Unique Plan Description: Organ Retrieval Diagnostic Orders
Plan Selection Display: Organ Retrieval Diagnostic Orders
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2025-05-14 10:23:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-06-03 15:35:06
Available at all facilities: Yes

Organ Retrieval Diagnostic Orders
Vital Signs
	Temperature
		T;N, Q1H, via rectal or bladder
			Comment: may use warming blanket as needed to keep temp >36-37.5C
Activity
	Elevate head of bed
		T;N
			Comment: keep head of bed elevated > or = to 30 degrees
	Turn patient
		T;N, Q2H-Sch
Diet
Laboratory
	Glucose POC - RN
		T;N, Once, Notify Donor Coordinator >180
		T;N, TIDAC, Notify Donor Coordinator if >180
		T;N, Q4H, Notify Donor Coordinator if >180
		T;N, Q2H-Sch, Notify Donor Coordinator if >180
		T;N, Q1H, Notify Donor Coordinator if >180
	ABORh Patient Type
		T;N, Stat, spec type = Blood
			Comment: 1 of 2(two different draw times)
		Stat, spec type = Blood
			Comment: 2 of 2 (two different draw times)
		T;N, Stat, spec type = Blood
			Comment: 1 of 2 with subtype for A1, as applicable (two different draw times)
		T;N, Stat, spec type = Blood
			Comment: 2 of 2 with subtype for A1, as applicable (two different draw times)
	HGB A1C
		T;N, Stat, spec type = Blood
	Beta-HCG Quantitative - Pregnancy
		T;N, Stat, spec type = Blood
			Comment: if female less than or equal to 55 yrs of age
	CBC with Diff
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Magnesium Level
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Phosphorus
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Ionized Calcium
		T;N, Stat, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	LD
		T;N, Stat, Once, spec type = Blood
	GGT
		T;N, Stat, spec type = Blood
	Bilirubin Direct
		T;N, Stat, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Amylase Level
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Lipase Level
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	CK
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	CKMB
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	hs Troponin T - MH/WH/JE
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	hs Troponin I - FH
		T;N, Stat, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Blood Gases Arterial (ABG) - MH/WH/JE
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Blood Gases Arterial (ABG) - FH
		T;N, Stat, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	.Protime - MH/WH/JE
		T;N, Stat, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N+360, Q6H, Timed, spec type = Diagnostic Blood
	PTT - MH/WH/JE
		T;N, Stat, Once, spec type = Blood
		T;N+360, Timed, Q6H, spec type = Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N+360, Q6H, Timed, spec type = Diagnostic Blood
	Crossmatch Red Blood Cells
		T;N, Routine, # to GIVE 0 (Zero), # to HOLD 2, spec type = Blood
	Sputum Culture
		T;N, Stat, Expectorated, spec type = Sputum
			Comment: do NOT perform AFB or fungal cultures
	Culture Urine
		T;N, Stat, Urine, spec type = Urine
			Comment: to be run regardless of reflex (UNOS requirement)
	UA w/Microscopic Organ Retrieval
		T;N, Stat, Stat, spec type = Urine
			Comment: UA w/Microscopic for Organ Retrieval
	Microscopic Urine Organ Retrieval
		T;N, Stat, Stat, spec type = Urine
			Comment: UA w/Microscopic for Organ Retrieval
	UA w/Microscopic Organ Retrieval
		T;N+360, Timed Study, Stat, spec type = Urine, Q6H
			Comment: UA w/Microscopic for Organ Retrieval
	Microscopic Urine Organ Retrieval
		T;N+360, Timed Study, Stat, spec type = Urine, Q6H
			Comment: UA w/Microscopic for Organ Retrieval
Diagnostic Tests
	Chest 1 View
		Lung evaluation for Donor Coordinator, T;N, Stat, Findings/Abnormal
		Lung evaluation for Donor Coordinator, T+1;N, Findings/Abnormal, DAILY
	ECG
		
	Echo w Doppler resting
		Indication: Heart Transplant
			Comment: Copy of disc required; Check with Donor coordinator before ordering
IV Solutions
	Lactated Ringers Injection
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 150 ml/hr
		1,000 mL, IV, 20 ml/hr
	Dextrose 5% in Water
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 150 ml/hr
		1,000 mL, IV, 20 ml/hr
	Sodium Chloride 0.9%
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 150 ml/hr
		1,000 mL, IV, 20 ml/hr
	Sodium Chloride 0.9% with KCl 20mEq
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 150 ml/hr
		1,000 mL, IV, 20 ml/hr
	Sodium Chloride 0.45%
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 150 ml/hr
		1,000 mL, IV, 20 ml/hr
	Sodium Chloride 0.45% w/ KCl 20mEq
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 150 ml/hr
		1,000 mL, IV, 20 ml/hr
	Sodium Chloride 0.9%
		500 mL, Invasive Monitoring Line, Continuous, Total Volume = 500
			Comment: Arterial Line Pressure Bag 300 mmHg
Medications
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	fludrocortisone
		0.05 mg, Tab, NASOGASTRIC, DAILY
		0.05 mg, Tab, ORAL GASTRIC, DAILY
	hydrocortisone
		50 mg, Injection, IV Push, Q6H
			Comment: For BD donors only
	Ancef IVPB
		1,000 mg, Injection-Premix, IVPB, Q8H, Indication: Surgical prophylaxis, 2 Dose(s)/Time(s)
			Comment: If not currently on antibiotic coverage. If allergy, check with Donor coordinator for alternative.
	Ancef IVPB (FH)
		1,000 mg, INT, IVPB, Q8H, Indication: Surgical prophylaxis, 2 Dose(s)/Time(s)
			Comment: If not currently on antibiotic coverage. If allergy, check with Donor coordinator for alternative.
	vasopressin 10units/NS 50mL
		10 units, EVERY BAG, 0.01 unit/min
		50 mL, IV, STAT, Increment Increase: 0.01 unit/min, Increment Decrease: 0.01 unit/min, Increment Freq: 30 min(s), Max Dose: 0.1 unit/min
			Comment: Titrate to keep UOP 1-3ml/kg/hr. 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. Max dose 0.04units/min
	sodium zirconium cyclosilicate
		10 gm, Suspension, By Mouth, TID
			Comment: For hyperkalemia
		10 gm, Suspension, By Mouth, BID
			Comment: For hyperkalemia
		10 gm, Suspension, By Mouth, DAILY
			Comment: For hyperkalemia
	sodium polystyrene sulfonate
		15 gm, Suspension, By Mouth, QID
			Comment: If Lokelma not available
		15 gm, Suspension, By Mouth, TID
			Comment: If Lokelma not available
		15 gm, Suspension, By Mouth, BID
			Comment: If Lokelma not available
		15 gm, Suspension, By Mouth, DAILY
			Comment: If Lokelma not available
	HEParin 5000 units/mL SUBCUTANEOUS
		5,000 units, Injection, SUBCUTANEOUS, Q8H-Sch, T;N
			Comment: VTE Prophylaxis
		5,000 units, Injection, SUBCUTANEOUS, Q8H-Sch, T;N+0480
			Comment: Start 8 hours after admission. VTE Prophylaxis
		5,000 units, Injection, SUBCUTANEOUS, Q8H-Sch, T+1;0600
			Comment: VTE Prophylaxis
Patient Care
	Discontinue
		T;N, All existing orders except for ventilator orders and settings, current pressors, current antibiotics
	Weight
		T;N
			Comment: to be done with Donor Coordinator
	Height
		T;N
			Comment: to be done with Donor Coordinator
	Arterial Line Monitoring
		T;N, arterial line if one is not already in place.
		T;N, Continuous. Connect Acumen (APCO) sensor line to patient
	Notify
		T;N, Notify Donor Coordinator with Stroke Volume (SV), Stroke Volume Index (SVI) Cardiac output (CO), Cardiac Index (CI)
	Notify MD
		T;N, Notify Intensivist for arterial line/central line placement
	Vital Signs/Hemodynamic Monitoring
		T;N, Monitor minimally invasive hemodynamics via Accumen/Arterial line with each vital sign
		T;N, Donor Coordinator management goals:  Temp 36-37.5C, Heart rate 60-120, SBP >/=100mmHg/MAP >76mmgHG, CVP 6-10 mmHG, SpO2 >/=95%, pH 7.30-7.45, Glucose <180mg/dL, urine output 1-3ml/kg/hr
	Cardiac Telemetry Monitoring
		Telemetry Indications: Other
	Monitor Central Venous Pressure (CVP)
		
	Enteral Tube
		T;N Per Orogastric Tube (OG) Insert | Clamp insert as needed
		T;N Per Orogastric Tube (OG) Insert Insert as needed
		T;N Per Orogastric Tube (OG) Connect to low continuous suction
		T;N Per Nasogastric Tube (NG) Insert | Clamp XRay as needed
		T;N Per Nasogastric Tube (NG) Insert XRay as needed
		T;N Per Nasogastric Tube (NG) Connect to low intermittent suction
	Airway Suction
		T;N, Q2H-Sch
			Comment: Deep pharyngeal to remove sub glottal secretions
	Oral Care
		T;N, Q2H-Sch
	Warming Blanket
		T;N, PRN to keep temp 97F (36-37.5 degrees C)
	Cooling Blanket
		T;N, PRN to keep temp 97F (36-37.5 degrees C)
	Intake and Output
		T;N, Q1H
			Comment: monitor urine output to keep 1-3ml/kg/hr. If urine output is >3ml/kg/hr  or <1ml/kg/hr x 2hr notify Donor Coordinator or result.
	Notify
		T;N, Donor coordinator of specific gravity if done
	Order Lab
		T;N, Urine specific gravity if Urine output is >3ml/kg/hr x 2 hours, and notify Donor Coordinator clinical coordinator of result.
Therapies
	Communication RT
		T;N
			Comment: fully inflate ETT cuff. Donor patient
	Continuous Pulse Oximetry Monitoring Check
		T;N

Tube Feeding Orders
Diet
	Tube Feeding
		T;N, Continuous
			Comment: Change the enteral feed tubing every 24 hours or as ordered.
	Tube Feeding Rate Change
		T;N, Increase to goal rate per dietitian recommendations. Discontinue TF Rate Change order once goal is reached
	Tube Feeding - Instill
		Tap water, 30 ml, Q4HR
Laboratory
	Basic Metabolic Panel
		T+1;0400, Routine, Q24H, 5, Day(s), spec type = Blood
			Comment: (Tube Feeding Orders)
		T;N, Routine, spec type = Blood
			Comment: (Tube Feeding Orders)
		T+10;0400, Routine, Q7D-Lab, spec type = Blood
			Comment: (Tube Feeding Orders)
	Magnesium Level
		T;N, Routine, spec type = Blood
			Comment: (Tube Feeding Orders)
		T+1;0400, Routine, Q24H, 5, Day(s), spec type = Blood
			Comment: (Tube Feeding Orders)
		T+10;0400, Routine, Q7D-Lab, spec type = Blood
			Comment: (Tube Feeding Orders)
	Phosphorus
		T;N, Routine, spec type = Blood
			Comment: (Tube Feeding Orders)
		T+1;0400, Routine, Q24H, 5, Day(s), spec type = Blood
			Comment: (Tube Feeding Orders)
		T+10;0400, Routine, Q7D-Lab, spec type = Blood
			Comment: (Tube Feeding Orders)
Diagnostic Tests
	Chest 1 View
		T;N, Routine, Tube Placement F/U
			Comment: Before initial feeding
Medications
	Dulcolax
		10 mg, Suppository, RECTALLY, DAILY, PRN, if no BM, T;N
			Comment: if no BM for 3 days.
	Reglan
		10 mg, Injection, IV Push, Q6H, PRN, see comment, T;N
			Comment: if holding tube feeding for residual.
		10 mg, Injection, IV Push, Q8H, see comment, T;N
			Comment: if holding tube feeding for residual.
	thiamine
		100 mg, Tab, NASOGASTRIC, DAILY, duration: 7 Day(s)
Patient Care
	Tube Feeding Residual Check
		T;N, hold feeding if gastric residual is greater than 500 ml
			Comment: After 4 hours, restart at previous rate if residual is acceptable. If the problem is not resolved, continue to hold for 4 hours and recheck. Residuals will not be checked for post pyloric feeding tube, or feeding tubes.
	Notify MD
		T;N, If residuals continue to be unacceptable after 8 hours of holding tube feeding.
	Discontinue IV Fluids
		T;N
			Comment: When tube feeding reaches goal rate
Consults/Follow-up
	Consult Dietitian
		T;N, Regarding: Tube feeding

Blood Culture Set
Laboratory
	.Blood Culture.
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		T+1;0400, Routine, spec type = Blood
	.Blood Culture
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		T+1;0400, Routine, spec type = Blood

Central Line Venous 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
		20 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
		30 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
	heparin flush 100 units/mL
		600 units, IV Push, Q24H, PRN for IV line flush
			Comment: PRIOR TO DISCHARGE: For open ports only at discharge.
		500 units, IV Push, Q24H, PRN for IV line flush
			Comment: PRIOR TO DISCHARGE: For open ports only at discharge.
	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
	Central Line-Insert
		T;N

Insulin Drip (IV Infusion) Protocol
Laboratory
	Glucose POC - RN
		T;N, Q1H
		T;N, As needed for signs and symptoms of hypoglycemia
IV Solutions
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	insulin regular 100 units/NS 100 mL Premix
		100 units, EVERY BAG, 2 units/hr
		100 mL, IV, Routine, T;N, Total Volume = 100
			Comment: Concentration: 1 unit/mL, Initial rate based on initial glucose:  181-300: 2 units/hr;  301-400:  3 units/hr; 401 or greater: 4 units/hr;   Titrate infusion to target glucose of 140-180: If glucose is:1) Less than 100 discontinue infusion, ,continue blood glucose monitoring and follow Insulin IV infusion hypoglycemia treatment parameters if necessary; restart drip at 1/2 previous rate when glucose >120.2) 100-120, decrease infusion by 1 unit/hr3) 121-139,decrease rate by 0.5unit/hr4) 140-180 , no change5) 181-249, and is greater than or equal to the previous glucose, increase infusion by 0.5 unit/hr6) 181-249, and is less than the previous glucose, maintain same rate7) 250-350, increase infusion by 1 unit/hr8) > 351, increase infusion by 2 unit/hr. Contact MD if rate >10 unit/hr.  If the glucose decreases >75mg/dl from the last glucose check, decrease insulin rate by 50% and check blood glucose in 30 minutes. If enteral and/or parenteral nutrition support is stopped or held, decrease infusion to 0.5 unit/hour and notify physician
	Dextrose 5% with 0.45% NaCl
		1,000 mL, IV, Routine, 50 ml/hr, Total Volume = 1,000
			Comment: Begin if patient not currently on dextrose containing IV or TPN when glucose is 200 or less.  If patient has a current IV order that doesn't contain dextrose, add dextrose to that IV and do not start this D5/45 Order.
Medications
	insulin regular
		5 units, Solution-Injection, IV Push, Once, PRN see comment
			Comment: Prior to starting insulin drip if initial blood glucose 301 or greater
	Dextrose 50% injection
		25 mL, Injection, IV Push, Q15MIN, PRN low blood sugar, Routine
			Comment: Give if blood glucose less than 60mg/dL or 60-70 mg/dL and patient unable to tolerate oral intake. Notify provider if given with corresponding POC glucose recheck value.
		50 mL, Injection, IV Push, Q15MIN, PRN low blood sugar, Routine
			Comment: Give if blood glucose less than 60mg/dL or 60-70 mg/dL and patient unable to tolerate oral intake. Notify provider if given with corresponding POC glucose recheck value.
	Dextrose 10% in Water (FH)
		250 mL, Injection, IVPB, Q30MIN, PRN low blood sugar, infuse over 30 min(s)
			Comment: Give if blood glucose less than 60mg/dL or 60-70 mg/dL and patient unable to tolerate oral intake. Notify provider if given with corresponding POC glucose recheck value.
	glucagon
		1 mg, Injection, IV Push, Q15MIN, PRN low blood sugar, Routine, T;N
			Comment: Give if blood glucose < 70mg/dL AND if dextrose 50% injectable unavailable OR inadequate response to IV dextrose 50%. May give SubQ or IM if patient does not have IV access. Notify provider if given with corresponding POC glucose recheck value.
Patient Care
	Notify MD
		T;N, for instructions if dietary change: abrupt change in oral intake, change to NPO status, tube feedings are held or discontinued, TPN held or discontinued.  (caloric intake necessary to prevent hypoglycemia)
		T;N, If insulin requirements > 10units/hr for further instruction
	Notify MD of Lab results
		T;N, if blood glucose is not less than 180 after 6 hours on the Insulin IV Infusion protocol.
	IV Insulin Parameters
		T;N, Decrease infusion to 0.5 units/hour if enteral and/or parenteral nutrition support is stopped or held and notify physician.
		T;N, If the glucose decreases >75mg/dl from the last glucose check, decrease insulin rate by 50% and check blood glucose in 30 minutes.
		T;N, If initial glucose < 180, do not start infusion.  Enter order for blood glucose Q4H and start infusion if necessary based on parameters.
		T;N, When glucose </= 200, and patient not on a dextrose containing IV/TPN: add D5W to current IV.  Continue same IV base, electrolytes and rate.  If patient not currently on IV or TPN, initiate D5W/0.45% sodium chloride.
		T;N, Stop insulin infusion 2 hours after administration of antidiabetic medication ordered for transition from IV infusion (long-acting insulin, etc.)
	Order Lab
		When glucose is in target range (140-180) for 6 hours, cancel glucose Q1H order and enter new glucose order Q2H.  If glucose falls out of target range, change glucose checks back to Q1H until in range again for 6 hours.
	Hypoglycemia Treatment Parameters
		T;N, When blood glucose is greater than 120 mg/dL, restart infusion at 1/2 previous rate and change glucose checks to every hour until glucose is in the target range (140-180) for 6 hours, then may change to Q2H glucose checks.
		T;N, Hypoglycemia protocol initiated for patients with glucose <70mg/dl.  Patient should have an IV while on insulin protocol.
		T;N, glucose <60 mg/dL, discontinue infusion and treat with Dextrose 50% 25 mL OR glucagon 1mg as per medication orders. Notify provider as per critical result protocol.
			Comment: Repeat treatment as outlined in hypoglycemia parameters. Notify provider of all treatments given and POC glucose recheck values. When notifying provider of hypoglycemic treatment, clarify with provider future instructions on diabetic medication therapy
		T;N, glucose 60-70 mg/dL, discontinue infusion, and administer 4 oz apple juice, 4 oz non-diet soda, or glucose gel.  If patient NPO or unable to tolerate oral intake, give Dextrose 50% 25 mL OR glucagon 1mg as per medication orders.
			Comment: Repeat treatment as outlined in hypoglycemia parameters. Notify provider of all treatments given and POC glucose recheck values. When notifying provider of hypoglycemic treatment, clarify with provider future instructions on diabetic medication therapy.
		T;N, After initial treatment of any glucose value </= 70 mg/dL, repeat POC glucose in 15 min; if result </= 70mg/dL continue treating as per protocol and rechecking glucose 15 min after treatment until glucose >70mg/dL.
			Comment: Notify provider of all treatments given and corresponding POC glucose recheck values. When notifying provider of hypoglycemic treatment, clarify with provider future instructions on diabetic medication therapy.
		T;N, If the patient has a diet ordered and Once glucose is within normal limits, give 1 complex carb and 1 protein source.
			Comment: (such as ½ sandwich OR 1 individual container of peanut butter and 3 packs of crackers) or patient meal if patient able to take orals to prevent recurrent hypoglycemia.When notifying provider of hypoglycemic treatment, clarify with provider future instructions on diabetic medication therapy.

Organ Retrieval: Lung Recruitment Orders
Laboratory
	Blood Gases Arterial (ABG) - MH/WH/JE
		T;N+360, Timed, Q6H, spec type = Blood
		T;N, Timed, Q4H, spec type = Blood
	Blood Gases Arterial (ABG) - FH
		T;N+360, Timed, Q6H, spec type = Blood
		T;N, Timed, Q4H, spec type = Blood
Bronchial Washing
	Cell Count/Diff Body Fluid
		T;N, Routine, spec type = Bronchial Wash/Secretion
	Culture Routine
		T;N, Routine, Washing, spec type = Bronchial Wash/Secretion
	Unlisted Laboratory Procedure
		T;N, Routine, spec type = Body Fluid
			Comment: UNMC, RESPP, Respiratory Pathogen Panel by PCR Bronchial Wash
		T;N, Routine, spec type = Body Fluid
			Comment: ARUP #2010775. Mycobacterium tuberculosis Complex Detection and Rifampin Resistance by PCR Bronchial Wash
Bronchial Aveolar Lavage
	Cell Count/Diff Body Fluid
		T;N, Routine, spec type = Bronchial Alveolar Lavage
	Culture Routine
		T;N, Routine, Aspirate, spec type = Bronchial Alveolar Lavage
	Unlisted Laboratory Procedure
		T;N, Routine, spec type = Body Fluid
		T;N, Routine, spec type = Body Fluid
Diagnostic Tests

	Chest 1 View
		T;N, Q4H
		T;N, Q6H
Medications
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q2H
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Q4H
			Comment: If duoneb not available, enter order for: Albuterol 2. 5mg w/0.5mg
	levalbuterol 1.25 mg/3 ml inhalation solution
		0.5 mL, Solution-Nebulization, NEBULIZED, Q4H
	sodium chloride 7% inhalation soln
		3 mL, Solution-Nebulization, NEBULIZED, Q4H
Therapies
	Bronchoscopy-Order
		
			Comment: asap (CHECK WITH DONOR COORDINATOR BEFORE ORDERING THIS)
	Chest Physiotherapy
		T;N, All Areas, Q4H

Organ Retrieval Hypernatremia (for Na>165)
Medications
	metoclopramide
		10 mg, Injection, IV Push, Q6H, PRN see comment, T;N
			Comment: If holding tube feeding for residual.
	erythromycin IVPB
		3 mg/kg, INT, IVPB, Q8H, PRN, see comment, T;N, Infuse Over 45 min(s)
			Comment: If holding tube feeding for residual. Infuse over 45 minutes.
Patient Care
	GI Tube
		T;N, Q2H
			Comment: Instill 200 ml of tap water per gastric tube and clamp for 2 hours. Repeat every 2 hours.
		T;N, Check residual, Q4H
			Comment: Check residual q4h. Re-instill residual and add difference for a total 200ml. Repeating until Na+ level normal (enter goal) If patient continues to have elevated residuals, notify Donor coordinator for consideration of gut stimulator

Organ Retrieval Levothyroxine (T4) Protocol
IV Solutions
	levothyroxine 100 mcg/250mL NS
		250 mL, IV
			Comment: Start after Levothyroxine, insulin, dextrose, and solumedrol given. Start at 25 ml/hr (10 mcg/hr) initially. Goal to maintain MAP >60 mmHg or SBP >90 mmHg. Any titrations or rate changes per Donor Coordinator. Begin to taper off existing vasopressors after T4 initiated to maintain Target goal.
		100 mcg, EVERY BAG, 10 mcg/hr
Medications
	Dextrose 50%
		50 mL, Injection, IV Push, Once, STAT
	Solu-MEDROL IVPB
		2 gm, IVPB, Once, T;N
			Comment: in 50 mL D5W, Infuse over  1 hour
	levothyroxine
		20 mcg, Injection, IV Push, Once, STAT
	insulin regular
		20 units, Solution-Injection, IV Push, Once, T;N
			Comment: Give in rapid succession prior to starting T4 drip

*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