Unique Plan Description: NICU Cardiology (WH)
Plan Selection Display: NICU Cardiology (WH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2022-04-05 12:37:01
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-04-05 12:40:57
Available at all facilities: No

NICU Cardiology (WH)
Diagnostic Tests
Cardiology
	ECG Pediatric
		Stat, Indication: Arrhythmia
	Echocardiogram to be done by CH
		Stat, Indication: Congenital anomalies | Arrhythmia
	Holter Monitor to be done by CH
		
IV Solutions
Dopamine Standard Concentration
	DOPamine 40 mg/D5W 25 mL Syringe (NICU)-Standard
		25 mL, IV
		40 mg, EVERY BAG, 2.5 mcg/kg/min
Dopamine Non-Standard Concentration
	DOPamine 20 mg/D5W 25 mL Syringe (NICU)
		25 mL, IV
		20 mg, EVERY BAG, 2.5 mcg/kg/min
	DOPamine 80 mg/D5W 25 mL Syringe (NICU)
		25 mL, IV
		80 mg, EVERY BAG, 2.5 mcg/kg/min
DoBUTamine Standard Concentration
	DOBUTamine 50 mg/D5W 25 mL Syringe (NICU)-Standard
		25 mL, IV
		50 mg, EVERY BAG, 2.5 mcg/kg/min
		25 mL, IV
		50 mg, EVERY BAG, 2.5 mcg/kg/min
EPINEPHrine
	Epinephrine 1000 mcg/D5W 20 mL Syringe (NICU)
		20 mL, IV
		1,000 mcg, EVERY BAG, 0.1 mcg/kg/min
Esmolol
	esmolol 200mg/20mL Syringe NICU
		20 mL, IV
			Comment: Titrate orders by 50mcg/kg/min
		200 mg, EVERY BAG, 50 mcg/kg/min
PG-E
	alprostadil 250 mcg/D5W 25 mL (NICU)
		25 mL, IV
		250 mcg, EVERY BAG, 0.01 mcg/kg/min
Vasopressin
	vasopressin 20 units/D5W 20 mL (NICU)
		20 mL, IV
		20 units, EVERY BAG, 0.01 unit/kg/hr
Milrinone
	milrinone
		75 mcg/kg, Injection, IV PUSH, Once
			Comment: infuse loading dose over 15min
	milrinone 4,000 mcg/D5W 20 mL (NICU)
		20 mL, IV
		4,000 mcg, EVERY BAG, 0.5 mcg/kg/min
Medications

		Dilution Vial Provided from Pharmacy(NOTE)*
	adenosine NICU
		50 mcg/kg, Solution-Injection, IV Push, Once
			Comment: May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg.  Dilution vial provided from pharmacy.
		100 mcg/kg, Solution-Injection, IV Push, Once
			Comment: May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg.  Dilution vial provided from pharmacy.
		150 mcg/kg, Solution-Injection, IV Push, Once
			Comment: May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg.  Dilution vial provided from pharmacy.
		200 mcg/kg, Solution-Injection, IV Push, Once
			Comment: May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg.  Dilution vial provided from pharmacy.
		250 mcg/kg, Solution-Injection, IV Push, Once
			Comment: May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg.  Dilution vial provided from pharmacy.
		300 mcg/kg, Solution-Injection, IV Push, Once
			Comment: max of 300 mcg/kg.  Dilution vial provided from pharmacy.
		vial obtained from code pink cart(NOTE)*
	adenosine injection
		50 mcg/kg, Injection, IV Push, Once
			Comment: adenosine 2mL vial (3,000mcg/mL) May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg vial obtained from code pink cart.
		100 mcg/kg, Injection, IV Push, Once
			Comment: adenosine 2mL vial (3,000mcg/mL) May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg vial obtained from code pink cart.
		150 mcg/kg, Injection, IV Push, Once
			Comment: adenosine 2mL vial (3,000mcg/mL) May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg vial obtained from code pink cart.
		200 mcg/kg, Injection, IV Push, Once
			Comment: adenosine 2mL vial (3,000mcg/mL) May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg vial obtained from code pink cart.
		250 mcg/kg, Injection, IV Push, Once
			Comment: adenosine 2mL vial (3,000mcg/mL) May increase dose in 50 mcg/kg increments every 2 minutes to max of 300 mcg/kg vial obtained from code pink cart.
		300 mcg/kg, Injection, IV Push, Once
			Comment: adenosine 2mL vial (3,000mcg/mL) max of 300 mcg/kg; vial obtained from code pink cart.
	esmolol BOLUS (NICU)
		100 mcg/kg, Injection, IVPB, Once, infuse over 5 min(s)
		200 mcg/kg, Injection, IVPB, Once, infuse over 5 min(s)
		300 mcg/kg, Injection, IVPB, Once, infuse over 5 min(s)
		400 mcg/kg, Injection, IVPB, Once, infuse over 5 min(s)
		500 mcg/kg, Injection, IVPB, Once, infuse over 5 min(s)
	captopril
		0.05 mg/kg, Suspension, Gastric Tube, Q8H
	hydrocortisone IVPB (NICU)
		1 mg/kg, Solution-Injection, IVPB, Q8H
	propranolol oral solution
		0.25 mg/kg, Solution, Gastric Tube, Q6H-Sch
	sildenafil
		0.5 mg/kg, Suspension, Gastric Tube, Q8H-Sch
		Ibuprofen *High dose* regimen(NOTE)*
	ibuprofen oral suspension
		20 mg/kg, Suspension, Gastric Tube, Once, T;N
			Comment: give with scheduled feeding
		10 mg/kg, Suspension, Gastric Tube, Q24H, T+1;N, duration: 2 Dose(s)/Time(s)
			Comment: give with scheduled feeding
	acetaminophen
		15 mg/kg, Suspension, Gastric Tube, Q6H, duration: 7 Day(s)
			Comment: give with scheduled feeding
	ibuprofen intravenous solution
		20 mg/kg, Solution, Injection, IVPB, Once
			Comment: infuse over 15 minutes
		10 mg/kg, Solution-Injection, IVPB, Q24H, T+1;N, duration: 2 Dose(s)/Time(s)
			Comment: infuse over 15 minutes
		Indomethacin for <48 hours of age, choose the following two orders:(NOTE)*
	indomethacin IVPB (NICU)
		0.2 mg/kg, INT, IVPB, Once
			Comment: PDA Closure Dose (mg/kg)Age at 1st Dose          1st          2nd          3rd< 48H                          0.2          0.1           0.12 to 7 D                       0.2          0.2           0.2>7 D                            0.2          0.25         0.25
		0.1 mg/kg, INT, IVPB, Q24H, T+1;N, 2 Dose(s)/Time(s)
			Comment: PDA Closure Dose (mg/kg)Age at 1st Dose          1st          2nd          3rd< 48H                          0.2          0.1           0.12 to 7 D                       0.2          0.2           0.2>7 D                            0.2          0.25         0.25
		Indomethacin for 2-7 days of age, choose the following order:(NOTE)*
		0.2 mg/kg, INT, IVPB, Q24H, 3 Dose(s)/Time(s)
			Comment: PDA Closure Dose (mg/kg)Age at 1st Dose          1st          2nd          3rd< 48H                          0.2          0.1           0.12 to 7 D                       0.2          0.2           0.2>7 D                            0.2          0.25         0.25
		Indomethacin for >7 days of age, choose the following two orders:(NOTE)*
		0.2 mg/kg, INT, IVPB, Once
			Comment: PDA Closure Dose (mg/kg)Age at 1st Dose          1st          2nd          3rd< 48H                          0.2          0.1           0.12 to 7 D                       0.2          0.2           0.2>7 D                            0.2          0.25         0.25
		0.25 mg/kg, INT, IVPB, Q24H, T+1;N, 2 Dose(s)/Time(s)
			Comment: PDA Closure Dose (mg/kg)Age at 1st Dose          1st          2nd          3rd< 48H                          0.2          0.1           0.12 to 7 D                       0.2          0.2           0.2>7 D                            0.2          0.25         0.25

*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