Unique Plan Description: Stroke Diagnostic Protocol
Plan Selection Display: Stroke Diagnostic Protocol
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2023-07-25 15:14:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-10-10 18:37:22
Available at all facilities: No

Stroke Diagnostic Protocol
Vital Signs
	Weight
		Once
	Vital Signs
		T;N, Q15 min x 4, if stable change to hourly.
Diet
	NPO
		T;N
Laboratory
	CBC with Diff
		Stat, spec type = Blood, Stroke Alert
	Comprehensive Metabolic Panel
		Stat, spec type = Blood, Stroke Alert
	Glucose POC - RN
		T;N, Once, NOW, Stroke Alert
	INR - MH/WH/JE
		Stat, spec type = Blood, Stroke Alert
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood, Stroke Alert
		T;N, Stat, spec type = Therapeutic Blood, Stroke Alert
	PTT - MH/WH/JE
		Stat, spec type = Blood, Stroke Alert
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood, Stroke Alert
	Hemoglobin A1C
		Stat, spec type = Blood, Stroke Alert
			Comment: Stroke alert
	Lipid Panel
		T;N, Stat, spec type = Blood
			Comment: Stroke alert
	hs Troponin T - MH/WH/JE
		Stat, spec type = Blood, Stroke Alert
			Comment: Stroke alert Results available with in 45minutes.
	hs Troponin I - FH
		Stat, spec type = Blood, Stroke Alert
Diagnostic Tests
	Chest 1 View
		Stat
	CT Head w/o Contrast for Stroke Alert
		Stat, CVA
	CTA Head and Neck for Stroke Alert
		T;N, Stat, CVA
	CTP Head for Stroke Alert
		T;N, Stat, CVA
	CT Head w/o Contrast for Stroke Alert
		Stat, CVA
	ECG
		Stat, Indication: Stroke
Medications
Patient Care
	Neurological Assessment-Focused
		T;N
			Comment: Q15 min x4, if stable, change to hourly
	Complete NIH Stroke Assessment
		T;N, Once
	Peripheral Lock-Insert
		T;N
Therapies
Consults/Follow-up
	Consult Tele Neurology (JEFH)
		Reason for Referral: Diagnosis: Stroke, now
	Consult Neuro Hospitalist
		Reason for Referral: Stroke, Refer to/Consult with: MPC Neurologist

Oxygen Protocol
Therapies
Respiratory Therapy
	Oxygen Therapy
		T;N
	Pulse Oximetry Spot Check RT
		T;N, BID
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID

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