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Health Care Associated ICU and non-ICU Respiratory: Oxygen Protocol Place patient on oxygen to maintain SpO2 greater than or equal to ________% Respiratory Medication Protocol Additional Respiratory Care orders ______________________________________________________________________________________________________________ Medications: Saline Lock IV __________________________________________________________________________ Laxative / Bowel Protocol: Regular Renal Antiemetic: Ondansetron HCL (Zofran) 4 mg IV Q 6 h PRN x 2 doses/24 hr. If over 2 doses needed, use Metoclopramide 10 mg IV Q 6 h PRN nausea / vomiting. -OR- _____________________________________________________________________________________________________________________ Hypnotic: Temazepam (Restoril) _________mg PO at hour of sleep PRN -OR- Zolpidem (Ambien) __________mg PO at hour of sleep PRN Antibiotics: Select appropriate regimen. (Choose one ) Community Acquired Non-ICU Patients Diagnosis: Pneumonia Aspiration Pneumonia Other Diagnosis: ____________________________________________________ Admitting Dr: ____________________________________________________________ Admit Status: Inpatient Observation Admit Unit: Med/Surg Tele ICU Code Status: Full code No code Limited Code Discussed with: Family Patient Estimated length of stay (circle): 1 2 3 4 5 6 7 >7 Estimated Disposition: Home SNF Home Health Assisted Living SCANNED TO PHARMACY STAT MEDICATION Diagnostic Tests: Order if not done in Emergency Department
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