Unique Plan Description: Imaging IR Contrast Meds
Plan Selection Display: Imaging IR Contrast Meds
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-20 15:32:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2020-04-20 15:32:00
Available at all facilities: No

Imaging IR Contrast Meds
Laboratory
	Glucose POC - RN
		T;N, Once
	Creatinine in Radiology (MH)
		T;N, Once
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL, Syringe, IV Push, IN IMAGING, IV line flush
		20 mL, Syringe, IV Push, IN IMAGING, IV line flush
	sodium chloride
		10 mL, Injection, IV Push, IN IMAGING
	lidocaine 1% injectable solution (MH/WH/FH)
		0.1 mL, IntraDermal, IN IMAGING
			Comment: For IV start
	sodium chloride bacteriostatic 0.9% injectable soln
		0.1 mL, Injection, IntraDermal, IN IMAGING
	heparin flush 100 units/mL
		500 units, IV Push, IN IMAGING, Routine
		600 units, IV Push, IN IMAGING, Routine
	Sodium Chloride 0.9%
		500 mL, IV, 1 Dose(s)/Time(s), 20 ml/hr
			Comment: IN IMAGING
	Omnipaque 240 mg/mL 10mL vial
		10 mL, Injection, IV Push, IN IMAGING
	Omnipaque 240 mg/mL 20mL vial
		20 mL, Injection, IV Push, IN IMAGING
	Omnipaque 300 mg/mL 10mL vial
		10 mL, Injection, IV Push, IN IMAGING
	Omnipaque 350 mg/mL 50mL vial
		50 mL, Injection, IV Push, IN IMAGING
	Visipaque 270 mg/mL 50mL vial
		50 mL, Injection, IV Push, IN IMAGING
	Visipaque 270 mg/mL 100mL vial
		100 mL, Injection, IV Push, IN IMAGING
	Visipaque 320 mg/mL 50mL vial
		50 mL, Injection, IV Push, IN IMAGING
	Visipaque 320 mg/mL 100mL vial
		50 mL, Injection, IV Push, IN IMAGING
	Gadavist 7.5 mL vial
		0.1 mL, Solution-Injection, IV Push, IN IMAGING
			Comment: Added to 10mL sodium chloride 0.9%
	Multihance 529mg/mL 5mL vial
		5 mL, Injection, IV Push, IN IMAGING
	Gastrografin 30 mL
		30 mL, Solution-Oral, By Mouth, IN IMAGING, T;N
		30 mL, Solution-Oral, RECTALLY, IN IMAGING, T;N
	Isovue-M-200 41% intrathecal solution
		10 mL, Injection, Epidural, IN IMAGING
	Isovue-M-300 61% intrathecal solution
		15 mL, Injection, Epidural, IN IMAGING
	Isovue-300 61% 30mL vial
		30 mL, Injection, IV Push, IN IMAGING
		30 mL, Injection, IntraArticular, IN IMAGING
	Kenalog-40
		40 mg, Injection, IntraArticular, IN IMAGING
	DEPO-Medrol
		40 mg, Suspension-Injection, IntraArticular, IN IMAGING
	Naropin 0.5% injectable solution
		30 mL, Injection, IntraArticular, IN IMAGING
	Sensorcaine-MPF 0.25%
		30 mL, Injection, IntraArticular, IN IMAGING
	Sensorcaine-MPF 0.5%
		30 mL, Injection, IntraArticular, IN IMAGING
	Xylocaine 2% topical gel syringe
		6 mL, Gel, TOPICAL, IN IMAGING, T;N
	lidocaine 4% topical solution
		5 mL, Gel, TOPICAL, IN IMAGING, T;N
	Pain Ease Medium Stream
		1 spray, Spray, TOPICAL, IN IMAGING, T;N
	Decadron injectable
		10 mg, Injection, Epidural, IN IMAGING
	lidocaine 2% preservative-free injectable solution
		1 mL, Injection, Epidural, IN IMAGING
	lidocaine 1% preservative-free injectable solution
		30 mL, Injection, SUBCUTANEOUS, IN IMAGING
	lidocaine-EPINEPHrine 1%-1:100000 injectable solution
		20 mL, Injection, SUBCUTANEOUS, IN IMAGING
	HEParin 1000 units/mL injectable solution (JE)
		10,000 units, Injection, Irrigation, IN IMAGING, Routine
			Comment: Added to irrigation solution
	HEParin 1000 units/mL injectable soln
		10,000 units, Injection, Irrigation, IN IMAGING, Routine
			Comment: Added to irrigation solution
	heparin flush 10 units/mL intravenous solution
		10 units, Syringe, IV Push, IN IMAGING, Routine
	Sodium Chloride 0.9% irrigation 250mL
		250 mL, Irrigation
	sodium bicarb 10mEq/lidocaine 1% 50mL/NS 500mL (tumescent lidocaine)
		10 mEq, Irrigation, Once, Routine, T;N
		50 mL, EVERY BAG
		500 mL, EVERY BAG
Patient Care

Rad Contrast Reaction IV Pre Med orders
Medications
		It is recommended to wait 4-5 hours prior to administering IV Contrast. If the exam is urgent, the wait time can be waived at the discretion of a physician after 1 hour of administering both of the pre-medications.(NOTE)*
	Decadron injectable
		7.5 mg, Injection, IV PUSH, Once
			Comment: 4-5 hours prior to exam.
	Benadryl
		50 mg, Injection, IV Push, Once
			Comment: 1 hour prior to exam.   IV contrast can be administered after 1 hour of premedication.
	SOLU-Medrol
		40 mg, Injection, IV PUSH, Once
			Comment: Alternative to Decadron.  4-5 hours prior to exam.
Patient Care
	Fall Precautions
		T;N
			Comment: Use fall precaution protocol for 6 hours after Diphenhydramine given

Rad Post Glucophage
	Notify MD
		T;N, Call attending: pt on a brand of metformin and has received iodinated contrast placing pt at risk of lactic acidosis.
	Patient Education
		Instructions: Provide patient with printed handout information sheet with date/time to restart metformin containing medications.
Consults/Follow-up
	Pharmacy Consult
		T;N, Patient is on a brand of metformin, and has received iodinated contrast.  Please check that medications have been discontinued
			Comment: Patient is on a brand of metformin, and has received iodinated contrast.  Please check that medications have been discontinued

Rad Contrast Reaction Oral Pre Med orders
Medications
	predniSONE
		50 mg, Tab, By Mouth, Once
			Comment: 13 hours before contrast
		50 mg, Tab, By Mouth, Once
			Comment: 7 hours before contrast
		50 mg, Tab, By Mouth, Once
			Comment: 1 hour before contrast
		For JE patients, preferred medication is Benadryl:(NOTE)*
	Benadryl
		50 mg, Capsule, BY MOUTH, Once
			Comment: 1 hour before contrast.
		For FH/MH/WH patients, preferred medication is Claritin:(NOTE)*
	Claritin
		10 mg, Tab, By Mouth, Once
			Comment: 1 hour before contrast
	Medrol
		32 mg, Tab, BY MOUTH, Once
			Comment: 12 hours before contrast administration
		32 mg, Tab, BY MOUTH, Once
			Comment: 2 hours before contrast administration
	predniSONE 50 mg oral tablet
		See instructions, Take 1 tab by mouth 13 hours, 7 hours and 1 hour before radiology exam with contrast., # 3 TAB, 0 Refill(s)
	Claritin 10 mg oral tablet
		See instructions, Take 1 tab, BY MOUTH 1 hour before radiology exam with contrast., # 1 TAB, 0 Refill(s)
	Medrol 32 mg oral tablet
		See instructions, Take 1 tab by mouth 12 hours and 2 hours before radiology exam with contrast., # 2 TAB, 0 Refill(s)

*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