Unique Plan Description: NICU Hyperbilirubinemia (WH)
Plan Selection Display: NICU Hyperbilirubinemia (WH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2011-11-22 14:39:19
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-10-12 09:10:23
Available at all facilities: Yes

NICU Hyperbilirubinemia (WH)
Laboratory
STAT Lab
	Bilirubin Total
		T;N, Stat, spec type = Blood
	Bilirubin Total and Direct
		T;N, Stat, spec type = Blood
	CBC with Diff
		T;N, Stat, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Stat, spec type = Blood
	Direct Coombs
		T;N, Stat, spec type = Blood
	Neonatal Crossmatch
		T;N, Stat, spec type = No Collection, Irradiated
	Reticulocyte Count
		T;N, Stat, spec type = Blood
	Type and Screen (No Product on hold)
		T;N, Stat, spec type = Blood
PM Lab
	Bilirubin Total
		T;2000, Routine, spec type = Blood
	Bilirubin Total and Direct
		T;2000, Routine, spec type = Blood
	CBC with Diff
		T;2000, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;2000, Routine, spec type = Blood
	Reticulocyte Count
		T;2000, Routine, spec type = Blood
Tomorrow's Lab
	Bilirubin Total
		T+1;0400, Routine, spec type = Blood
	Bilirubin Total and Direct
		T+1;0400, Routine, spec type = Blood
	CBC with Diff
		T+1;0400, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T+1;0400, Routine, spec type = Blood
	Reticulocyte Count
		T+1;0400, Routine, spec type = Blood
Medications

	immune globulin intravenous - Privigen
		0.5 gm/kg, IVPB, Once, T;N, Infuse Over: 4 hr
			Comment: 0-15 minutes = 0.25mL/kg/hr = 0.025gm/kg/hr15-30 minutes = 0.5mL/kg/hr = 0.05gm/kg/hr30-45 minutes = 1mL/kg/hr = 0.1gm/kg/hr45-60 minutes = 2mL/kg/hr = 0.2gm/kg/hr60-75 minutes = 4mL/kg/hr = 0.4gm/kg/hr  The listed infusion time is ~ max time needed for a 1gm/kg dose, follow titration schedule.
Patient Care
	Obtain Consent/Permit for:
		T;N, DAILY, double volume exchange.
	Phototherapy
		T;N, Spot Lights, Initiate
		T;N, NeoBlue, Initiate
		T;N, Bili Blanket, Initiate
		T;N, Phototherapy Double, Initiate
		T;N, Phototherapy Triple, Initiate

*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