Pharmacy to prepare using 250mg/5ml vial (conc: 50mg/ml).
Patient Care
	Notify MD
		T;N, for signs of bleeding (increased bruising, nosebleeds, black/tarry stools, hematemesis)
		T;N, for any PTT > 42 seconds

*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