Unique Plan Description: RT BRONCHODILATOR PROTOCOL
Plan Selection Display: RT BRONCHODILATOR PROTOCOL
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2020-04-30 10:57:28
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 10:49:11
Available at all facilities: Yes

RT BRONCHODILATOR PROTOCOL
Medications
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RT LEVEL 1 BRONCHODILATOR
		Level 1: Assessment Score 0 - 5(NOTE)*
		Albuterol q6hr PRN(NOTE)*
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q6H, PRN for wheezing and/or shortness of breath
			Comment: Level 1 - RT Dosing per protocol

RT LEVEL 2 BRONCHODILATOR
		Level 2: Assessment Score 6 - 10(NOTE)*
		Duoneb q6hr-while awake + Albuterol q2hr PRN(NOTE)*
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Q6H
			Comment: Level 2 - RT Dosing per protocol (maximum: 3 mL every 4 hours) - While awake. Chart NOT DONE if patient not awake
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q2H, PRN for shortness of breath
			Comment: Level 2 - RT Dosing per protocol

RT LEVEL 3 BRONCHODILATOR
		Level 3: Assessment Score 11 - 15(NOTE)*
		Duoneb q4hr-while awake + Albuterol q2hr PRN(NOTE)*
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Q4HAWAKE
			Comment: Level 3 - RT Dosing per protocol (maximum: 3 mL every 4 hours)
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q2H, PRN for shortness of breath
			Comment: Level 3 - RT Dosing per protocol

RT LEVEL 4 BRONCHODILATOR
		Level 4: Assessment Score 16 - 20(NOTE)*
		Duoneb q4hr + Albuterol q2hr PRN(NOTE)*
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Q4H
			Comment: Level 4 - RT Dosing per protocol
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q2H, PRN for wheezing and/or shortness of breath
			Comment: Level 4 - RT Dosing per protocol

RT LEVEL 5 BRONCHODILATOR
		Level 5: Assessment Score >= 21(NOTE)*
		Albuterol q2hr alternating with Duoneb q2hr(NOTE)*
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Q4H, T;N+120
			Comment: Level 5 - RT Dosing per protocol: Update physician of patient severityPharmacist, adjust schedule if needed to ensure Duoneb is 2 hours after albuterol.
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q4H
			Comment:  Level 5 - RT Dosing per protocol: Update physician of patient severity

*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