Unique Plan Description: Cards TEE Pre Op
Plan Selection Display: Cards TEE Pre Op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2013-12-30 09:59:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-11-02 08:43:26
Available at all facilities: Yes

Cards TEE Pre Op
Diet
	NPO
		T;N
			Comment: including medications after midnight
		T;N
			Comment: including medications after light breakfast and by 7:00am
Laboratory
	INR - MH/WH/JE
		T;N, Stat, spec type = Blood
	Prothrombin Time (PT) - FH
		T;N, Stat, spec type = Diagnostic Blood
		T;N, Stat, spec type = Therapeutic Blood
	Lipid Panel
		T;N, Stat, spec type = Blood
	CBC with Diff
		T;N, Stat, spec type = Blood
	Basic Metabolic Panel
		T;N, Stat, spec type = Blood
	PTT - MH/WH/JE
		T;N, Stat, spec type = Blood
	Partial Thromboplastin Time (PTT) - FH
		T;N, Stat, spec type = Diagnostic Blood
	Pregnancy Test Urine
		T;N, Routine, Routine, spec type = Urine
			Comment: if still menstruating and has not had not had hysterectomy or tubal ligation
Diagnostic Tests
	TEE Transesophageal Echocardiogram
		T;N, Routine
IV Solutions
	Sodium Chloride 0.9%
		500 mL, IV, Routine, 2 hr, 250 ml/hr
			Comment: to begin at time of procedure
		1,000 mL, IV, Routine, 2 hr, 50 ml/hr
			Comment: to begin at time of procedure
Medications
	benzocaine topical 20% mucous membrane spray
		1 spray, Aerosol, By Mouth, Once, Routine
	fentaNYL
		25 mcg, Injection, IV Push, Q5MIN, PRN, sedation, T;N, 4 Dose(s)/Time(s)
	Versed 5 mg/5 mL vial
		2 mg, Injection, IV Push, Q5MIN, PRN, sedation, 5 Dose(s)/Time(s)
			Comment: Up to 5 doses for procedure under direction of MD
	Versed (FH)
		2 mg, Injection, IV Push, Q5MIN, PRN for sedation, duration: 5 Dose(s)/Time(s)
			Comment: Up to 5 doses for procedure under direction of MD
	Valium Injectable
		5 mg, Injection, IV Push, Q5MIN, PRN, sedation
			Comment: titrate 2-5mg to affect per MD
	lidocaine Viscous 2% solution
		15 mL, Solution, By Mouth, Once
			Comment: Swish and Swallow
	glycopyrrolate
		0.2 mg, Injection, IV Push, Once, PRN, see comment
			Comment: Decrease oral Secretions
	flumazenil
		0.2 mg, Injection, IV Push, Q1MIN, PRN, see comment
			Comment: until desired effect, may repeat up to 5 doses total or 1 mg for reversal of anesthesia
	Narcan
		0.4 mg, Injection, IV Push, Q5MIN, PRN, see comment
			Comment: for reversal of fentanyl (or opiate), May repeat up to 5 doses total or 1mg. If patient becomes somnolent with minimal or no response to stimuli or respiratory rate is less than or equal to 10bpm. Infuse each 0.4mg over 15 seconds.
Patient Care
	Obtain Consent/Permit for:
		T;N, for Transesophageal Echocardiography
	Obtain supplies/equipment
		T;N, oral suction, oxygen and airway management equipment immediately available.

*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