Unique Plan Description: Palliative Care Sedation Adult
Plan Selection Display: Palliative Care Sedation Adult
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2017-12-05 06:39:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-09-15 15:14:17
Available at all facilities: No

Palliative Care Sedation Adult
IV Solutions
	midazolam
		5 mg, Injection, IV Push, Once
	Versed 50 mg/NS 50 mL Premix
		100 mL, IV
		50 mg, EVERY BAG, 1 mg/hr
	Ativan 50mg/50mL Premix
		50 mg, EVERY BAG, 0.5 mg/hr
		50 mL, IV
			Comment: Start at 0.5mg/hr. Titrate by 0.5mg/hr at a maximum of every 20 minutes until desired RASS score achieved.  Max dose of 4mg/hr. Reduce dose by 0.5mg/hr at a minimum every 20 minutes after adequate sedation established and adjust to desired RASS score.  Contact ordering LIP if unable to titrate up or down or if max dose is reached and the desired RASS score is not achieved.
	PHENobarbital IVPB
		100 mg, INT, IVPB, Once, T;N
	PHENobarbital 650mg/NS 500mL
		500 mL, IV
		650 mg, EVERY BAG, 10 mg/hr
SUBQ Infusions
	LORazepam 100 mg/50 mL SQ Infusion
		100 mg, EVERY BAG
		50 mL, SUBCUTANEOUS INFUSION
			Comment: Notify the provider for any concerns about dosing. Re-assess pain, respiratory rate, respiratory pattern in 30-60minutes after any dose change.  Pharmacist to review dosing, product concentration, and modify order such that total rate does not exceed 3ml/hr .  With any rate change calculate maximum times patient could administer bolus + nurse administer bolus + basal. If this amount exceeds 3mL notify pharmacy for change in concentration.
	midazolam 100mg/NS 50mL SQ Infusion
		50 mL, SUBCUTANEOUS INFUSION
			Comment: Notify the provider for any concerns about dosing. Re-assess pain, respiratory rate, respiratory pattern in 30-60minutes after any dose change.  Pharmacist to review dosing, product concentration, and modify order such that total rate does not exceed 3ml/hr .  With any rate change calculate maximum times patient could administer bolus + nurse administer bolus + basal. If this amount exceeds 3mL notify pharmacy for change in concentration.
		100 mg, EVERY BAG
Medications
Analgesics/adjuncts & Anti-Anxiety
	Decadron injectable
		4 mg, Injection, IV PUSH, DAILY, T+1;0900
			Comment: for pain or dyspnea
		8 mg, Injection, IV PUSH, DAILY, T+1;0900
			Comment: for pain or dyspnea
		10 mg, Injection, IV PUSH, DAILY, T+1;0900
			Comment: for pain or dyspnea
		12 mg, INT, IVPB, DAILY, T+1;0900
			Comment: for pain or dyspnea
		16 mg, INT, IVPB, DAILY, T+1;0900
			Comment: for pain or dyspnea
		20 mg, INT, IVPB, DAILY, T+1;0900
			Comment: for pain or dyspnea
		As needed(NOTE)*
		4 mg, Injection, IV PUSH, Once, NOW
			Comment: for pain or dyspnea
		8 mg, Injection, IV PUSH, Once, NOW
			Comment: for pain or dyspnea
		10 mg, Injection, IV PUSH, Once, NOW
			Comment: for pain or dyspnea
		12 mg, INT, IVPB, Once, NOW
			Comment: for pain or dyspnea
		16 mg, INT, IVPB, Once, NOW
			Comment: for pain or dyspnea
		20 mg, INT, IVPB, Once, NOW
			Comment: for pain or dyspnea

*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