Unique Plan Description: Neurosurg Gamma Knife, Pre Op
Plan Selection Display: Neurosurg Gamma Knife, Pre Op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-11-04 18:18:15
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 09:22:50
Available at all facilities: No

Neurosurg Gamma Knife, Pre Op
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
Diet
	NPO
		For 6 hours prior to frame placement
Laboratory
	Creatinine
		T;N, Stat, spec type = Blood
	Pregnancy Test Urine
		Nurse Collect, T;N, Stat, Stat, spec type = Urine
	CBC with Diff
		T;N, Stat, spec type = Blood
	Hematocrit
		T;N, Stat, spec type = Blood
	INR - MH/WH/JE
		T;N, Stat, spec type = Blood
	Heparin Anti-Xa Heparin
		T;N, Stat, spec type = Blood
	Basic Metabolic Panel
		T;N, Stat, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Stat, spec type = Blood
IV Solutions
Medications
	lidocaine-EPINEPHrine 1%-1:100000 injectable solution
		20 mL, Injection, MISC, Once
			Comment: Give locally in POH-have at bedside
	midazolam
		1 mg, Injection, IV Push, Once, PRN, see comment
			Comment: for IV sedation in PreOp holding/gamma knife treatment area,; Titrate per MD order.
		2 mg, Injection, IV Push, Once, PRN, see comment
			Comment: for IV sedation in PreOp holding/gamma knife treatment area,; Titrate per MD order.
		3 mg, Injection, IV Push, Once, PRN, see comment
			Comment: for IV sedation in PreOp holding/gamma knife treatment area,; Titrate per MD order.
		4 mg, Injection, IV Push, Once, PRN, see comment
			Comment: for IV sedation in PreOp holding/gamma knife treatment area,; Titrate per MD order.
	Ativan
		1 mg, Tab, SUBLINGUAL, Once
			Comment: in POH, after consents signed.
Patient Care
	Obtain Consent/Permit for:
		T;N

VTE Prophylaxis Pre Op
Medications
	HEParin 5000 units/mL SUBCUTANEOUS
		5,000 units, Injection, SUBCUTANEOUS, PREOP, T;N
	Lovenox
		40 mg, Syringe, SUBCUTANEOUS, PREOP, T;N
		30 mg, Syringe, SUBCUTANEOUS, PREOP, T;N
Patient Care
	Sequential Compression Device Pre Procedure
		T;N, Apply, Once
			Comment: knee high
	Anti Embolism Stockings Pre Procedure
		T;N, Apply, Once
			Comment: knee high

Peripheral Lock - Access
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL Syringe IV PUSH BID
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
	lidocaine 1% injectable solution (MH/WH/FH)
		0.1 mL, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start
	sodium chloride bacteriostatic 0.9% injectable soln
		0.1 mL, Injection, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start, use if patient has lidocaine allergy.
	Sodium Chloride 0.9% IVPB Flush
		25 mL, IVPB, Q1H, PRN, IV line flush, 5 min(s)
			Comment: Use if medication not compatible with primary line or there is no primary line;  infuse 25mL.
Patient Care
	Peripheral Lock-Insert
		T;N

*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