Announcements ADMIT order REQUIRED to be entered to complete admission process for all appropriate ordersets.
|
|
|
- Cameron Harper
- 7 years ago
- Views:
Transcription
1 Page 1 of 9 HOSP: STROKE POST ALTEPLASE (tpa) INFUSION ORDERSET [1020] 6/9/10 PT OT ST start time restriction removed 5/4//10 Revised VTE Prophylaxis 4/13/10 mult new changes 12/22/09 stroke coordinator consult added 9/17/09 added SWRMC rehab order 2007 ASA ICH Guidelines Stroke URL: Q:\Micromedex\PDF\ASA ICH Guidelines Stroke 2007.pdf 2007 ASA Ischemic Stroke Guidelines Stroke URL: Q:\Micromedex\PDF\ASA Ischemic Stroke Guidelines Stroke 2007.pdf 2009 ASA SAH Guidelines URL: Q:\Micromedex\PDF\ASA SAH Guidelines 2009.pdf Information Announcements ADMIT order REQUIRED to be entered to complete admission process for all appropriate ordersets. Step #1: Place Resuscitations Orders. Complete Step #2 and #3, (if applicable) Step #4: Complete Extent of Care note. STEP 1: Place order for Resuscitation Orders, U.S. Living Will Registry America Living Will Registry FULL CODE-CODE BLUE TEAM WILL BE CALLED DNR-CODE BLUE TEAM WILL NOT BE CALLED COMFORT MEASURES- DNR URL: URL: STEP 2: Limitations of Care DO NOT GIVE ANTIBIOTICS DO NOT PERFORM BLOOD DRAWINGS DO NOT GIVE BLOOD/ BLOOD PRODUCTS DO NOT GIVE CHEMOTHERAPY DO NOT PERFORM DIALYSIS DO NOT INTUBATE DO NOT GIVE IV FLUIDS DO NOT PERFORM SURGERY DO NOT TRANSFER TO INTENSIVE CARE DO NOT GIVE TUBE FEEDINGS OR TPN PATIENT DOES NOT WISH SUPPORT FOR PERSISTENT VEGETATIVE STATE OR PERMANENT COMA Step #3: Extent of Care REQUESTED BY PATIENT WITH DECISION- MAKING CAPACITY- DNR order cannot be revoked by family or legal surrogate or Health Agent REQUESTED BY HEALTHCARE AGENT OR SURROGATE FOR PATIENT WITHOUT CAPACITY- (must document lack of decision
2 Page 2 of 9 capacity) EMERGENT AND UNABLE TO LOCATE ANY FAMILY- Second Physician on Medical Staff (not in same medical practice) concurs with need for DNR (both must chart their rationale) VTE Prophylaxis VTE Prevention: Chest Journal Heparin Subcutaneous - To begin 24 hours AFTER TPA infusion ends. Heparin- Pharmacy to dose - START 24 HOURS AFTER TPA infusion ends. heparin 5000 units subcutaneous q8 - to begin 24 hours AFTER TPA infusion ends. heparin 5000 units subcutaneous BID- CONSIDER:q8h dosing is more effective however q12h dosing may offer less bleeding complications in the elderly, frail, and renally compromised - to begin 24 hours AFTER TPA infusion ends. PLATELET COUNT q72h - CONSIDER: order on all patients on SQ heparin Enoxaparin (Lovenox) - to begin 24 hours AFTER TPA infusion ends. Pharmacy to dose enoxaparin (Lovenox) - to begin 24 hours AFTER TPA infusion ends. enoxaparin (LOVENOX) 40mg daily- to begin 24 hours AFTER TPA infusion ends. Platelet Count: CONSIDER: order on all patients on SQ enoxaparin (LOVENOX) URL: Q:\Micromedex\PDF\VTE Chest Guidelines 08.pdf Pharmacy to dose heparin SQ for VTE prophylaxis, to begin 24 hours AFTER TPA infusion ends Units, Subcutaneous, EVERY 8 HOURS Starting tomorrow at 5:00 AM 5000 Units, Subcutaneous, 2 TIMES DAILY Starting tomorrow at 9:00 AM Routine, EVERY 72 HOURS, Starting 6/25/10 For Until specified, Lab Performed, Discontinue platelet draws once SQ heparin prophylaxis is discontinued Pharmacy to dose enoxaparin (LOVENOX) for VTE prophylaxis - begin 24 hours AFTER TPA infusion ends. 40 mg, Subcutaneous, DAILY Starting tomorrow at 9:00 AM Routine, EVERY 72 HOURS, Starting 6/25/10 For Until specified, Lab Performed, Discontinue platelet draws once SQ lovenox prophylaxis is discontinued Non Pharmacologic Antiembolic Therapies SEQUENTIAL COMPRESSION STOCK Vital Signs and Neurological Checks VITAL SIGNS VITAL SIGNS NEUROLOGICAL CHECKS NEUROLOGICAL CHECKS Routine, CONTINUOUS, Starting today For Until specified, AT ALL TIMES while in bed Until specified, every 15 mins for 2 hours, then every 30 minutes for 6 hours, then every hour for 16 hours post initiation of tpa infusion then per routine. Until specified, Post Alteplase Infusion with vital signs Activity ACTIVITY BEDREST Now, UNTIL DISCONTINUED, Starting today For 24 Hours
3 Page 3 of 9 Dietary and Swallow Evaluations Nurse Swallow Screen Nurse Swallow Screen If patient PASSES Nurse Swallow Screen... If patient FAILS Nurse Swallow Screen... IV Therapy IV Fluids NS infusion NS with KCl 20 meq/l infusion Lab Orders Hematology CBC Chemistry BASIC METABOLIC PANEL COMPREHENSIVE METABOLIC PANEL Lipid Complete Panel HEMOGLOBIN A1C HOMOCYSTEINE STAT, UNTIL DISCONTINUED, Starting today For Until specified, PRIOR TO ANY ORAL INTAKE Until specified, Order dysphagia tray until diet order can be obtained from MD Until specified, Keep NPO with IV fluids and Head of bed elevated at least 30 degrees. Place order Speech Therapy consult. 100 ml/hr, Intravenous, CONTINUOUS Starting For 24 Hours 100 ml/hr, Intravenous, CONTINUOUS Starting For 24 Hours Routine, ONCE TOMORROW AM, Starting tomorrow at 4:00 AM For 1, Lab Performed Routine, ONCE TOMORROW AM, Starting today at 2:33 PM For 1, Lab Performed,. Routine, ONCE TOMORROW AM, Starting today at 2:33 PM For 1, Lab Performed Routine, ONCE TOMORROW AM, Starting today at 2:33 PM For 1, Lab Performed, Fasting specimen Routine, ONCE TOMORROW AM, Starting today at 2:33 PM For 1, Lab Performed Routine, ONCE TOMORROW AM, Starting tomorrow For 1, Lab Performed LABS- for patients experiencing neurological deterioration, new onset headache, nausea, vomiting, acute increase in blood pressure or bleeding CBC FIBRINOGEN APTT PT-INR STAT, PRN, Starting today For 1, Lab Performed, for patients experiencing neurological deterioration, new onset headache, nausea, vomiting, acute increase in blood pressure or bleeding STAT, PRN, Starting today For 1, Lab Performed, If neurological deterioration, new onset headache, nausea, vomiting, acute increase in blood pressure or bleeding STAT, PRN, Starting today For 1, Lab Performed, If neurological deterioration, new onset headache, nausea, vomiting, acute increase in blood pressure or bleeding STAT, PRN, Starting today, Lab Performed, If neurological deterioration, new onset headache,
4 Page 4 of 9 TYPE AND SCREEN Occult Blood OCCULT BLOOD GASTRIC ANALYSIS OCCULT BLOOD STOOL IP OCCULT BLOOD URINE nausea, vomiting, acute increase in blood pressure or bleeding STAT, PRN, Starting today For 1, If neurological deterioration, new onset headache, nausea, vomiting, acute increase in blood pressure or bleeding STAT, PRN, Starting today For Until specified, Unit Performed STAT, PRN, Starting today For Until specified, Unit Performed STAT, PRN, Starting today For Until specified, Clean Catch Urine, Lab Performed Glucose Checks GLUCOSE (tube feedings) Routine, EVERY 6 HOURS, Starting today For 48 Hours, Unit Performed, If on tube feedings for 48 hours GLUCOSE (oral diet) Routine, 4 TIMES DAILY AC BEDTIME, Starting today with First Occurrence As Scheduled For 48, Unit Performed, If on oral diet Diagnostic Tests CARDIAC TESTS EKG 12 LEAD UNIT PERFORMED ECHO PER STROKE PROTOCOL Radiology Tests CHEST PORTABLE STAT, ONE TIME, Starting today For 1 Indication for Exam: CVA/STROKE if not already done since symptom onset STAT, ONE TIME, Starting today For 1 Portable Bedside?: Yes Indications: stroke post TPA Routine, ONCE, Starting today For 1 Portable Bedside?: Yes Indication for exam: OTHER(SEE COMMENTS BOX) Indications: stroke, aspiration pneumonia If not performed in last 24 hours CT SCANS CT HEAD without CONTRAST Routine, ONCE, Starting tomorrow For 1 Indication for Exam: OTHER (SEE COMMENTS BOX) CT HEAD without CONTRAST STAT, ONCE, Starting tomorrow For 1 Indication for Exam: OTHER (SEE COMMENTS BOX) MRAs MRA HEAD without CONTRAST STAT, ONCE, Starting today For 1
5 Page 5 of 9 MRIs MRA NECK with/without CONTRAST MRI HEAD with/without CONTRAST MR HEAD W/WO CONTRAST MRI HEAD without CONTRAST CTAs CT CTA HEAD, NECK Peripheral Vascular Labs PVL CAROTID ARTERY BILAT STROKE PROTOCOL Consults MD Consults PALLIATIVE CARE CONSULT If not performed since symptom onset. COMPLETE safety screen form. STAT, ONCE, Starting today For 1 If not performed since symptom onset. COMPLETE safety screen form. Panel Routine, ONCE, Starting Routine, ONCE, Starting today For 1 If not performed since symptom onset. COMPLETE safety screen form. Routine, ONCE, Starting today For 1 Indication for Exam: OTHER (SEE COMMENTS BOX) Routine, ONCE, Starting today For 1 After 5 pm weekdays and on weekends, notify tech on call. Consider if MRA and/or CTA neck abnormal or neither ordered Now Indication for Consult: Did a specific event trigger this consult?: DEPARTMENTAL CONSULTS CARE COORDINATION Routine, ONE TIME, Starting today For 1 Reason for CM Consult/Care Coordination?: SERVICES TO BE DETERMINED AT DISCHARGE. OCCUPATIONAL THERAPY: EVALUATE (also order Tx) OCCUPATIONAL THERAPY: TREAT (also order eval) STAT, ONE TIME (REHAB), Starting today For 1 Indications?: stroke consult. Restrictions? Please add details in Comments: OTHER May be out of bed for treatment if systolic blood pressure GREATER than 110. STAT, PER THERAPIST DISCRETION, Starting today For Until specified Indications?: stroke consult.
6 Page 6 of 9 PHYSICAL THERAPY: EVALUATE (also order Tx) PHYSICAL THERAPY: TREAT(also order eval) Restrictions? Please add details in Comments: OTHER May be out of bed for treatment if systolic blood pressure GREATER than 110. STAT, ONE TIME (REHAB), Starting today For 1 Indications?: stroke consult. Restrictions? Please add details in Comments: OTHER May be out of bed for treatment if systolic blood pressure GREATER than 110. STAT, PER THERAPIST DISCRETION, Starting today For 1 Indications?: stroke consult Restrictions? Please add details in Comments: OTHER May be out of bed for treatment if systolic blood pressure GREATER than 110. SPEECH EVALUATION (also order with Tx) STAT, ONE TIME (REHAB), Starting today For 1 Reason for SLP?: Indications: Language Pathologyaphasia, cognition, dysphagia NOTIFY dietician it patient fails swallow evaluation SPEECH TREATMENT(also order eval) PT/ST/OT NOT ORDERED DUE TO: STAT, PER THERAPIST DISCRETION, Starting today For 1 Reason for SLP?: Indications: Language Pathologyaphasia, cognition, dysphagia NOTIFY dietician it patient fails swallow evaluation Reason: Stroke Coordinator Consult (Required) STROKE COORDINATOR CONSULT Rehab Consults REHAB 9TH FLOOR CONSULT (SNGH) PHYSICAL MEDICINE REHAB CONSULT (SVBGH) INPATIENT REHAB CONSULT (SWRMC) Physician Notification NURSE TO NOTIFY MD NOTIFY MD...ASAP of bleeding and HOLD antithrombotics IMMEDIATELY Routine, ONE TIME, Starting today For Until specified STAT, Indications: Stroke (This order is for 9B to evaluate the patient's candidacy for admission to SNGH rehab unit after discharge from the hospital) CONSULT MUST BE COMPLETED WITHIN 24 hours OF ADMISSION/ INITIATION OF THIS ORDER Nursing to call rehab unit Routine, Nurse to call IP Rehab Unit Routine, Indications: Stroke Post Alteplase (tpa). CONSULT MUST BE COMPLETED WITHIN 24 hours OF ADMISSION/ INITIATION OF THIS ORDER Nursing to call rehab unit STAT, UNTIL DISCONTINUED, Starting today For Until specified, If neurologic deterioration, change in mental status, new onset headache, nausea, vomiting, pupillary changes, acute INCREASE in blood pressure or bleeding
7 Page 7 of 9 Nursing Orders Nursing Interventions ASSESS- puncture sites COOLING BLANKET INTAKE AND OUTPUT Routine, PRN, Starting today For Until specified, For bleeding or hematoma Routine, PRN, Starting today For Until specified, For temperature GREATER than F Until specified, Per nursing unit routine Medications Blood Pressure Management- patients WITHOUT CHF or COPD. Goal is to maintain blood pressure LESS than 180/105 before, during, and for 24 hours after alteplase infusion. Select only ONE labetalol (NORMODYNE) 5 mg/ml syringe - q10 10 mg, IV PUSH, EVERY 10 MIN PRN Starting today minutes PRN nicardipine (CARDENE) in NS 20 mg/200 ml IV at 2:33 PM For 30 Dose(s) 5 mg/hr, Intravenous, CONTINUOUS-PRN Starting Blood Pressure Management- patients WITH CHF or COPD. Goal is to maintain blood pressure LESS than 180/105 before, during, and for 24 hours after alteplase infusion. Select only ONE enalaprilat (VASOTEC) injection nitroprusside (NIPRIDE) 50 mg in D5W 250 ml Infusion 1.25 mg, IV PUSH, EVERY 6 HOURS PRN Starting 0.5 mcg/kg/min, Intravenous, CONTINUOUS Starting Antihyperlipidemic Medications atorvastatin (LIPITOR) tablet - 80 mg simvastatin (ZOCOR) tablet - 10 mg simvastatin (ZOCOR) tablet - 20 mg simvastatin (ZOCOR) tablet - 30 mg simvastatin (ZOCOR) tablet - 40 mg 80 mg, Oral, EVERY NIGHT AT BEDTIME Starting 10 mg, Oral, EVERY NIGHT AT BEDTIME Starting 20 mg, Oral, EVERY NIGHT AT BEDTIME Starting 30 mg, Oral, EVERY NIGHT AT BEDTIME Starting 40 mg, Oral, EVERY NIGHT AT BEDTIME Starting Antithrombotic Medications - To Begin 24 Hours After Alteplase Ends DO NOT ADMINISTER ANTITHROMBOTICS UNTIL 24 HOURS AFTER END OF TPA INFUSION aspirin chew tab - to begin 24 hours after end of t-pa infusion aspirin tablet - to begin 24 hours after end of t- PA infusion aspirin suppository - for patients that are NPO - to begin 24 hours after end of t-pa infusion clopidogrel (PLAVIX) tablet - to begin 24 hours after end of t-pa infusion dipyridamole-aspirin (AGGRENOX) mg capsule - to begin 24 hours after end of t-pa infusion warfarin (COUMADIN) - Pharmacy to dose - to begin 24 hours after end of t-pa infusion DO NOT ADMINISTER ANTITHROMBOTICS UNTIL 24 HOURS AFTER END OF TPA INFUSION 162 mg, Oral, DAILY Starting tomorrow at 9:00 AM 325 mg, Oral, DAILY Starting tomorrow at 9:00 AM 150 mg, Rectal, DAILY Starting tomorrow at 9:00 AM 75 mg, Oral, DAILY Starting tomorrow at 9:00 AM 1 Cap, Oral, 2 TIMES DAILY Starting tomorrow at 9:00 AM Pharmacy to manage warfarin post-stroke, tpa given. Do NOT administer until 24 hours after end of t-pa (Alteplase) infusion. Goal INR: {MEDS WARFARIN
8 Page 8 of 9 ANTITHROMBOTIC THERAPY CONTRAINDICATED Antiemetics metoclopramide (REGLAN) 10mg inj- not used in pregnancy ondansetron (ZOFRAN) 4mg tablet ondansetron (ZOFRAN)4 MG tab, RAPID DISSOLVE ondansetron (PF) (ZOFRAN) 4 mg/2 ml injection prochlorperazine (COMPAZINE) 10mg tablet prochlorperazine (COMPAZINE) 25mg suppository prochlorperazine (COMPAZINE) 10mg injection promethazine (PHENERGAN) 25mg tablet promethazine (PHENERGAN) 12.5mg suppository promethazine (PHENERGAN) 25mg suppository promethazine (PHENERGAN) 12.5mg injectionpreferred drug and dose in pregnancy INR GOAL:24504} 10 mg, IV PUSH, EVERY 6 HOURS PRN Starting 4 mg, Oral, EVERY 6 HOURS PRN Starting today at 2:33 PM 4 mg, Oral, EVERY 6 HOURS PRN Starting today at 2:33 PM 4 mg, IV PUSH, EVERY 6 HOURS PRN Starting 10 mg, Oral, EVERY 6 HOURS PRN Starting today at 2:33 PM 25 mg, Rectal, EVERY 6 HOURS PRN Starting today at 2:33 PM 10 mg, IV PUSH, EVERY 6 HOURS PRN Starting 25 mg, Oral, EVERY 6 HOURS PRN Starting today at 2:33 PM 12.5 mg, Rectal, EVERY 6 HOURS PRN Starting 25 mg, Rectal, EVERY 6 HOURS PRN Starting today at 2:33 PM 12.5 mg, IV PUSH, EVERY 6 HOURS PRN Starting General Medications acetaminophen (TYLENOL) tablet 650 mg, Oral, EVERY 4 HOURS PRN Starting today at 2:33 PM acetaminophen (TYLENOL) suppository 650 mg, Rectal, EVERY 4 HOURS PRN Starting famotidine (PEPCID) tablet 20 mg, Oral, 2 TIMES DAILY Starting today at 9:00 AM famotidine (PEPCID) injection 20 mg, IV PUSH, 2 TIMES DAILY Starting today at 9:00 AM omeprazole (PRILOSEC) capsule 40 mg, Oral, EVERY MORNING BEFORE BREAKFAST Starting today at 8:00 AM magnesium hydroxide (MILK OF MAGNESIA) 30 ml, Oral, EVERY 24 HOURS PRN Starting today 400mg/5ml suspension at 2:33 PM senna 6.5 % liquid 10 ml, Per NG tube, DAILY Starting today at 9:00 AM senna-docusate (SENOKOT-S) mg 1 Tab, Oral, DAILY Starting today at 9:00 AM Vaccines - consider in stroke patient with comorbidities (diabetes, CAD, PVD, COPD) influenza vaccine syringe (October 1 - March 31) 0.5 ml, Intramuscular, ONCE Starting today at 2:33 PM For 1 Dose(s) Influenza vaccine NOT indicated Influenza vaccine NOT indicated pneumococcal vaccine (PNEUMOVAX) injection 0.5 ml, Intramuscular, ONCE Starting today at 2:33 PM For 1 Dose(s) Pneumococcal vaccine NOT indicated Pneumococcal vaccine NOT indicated Respiratory Orders Respiratory
9 Page 9 of 9 OXYGEN (CANNULA/MASK) For Administrative Purpose Only DO NOT de-select item(s) STROKE POST ALTEPLASE (tpa) INFUSION ORDERSET- Version 5 released 5/4/10 Oxygen device: CANNULA Liters per minute: 2 LPM Keep oxygen saturation EQUAL to or GREATER than 95%. (If patient has COPD maintain oxygen saturation 90-94%)
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
MED Hospitalist Stroke-TIA Vital Signs Vital Signs Q4H (DEF)* Q2H Q1H Vital Signs Orthostatic Activity Activity Bedrest, for 12 hours then Up ad lib (DEF)* Bedrest, for 24 hours then Up ad lib Up Ad Lib
Acute Ischemic Stroke with tpa
Admission/Condition/Diagnosis Admission: Admitting Physician Attending Physician Assign to Inpatient Status Transfer to Level of Care: Physician MUST document in notes the risk, severity, and skilled nursing
PHYSICIAN ORDERS TRANSIENT ISCHEMIC ATTACK (TIA) OBSERVATION
SCREENING- ABCD-2 Score The ABCD2 score is a risk assessment tool designed to improve the prediction of short-term stroke risk after a transient ischemic attack (TIA). Higher ABCD2 scores are associated
Ischemic Stroke Clinical Pathway
Ischemic Stroke Clinical Pathway Legal Treatments Advance Directives Refer to the ED Stroke Algorithm Patient exam: review history, Check VS/Neuro every 2 hour or per M.D. order Strict I & O s Cardiac
INR: RUPTURED ANEURYSM: POST EMBOLIZATION Patient Identification Page 1 of 5. Allergies: Weight: kg Diagnosis:
Page 1 of 5 Allergies: Weight: kg Diagnosis: Service: Admission Admit to Inpatient Admit to Daypatient Place on Outpatient Observation Status Hospital Attending: Attending Physician Attending Provider:
Chronic Obstructive Pulmonary Disease (COPD) Admission Order Set
Patient Name: PHN: Page 1/1 Admit to Dr: Notified Consult: Dr: Family Dr: Precautions: Contact Droplet Enhanced Droplet Airborne - Reason: _ Code Status: Full Resuscitation or Consults: Reason: Dietician
[ ] Cardiac monitoring Routine, Until discontinued, Starting today, PACU (only)
![[ ] Cardiac monitoring Routine, Until discontinued, Starting today, PACU (only)](/thumbs/26/8687689.jpg "[ ] Cardiac monitoring Routine, Until discontinued, Starting today, PACU (only)")
If appropriate for patient condition, please consider the following order sets: Hydration Order for Reducing Risk of Radiocontrast Induced Nephrotoxicity #683 Over the Counter Patient Care Products #767
Acute Myocardial Infarction (the formulary thrombolytic for AMI at AAMC is TNK, please see the TNK monograph in this manual for information)
ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY Guidelines for Use of Intravenous Alteplase (Tissue Plasminogen Activator (t-pa)), Activase in the Treatment
[ ] POCT glucose Routine, As needed, If long acting insulin is given and patient NPO, do POCT glucose every 2 hours until patient eats.
![[ ] POCT glucose Routine, As needed, If long acting insulin is given and patient NPO, do POCT glucose every 2 hours until patient eats.](/thumbs/35/17205932.jpg "[ ] POCT glucose Routine, As needed, If long acting insulin is given and patient NPO, do POCT glucose every 2 hours until patient eats.")
Glycemic Control - Insulin Infusion NOTE: For treatment of Diabetic Ketoacidosis or Hyperglycemic Hyperosmolar Syndrome please go to order set named Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar
DATE / TIME PROVIDER INITIALS PHYSICIAN ORDERS
If appropriate for this patient, please consider the following order sets: Heart Failure Addendum #609; Acute COPD #789, Glycemic Control - Insulin Infusion #824, Glycemic Control - Subcutaneous Addendum
Inpatient Anticoagulation Safety. To provide safe and effective anticoagulation therapy through a collaborative approach.
Inpatient Anticoagulation Safety Purpose: Policy: To provide safe and effective anticoagulation therapy through a collaborative approach. Upon the written order of a physician, Heparin, Low Molecular Weight
Appendix L: HQO Year 1 Implementation Priorities
Appendix L: HQO Year 1 Implementation Priorities Chronic Obstructive Pulmonary Disease (Source: COPD Chairs) Non-Invasive Positive Pressure Ventilation Early Ambulation If possible, seek patient preferences
Stroke/VTE Quality Measure Build for Meaningful Use Stage 1
Stroke/VTE Quality Measure Build for Meaningful Use Stage 1 Presented by Susan Haviland, BSN RN Senior Consult, Santa Rosa Consulting Meaningful Use Quality Measures Centers for Medicare and Medicaid Services
General PROVIDER INITIALS: PHYSICIAN ORDERS
Height Weight Allergies If appropriate for patient condition, please consider the following order sets: Initiate Electrolyte Replcement: Med/Surg, Med/Surg Tele Physician Order #842 General Vital Signs
REMINDER: Please ensure all stroke and TIA patients admitted to hospital are designated as "Stroke Service" in Cerner.
ACUTE STROKE CLINICAL PATHWAY QEH/HH PCH KCMH Souris Western Stewart Memorial O'Leary PATIENT ID INCLUSION CRITERIA* All patients admitted to hosptial with a suspected diagnosis of acute ischemic stroke
Planning: Patient Goals and Expected Outcomes The patient will: Remain free of unusual bleeding Maintain effective tissue perfusion Implementation
Obtain complete heath history including allergies, drug history and possible drug Assess baseline coagulation studies and CBC Assess for history of bleeding disorders, GI bleeding, cerebral bleed, recent
Interventional Radiology Post Procedure Orders
Interventional Radiology Post Procedure Orders ALLERGIES & SENSITIVITIES: NKA Unapproved Abbreviations: QD, Q.D., qd, q.d., QOD, Q.O.D., qod, q.o.d., MgSO₄, MSO₄, MS, IU, U or u, ug, Trailing Zero (X.0mg),
Clinical Pathway Total Hip and Knee Replacement
Procedure: THR TKR SIDE: RIGHT LEFT DISCHARGE DESTINATION: HOME INPATIENT REHAB PREADMISSION TARGET DISCHARGE DATE 1. Assessment Preadmission assessment completed Consult: anesthesia or internal medicine
Upstate University Health System Medication Exam - Version A
Upstate University Health System Medication Exam - Version A Name: ID Number: Date: Unit: Directions: Please read each question below. Choose the best response for each of the Multiple Choice and Medication
General Surgery Admission / Post-Op Orders
Vineet Choudhry, M.D. 12414 Alderbrook Dr., Ste 101 Austin, Texas 78758 512-491-6542 office 512-491-0161 fax General Surgery Admission / Post-Op Orders Admit: Admit to Observation Services Admit to Inpatient
Suffolk County Community College School of Nursing NUR 133 ADULT NURSING I
Suffolk County Community College School of Nursing NUR 133 ADULT NURSING I Page # 1 Instructions for students: Case study # 1 For this lab, you are planning to provide care to the following client: CB
CLINICAL QUALITY MEASURES FINALIZED FOR ELIGIBLE HOSPITALS AND CRITICAL ACCESS HOSPITALS BEGINNING WITH FY 2014
CLINICAL QUALITY MEASURES FINALIZED FOR ELIGIBLE HOSPITALS AND CRITICAL ACCESS HOSPITALS BEGINNING WITH FY 2014 e 55 0495 2 Emergency Department (ED)- 1 Emergency Department Throughput Median time from
How To Treat An Alcoholic Patient
Height Weight Allergies If appropriate for patient condition, please consider the following order sets: Initiate Electrolyte Replcement: Med/Surg, Med/Surg Tele Physician Order #842 Discontinue all lorazepam
D( desired ) Q( quantity) X ( amount ) H( have)
Name: 3 (Pickar) Drug Dosage Calculations Chapter 10: Oral Dosage of Drugs Example 1 The physician orders Lasix 40 mg p.o. daily. You have Lasix in 20 mg, 40 mg, and 80 mg tablets. If you use the 20 mg
Basic Medication Administration Exam RN (BMAE-RN) Study Guide
Basic Medication Administration Exam RN (BMAE-RN) Study Guide Review correct procedure and precautions for the following routes of administration: Ear drops Enteral feeding tube Eye drops IM, subcut injections
Anticoagulation Dosing at UCDMC Indication Agent Standard Dose Comments and Dose Adjustments VTE Prophylaxis All Services UFH 5,000 units SC q 8 h
Indication Agent Standard Dose Comments and Dose Adjustments VTE Prophylaxis All Services UFH 5,000 units SC q 8 h See EMR adult VTE prophylaxis CI order set Enoxaparin See service specific dosing Assess
CORONARY ARTERY BYPASS GRAFT & HEART VALVE SURGERY
CORONARY ARTERY BYPASS GRAFT & HEART VALVE SURGERY www.cpmc.org/learning i learning about your health What to Expect During Your Hospital Stay 1 Our Team: Our cardiac surgery specialty team includes nurses,
Program Objectives. Why Use Anticoagulants? 6/5/2014
Larry Reis RPh CGP FASCP Prepared June 2014 for NADONA REIS RXCARE CONSULTING Reisrxcare@comcast.net 1 Program Objectives Discuss complications of current anticoagulant Rx Identify risks of using anticoagulants
Code Stroke: Early Recognition and Emergency Management of the Acute Stroke Patient
Code Stroke: Early Recognition and Emergency Management of the Acute Stroke Patient Ali Grubbs, RN BSN Clinical Staff Leader VUMC Adult Emergency Department Vanderbilt Adult Emergency Department Patient
INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco
INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco CLINICAL RECOGNITION Background: Appropriate inpatient glycemic
Use of Antithrombotic Agents In The Presence Of Neuraxial Anesthesia
Use of Antithrombotic Agents In The Presence Of Neuraxial Anesthesia Insertion, removal or presence of a catheter in selected sites can place a patient who is antithrombotic agent at risk for a local bleeding
SUR COLON Colo-Rectal POST OP ADULT [3043020758] Version: 18-Sep-2013 (3043020758)
![SUR COLON Colo-Rectal POST OP ADULT [3043020758] Version: 18-Sep-2013 (3043020758)](/thumbs/25/5847287.jpg "SUR COLON Colo-Rectal POST OP ADULT [3043020758] Version: 18-Sep-2013 (3043020758)")
SUR COLON Colo-Rectal POST OP ADULT [3043020758] Version: 18-Sep-2013 (3043020758) PATIENT CARE Admission [30430200010003] Admit to Inpatient [ADT1] Admitting Physician: Level of Care: Diagnosis/Reason
Stroke/TIA Interdisciplinary Plan of Care
Stroke/TIA Interdisciplinary Plan of Care Patient/family involved in development of plan of care Patient/family agrees with plan of care Patient unable to be involved in plan of care ER and 1st 24 Hours
DVT/PE Management with Rivaroxaban (Xarelto)
DVT/PE Management with Rivaroxaban (Xarelto) Rivaroxaban is FDA approved for the acute treatment of DVT and PE and reduction in risk of recurrence of DVT and PE. FDA approved indications: Non valvular
The degree of liver inflammation or damage (grade) Presence and extent of fatty liver or other metabolic liver diseases
ilearning about your health Liver Biopsy www.cpmc.org/learning What is a Liver Biopsy? A liver biopsy is a procedure where a specially trained doctor (typically a hepatologist, radiologist, or gastroenterologist)
Approved: Acute Stroke Ready Hospital Advanced Certification Program
Approved: Acute Stroke Ready Hospital Advanced Certification Program The Joint Commission recently developed a new Disease- Specific Care Advanced Certification program for Acute Stroke Ready Hospitals
Diabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes
Diabetes Expert Witness on: Diabetic Hypoglycemia in Nursing Homes Nursing home patients with diabetes treated with insulin and certain oral diabetes medications (i.e. sulfonylureas and glitinides) are
Guidelines and Protocols
TITLE: HEAD TRAUMA PURPOSE: To provide guidelines for rapid, accurate assessment of the head and intracranial structures for traumatic injury and to plan and implement appropriate interventions for identified
STATEMENT OF STANDARD
OHSU HEALTH CARE SYSTEM PRACTICE STANDARD Acute Stroke Practice Standard for the Emergency Department (includes ischemic stroke, TIAs, intracerebral hemorrhage, and non-subarachnoid hemorrhage), PS 01.11
USC Pediatric Residency Program Quality Improvement Pre-Program Self Assessment
USC Pediatric Residency Program Quality Improvement Pre-Program Self Assessment 1. Have you had previous experience in quality improvement (QI)? Yes No 2. How many formal quality improvement projects have
Ultrasound or Computed Tomography. PATIENT GUIDE and PREPARATION. Liver Biopsy
Ultrasound or Computed Tomography PATIENT GUIDE and PREPARATION Liver Biopsy What is a Liver Biopsy? A Liver Biopsy is a procedure that involves taking a specimen ( a small amount of tissue) from within
ACUTE STROKE PATHWAY
ACUTE STROKE PATHWAY THERE IS A NEED FOR STATEWIDE STROKE SYSTEM OF CARE ALL MISSISSIPPIANS SHOULD BE ABLE TO ACCESS NEW PROTOCOLS FOR STROKE TREATMENT JOINT EFFORT WITH EMS, PHYSICIANS, HOSPITALS AND
2.5mg SC daily. INR target 2-3 30 mg SC q 12 hr or 40mg daily. 10 mg PO q day (CrCl 30 ml/min). Avoid if < 30 ml/min. 2.
Anticoagulation dosing at UCDMC (SC=subcutaneously; CI=continuous infusion) Indication Agent Dose Comments Prophylaxis Any or No bleeding risk factors see adult heparin (VTE prophylaxis) IV infusion order
Level III Stroke Center Data Collection Requirements
Who? Level III Stroke Center Data Collection Requirements All LERN Level III Stroke Centers. LERN Level I and II Stroke Centers have reporting requirements to The Joint Commission or other Board approved
SECTION N: MEDICATIONS. N0300: Injections. Item Rationale Health-related Quality of Life. Planning for Care. Steps for Assessment. Coding Instructions
SECTION N: MEDICATIONS Intent: The intent of the items in this section is to record the number of days, during the last 7 days (or since admission/reentry if less than 7 days) that any type of injection,
Overview of the TJC/CMS VTE Core Measures
Overview of the TJC/CMS VTE Core Measures CMS Specification Manual 4.2 January 1, 2013 June 30, 2013 Victoria Agramonte, RN, MSN Project Manager, IPRO VTE Regional Learning Sessions NYS Partnership for
Community health care services Alternatives to acute admission & Facilitated discharge options. Directory
Community health care services Alternatives to acute admission & Facilitated discharge options Directory Introduction The purpose of this directory is to provide primary and secondary health and social
SCRN Medication Review. Susan M. Gaunt MS APRN ACNS-BC CCRN CNRN Gwinnett Medical Center
SCRN Medication Review Susan M. Gaunt MS APRN ACNS-BC CCRN CNRN Gwinnett Medical Center Objectives To explain the indications, contraindications, interaction, timing, dosing, side effects of: Thrombolytics
PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION
PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION This booklet was designed to help you and the important people in your life understand the treatment of high dose chemotherapy with stem cell support: a procedure
RENAL ANGIOMYOLIPOMA EMBOLIZATION
RENAL ANGIOMYOLIPOMA EMBOLIZATION The information about renal angiomyolipomas on the next several pages includes questions commonly asked about the embolization procedure. Please take a few moments to
Pharmacy. Page 1 of 10
Department: Pharmacy PP # RX 6007.1 Policy and Procedure Effective Date: August, 2010 Page 1 of 10 Subject/Title: Pharmacy Tech-Check-Tech Program Dates of Review/Revision: Approved By and Title: Director,
CARDIAC SURGERY INTRAVENOUS INSULIN PROTOCOL PHYSICIAN ORDERS INDICATIONS EXCLUSIONS. Insulin allergy
Page 1 of 5 INDICATIONS EXCLUSIONS 2 consecutive blood glucose measurements greater than 110 mg per dl AND NPO with a continuous caloric source AND Diagnosis of : Cardio-thoracic Surgery NOTE: This protocol
Outpatient Treatment of Deep Vein Thrombosis with Low Molecular Weight Heparin (LMWH) Clinical Practice Guideline August 2013
Outpatient Treatment of Deep Vein Thrombosis with Low Molecular Weight Heparin (LMWH) Clinical Practice Guideline August 2013 General Principles: There is compelling data in the medical literature to support
NURSING 500.105 Effective Date Title: 6/12 SCOPE OF PRACTICE FOR STUDENT NURSES AND NURSING ASSISTANTS
XXX DAYTONA XXX _OCEANSIDE HEALTH CARE PARTNERS Department: Page 1 of 5 POLICY & PROCEDURE Policy Number NURSING 500.105 Effective Date Title: 6/12 SCOPE OF PRACTICE FOR STUDENT NURSES AND NURSING ASSISTANTS
Basic Medication Administration Exam LPN/LVN (BMAE-LPN/LVN) Study Guide
Basic Medication Administration Exam LPN/LVN (BMAE-LPN/LVN) Study Guide Review correct procedure and precautions for the following routes of administration: Ear drops Enteral feeding tube Eye drops IM,
Building an Emergency Response to Acute Stroke
Great Lakes Stroke Network August 2006 Building an Emergency Response to Acute Stroke Wende N. Fedder RN, BSN, MBA Director, Stroke & Neurovascular Services Alexian Brothers Hospital Network Elk Grove
Ultrasound. PATIENT GUIDE and PREPARATION. Thoracentesis
Ultrasound PATIENT GUIDE and PREPARATION Thoracentesis What is a Thoracentesis? A Thoracentesis is a procedure that involves using a needle to drain fluid from either within the lungs or the surrounding
Making the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA
Making the Case for CPG s Jean Luciano, MSN, RN, CNRN, SCRN, CRNP, FAHA Claranne Mathiesen, MSN, RN, CNRN, SCRN, FAHA Disclosures Jeanie Luciano Genentech speakers bureau Claranne Mathiesen - none 1 Objective
Procedure for Inotrope Administration in the home
Procedure for Inotrope Administration in the home Purpose This purpose of this procedure is to define the care used when administering inotropic agents intravenously in the home This includes: A. Practice
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER - SHREVEPORT MEDICAL RECORDS CONTENT/DOCUMENTATION
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER - SHREVEPORT MEDICAL RECORDS CONTENT/DOCUMENTATION Hospital Policy Manual Purpose: To define the components of the paper and electronic medical record
The Ideal Hospital Discharge. Alayne D. Markland, DO, MSc UAB Department of Medicine Division of Geriatrics, Gerontology, & Palliative Care
The Ideal Hospital Discharge Alayne D. Markland, DO, MSc UAB Department of Medicine Division of Geriatrics, Gerontology, & Palliative Care Why is discharge planning important? Surging interest from professional
Stroke Care First week
Stroke Care First week Florence Nightingale (1820 1910) Stroke Unit Dedicated personnel trained in stroke management Stepwise guidelines supported by explicit checklists Continuous monitoring available
A new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration
of nurse A new insulin order form should be completed for subsequent changes to type of insulin and/or frequency of administration 1. Check times for point of care meter blood glucose testing. Pre-Breakfast
SUFFOLK COUNTY COMMUNITY COLLEGE NURSING DEPARTMENT MEDICATION ADMINISTRATION TEST NR 40 Practice test questions READ INSTRUCTIONS CAREFULLY
NR40 MEDICATION MATH TEST Practice questions page 1 SUFFOLK COUNTY COMMUNITY COLLEGE NURSING DEPARTMENT MEDICATION ADMINISTRATION TEST NR 40 Practice test questions READ INSTRUCTIONS CAREFULLY Students
Acute Coronary Syndrome
Acute Coronary Syndrome Quality Measures Length of Stay RCC Costs per Case Critical Event(s) Evaluation /Acute Phase ECG ASA on arrival (unless documented contraindication) Troponin STAT, repeat once in
Instructor Guide: CPOE (Order Entry) for the Nurse. Trainer Notes. Objective Learn about PowerPlans. Benefits of CPOE. Learn about Nurse Review
Instructor Guide: CPOE (Order Entry) for the Nurse Trainer Notes Section Name Duration Order Entry 45 minutes Objective Learn about PowerPlans Benefits of CPOE Learn about Nurse Review You ll Need Parking
REFERENCE. Admit to: Program/Service: Diagnosis: Droplet/ Contact Airborne/ Contact
Weight (kg) REFER TO THE ALLERGY SCREEN IN MEDITECH FOR ALLERGY INFORMATION To complete the order form, fill in the required blanks and/or check the appropriate boxes. To delete orders, draw one line through
PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG
DRUG AND TREATMENT Condition/Status This powerplan is only intended for use in those patients having symptoms related to alcohol withdrawal. See DSM-IV-TR criteria listed in the Alcohol Withdrawal ICU
Inpatient and Outpatient Manual Changes for 2015
Inpatient and Outpatient Manual Changes for 2015 Jill Daniel Project Manager Quality Measures Abstraction 15-036-AB GoToWebinar The Questions Chat Box Set your audio option Introduction to Data Dictionary
A Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation
Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation A Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation PATIENT EDUCATION GUIDE What is atrial fibrillation? Atrial fibrillation
Statement of Standard
OHSU HEALTH CARE SYSTEM PRACTICE STANDARD Acute Stroke Practice Guidelines f Inpatient Management of Ischemic Stroke and Transient Ischemic Attack (TIA), PS 01.14 Last Reviewed Date: 5/5/2010 Statement
SARASOTA MEMORIAL HOSPITAL
SARASOTA MEMORIAL HOSPITAL TITLE: NURSING PROCEDURE MANAGEMENT OF PATIENT S OWN INSULIN PUMP/CONTINUOUS SUBCUTANEOUS INSULIN INFUSION PUMP (dia13) DATE: REVIEWED: PAGES: 08/84 10/15 1 of 7 PS1094 ISSUED
RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND
RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND Monitor patient on the ward to detect trends in vital signs and to manage accordingly To recognise deteriorating trends and request relevant medical/out
Traditional anticoagulants
TEGH Family Practice Clinic Day April 4, 03 Use of Anticoagulants in 03: What s New (and What Isn t) Bill Geerts, MD, FRCPC Director, Thromboembolism Program, Sunnybrook HSC Professor of Medicine, University
Medication Calculation Practice Problems
1 Medication Calculation Practice Problems Dosage Calculation 1. The order is for 60 mg of furosemide (Lasix) po daily. Available to the nurse is Lasix 40 mg/tablet. The nurse would administer how many
ACUTE STROKE UNIT ORIENTATION
ACUTE STROKE UNIT ORIENTATION 2014 TEACHING YOUR STROKE PATIENTS ABOUT THEIR MEDICATION Please refer to Module 8: Secondary Stroke Prevention for additional information Blood Pressure Medication Angiotensin
YTTRIUM 90 MICROSPHERES THERAPY OF LIVER TUMORS
YTTRIUM 90 MICROSPHERES THERAPY OF LIVER TUMORS The information regarding placement of Yttrium 90 microsphres for the management of liver tumors on the next several pages includes questions commonly asked
BCCA Protocol Summary for Advanced Therapy for Relapsed Testicular Germ Cell Cancer Using PACLitaxel, Ifosfamide and CISplatin (TIP)
BCCA Protocol Summary for Advanced Therapy for Relapsed Testicular Germ Cell Cancer Using PACLitaxel, Ifosfamide and CISplatin (TIP) Protocol Code Tumour Group Contact Physician UGUTIP Genitourinary Dr.
Diabetic Ketoacidosis: When Sugar Isn t Sweet!!!
Diabetic Ketoacidosis: When Sugar Isn t Sweet!!! W Ricks Hanna Jr MD Assistant Professor of Pediatrics University of Tennessee Health Science Center LeBonheur Children s Hospital Introduction Diabetes
SLIDING SCALE INSULIN ASPART PROTOCOL PLAN
Weight Allergies Patient Care Accucheck Per Sliding Scale Insulin Frequency AC & HS AC & HS 3 days TID BID q12h q6h q6h 24 hr q4h q2h Sliding Scale Insulin Protocol Follow SSI Reference Text Medications
High Risk Emergency Medicine
High Risk Emergency Medicine Minor Head Injuries in Patients on Oral Anticoagulants David Thompson, MD, MPH Assistant Professor Department of Emergency Medicine No relevant financial relationships to disclose
LAMC Reversal Agent Guideline for Anticoagulants 2013. Time to resolution of hemostasis (hrs) Therapeutic Options
LAMC Reversal Agent Guideline for Anticoagulants 2013 Medication resolution of hemostasis (hrs) Intervention Administration Instructions Heparin 3-4 Protamine 1mg IV for every 100 units of heparin Slow
Update on Antiplatelets and anticoagulants. Outlines. Antiplatelets and Anticoagulants 1/23/2013. Timir Paul, MD, PhD
Update on Antiplatelets and anticoagulants Timir Paul, MD, PhD Antiplatelets Indications Doses Long term use (beyond 12 months) ASA and combination use of NSAIDS ASA resistance Plavix resistance Plavix
Electronic Medication Administration Record (emar) (For Cerner Sites Only)
POLICY NO. 1009 Approved: 12/05 Effective: 12/05 Reviewed: 9/10; 5/12 1. Purpose: Electronic Medication Administration Record (emar) (For Cerner Sites Only) To provide direction for the transcription and
Developing a Dynamic Team Approach to Stroke Care. Emergency Medical Services 2015
Developing a Dynamic Team Approach to Stroke Care Emergency Medical Services 2015 Why Stroke, Why now? A recent study showed that 80 percent of people in the United States live within an hour s drive of
convey the clinical quality measure's title, number, owner/developer and contact
CMS-0033-P 153 convey the clinical quality measure's title, number, owner/developer and contact information, and a link to existing electronic specifications where applicable. TABLE 20: Proposed Clinical
UPDATED INCLUSION AND EXCLUSION CRITERIA FOR IV TPA ADMINISTRATION ACUTE STROKE TREATMENT: AN UPDATE GOALS OF TALK
ACUTE STROKE TREATMENT: AN UPDATE James M. Gebel MD MS FAHA Medical Director Akron General Medical Center Cerebrovascular Center GOALS OF TALK Review changes to IV tpa administration as per new 2013 AHA
POAC CLINICAL GUIDELINE
POAC CLINICAL GUIDELINE Acute Pylonephritis DIAGNOSIS COMPLICATED PYELONEPHRITIS EXCLUSION CRITERIA: Male Known or suspected renal impairment (egfr < 60) Abnormality of renal tract Known or suspected renal
Lothian Diabetes Handbook MANAGEMENT OF DIABETIC KETOACIDOSIS
MANAGEMENT OF DIABETIC KETOACIDOSIS 90 MANAGEMENT OF DIABETIC KETOACIDOSIS Diagnosis elevated plasma and/or urinary ketones metabolic acidosis (raised H + /low serum bicarbonate) Remember that hyperglycaemia,
Medication Guidelines for LP/Myelograms Medication Recommendation Comments Plavix, Ticlid, other antiplatelet meds
Critical Laboratory Values for Lumbar Puncture/Myelography Lab Test PLT INR PTT Lab Value >25,000
PROTOCOL TITLE: Ambulatory Initiation and Management of Warfarin for Adults
PROTOCOL NUMBER: 7 PROTOCOL TITLE: Ambulatory Initiation and Management of Warfarin for Adults THIS PROTOCOL APPLIES TO: UW Health Clinics: all adult outpatients with an active order for warfarin TARGET
Causes Of High Coumadin Level And Symptoms
Causes Of High Coumadin Level And Symptoms coumadin toxicity guidelines skin coumadin diet pdf university of michigan coumadin diet espanol guide coumadin and vitamin k pdf reversal time coumadin warfarin
2013 ACO Quality Measures
ACO 1-7 Patient Satisfaction Survey Consumer Assessment of HealthCare Providers Survey (CAHPS) 1. Getting Timely Care, Appointments, Information 2. How well Your Providers Communicate 3. Patient Rating
Medical Management of Ischemic Stroke: An Update. Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center
Medical Management of Ischemic Stroke: An Update Siddharth Sehgal, MD Medical Director, TMH Neuroscience Center Objectives Diagnostic evaluation and management of acute ischemic stroke. Inpatient management
Stroke Reperfusion Therapy: IV t-pa Treatment Phase
Stroke Reperfusion Therapy: IV t-pa Treatment Phase IV tpa Administration for Adult Patients Arriving Within 3 Hours. Page Contents Consent Form Indications for IV tpa Contraindications Warnings t-pa Dosing
what is warfarin? Treatment with Warfarin (Coumadin ) What is warfarin?
What is warfarin? Warfarin sodium (Coumadin ) is a medication that works as an anti-coagulant. Anti means against and coagulant refers to blood clotting. An anticoagulant helps to prevent clots from forming
Endovascular Abdominal Aortic Aneurysm Repair Surgery
Endovascular Abdominal Aortic Aneurysm Repair Surgery You are scheduled for an admission to Cooper University Hospital for Endovascular Abdominal Aortic Aneurysm surgery (EVAR). Please read this handout,
The Clinical Evaluation of the Comatose Patient in the Emergency Department
The Clinical Evaluation of the Comatose Patient in the Emergency Department patients with altered mental status (AMS) and coma. treat patients who present to the Emergency Department with altered mental
REGIONAL SUSPECTED STROKE PROTOCOL
1. Stroke refers to any spontaneous damage to the brain caused by an abnormality of the blood supply by means of a clot or bleed. Strokes should be treated emergently. During a stroke, up to 2 million
Calculations Practice Problems
Calculations Practice Problems Note: A variety of types of problems are provided for practice. Not all situations will be encountered in all states, depending on state limitations to LPN/LVN practice.