Unique Plan Description: esketamine (Spravato) Protocol
Plan Selection Display: esketamine (Spravato) Protocol
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2019-09-18 08:28:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-07-12 23:27:56
Available at all facilities: Yes

esketamine (Spravato) Protocol
Diet
	NPO
		T;N, For 2 hours prior to Spravato dose and 30 minutes post-dose
Laboratory
	Beta-HCG Quantitative - Pregnancy
		Stat, spec type = Blood
Medications
	Spravato
		56 mg, Spray, NASAL, Once, T;N
			Comment: Gently blow nose to clear nostrils before the first device only. Administer with head tilted back at a 45 degree angle. Each nasal spray device contains 2 sprays (1 spray for each nostril) and delivers a total of 28 mg; spray once into each nostril per device. Use 2 devices for 56 mg dose, with a 5-minute rest between use of each device to allow for absorption. Patient to be NPO for 2 hours prior and 30 minutes after administration
		84 mg, Spray, NASAL, Once, T;N
			Comment: Gently blow nose to clear nostrils before the first device only. Administer with head tilted back at a 45 degree angle. Each nasal spray device contains 2 sprays (1 spray for each nostril) and delivers a total of 28 mg; spray once into each nostril per device. Use 3 devices for 84 mg dose, with a 5-minute rest between use of each device to allow for absorption. Patient to be NPO for 2 hours prior and 30 minutes after administration
	ondansetron
		4 mg, Tab, By Mouth, Once, PRN for nausea and/or vomiting, T;N
Patient Care
	Vital Signs
		Prior to Spravato dose, 40 minutes post-dose and as clinically indicated for at least 2 hours post-dose.  If clinically significant changes in vital signs occur or Blood Pressure > 140/80, contact ordering provider
	Notify MD
		Symptoms of disassociation or sedation linger beyond 2 hours post-dose or blood pressure is elevated above 140/80 at any time prior to or after administration of Spravato.
	Communication to HOSPITAL RN
		Complete Spravato REMS Monitoring Form and fax to Spravato REMS (1-877-778-0091) and scan into EMR.

*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