Unique Plan Description: NeuroSurg Neuro Endovasc Catheter Directed Thrombolysis
Plan Selection Display: NeuroSurg Neuro Endovasc Catheter Directed Thrombolysis
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2024-09-12 07:44:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-02-27 08:40:20
Available at all facilities: No

NeuroSurg Neuro Endovasc Catheter Directed Thrombo
Laboratory
	PTT - MH/WH/JE
		Timed, Q6H, 24, hr, spec type = Blood
	Hemoglobin and Hematocrit
		Timed, Q6H, 24, hr, spec type = Blood
	Fibrinogen Level - MH/WH/JE
		Timed, Q6H, 24, hr, spec type = Blood
	Basic Metabolic Panel
		T+1;0400, Routine, spec type = Blood
	CBC with Diff
		T+1;0400, Routine, spec type = Blood
	INR - MH/WH/JE
		T+1;0400, Routine, spec type = Blood
IV Solutions
	Sodium Chloride 0.45% w/ KCl 20mEq
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
	Dextrose 5% in Lactated Ringers
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
	Sodium Chloride 0.9%
		1,000 mL, IV, 50 ml/hr
		1,000 mL, IV, 75 ml/hr
		1,000 mL, IV, 100 ml/hr
		1,000 mL, IV, 125 ml/hr
		1,000 mL, IV, 300 ml/hr
Medications
	sodium chloride 0.9% flush injectable soln
		10 mL, Syringe, IV Push, Once, PRN IV line flush
			Comment: lysis catheter coolant line occlusion; call provider if additional doses are needed and/or attempt unsuccessful.
		10 mL, Syringe, IV Push, Once, PRN IV line flush
			Comment: lysis catheter tpa line occlusion; call provider if additional doses are needed and/or attempt unsuccessful.
	HEParin 25,000 units/premixed diluent 250 mL
		250 mL, IV, Routine, T;N
			Comment: Via Sheath
		25,000 units, EVERY BAG, 500 units/hr
Patient Care
	Incision/Drain Assessment-Focused
		T;N, Q1H
			Comment: monitor for excessive bleeding, and catheter placement
	Dressing Care
		Reinforce | Do not remove
	Discontinue
		Heparin protocol, no lab monitoring while lysis catheter in place
	Vascular Assessment-Focused
		T;N, Q1H
			Comment: While catheter in place
	No Venipunctures
		Avoid any unnecessary peripheral venous punctures for 24 hours post tpa infusion.
	Do Not
		No insertion of any IV, NG, central lines or arterial lines during tpa infusion and for 24 hours post tpa infusion
	Cardiac Telemetry Monitoring
		Telemetry Indications: Other

*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