Unique Plan Description: Pain MGMT Outpatient Pre Op
Plan Selection Display: Pain MGMT Outpatient Pre Op
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2025-01-14 14:06:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-05-28 07:21:49
Available at all facilities: No

Pain MGMT Outpatient Pre Op
Admit/Discharge/Transfer
	Admit to Observation Status
		T;N
Diet
	NPO
		Except for Medications | Except for Sips of Water
		After Midnight
			Comment: including tube feedings
Laboratory
	INR POC
		T;N, Blood
	INR - FH
		T;N, Routine, spec type = Diagnostic Blood
	Pregnancy Test Urine
		T;N, Stat, Stat, spec type = Urine
	Glucose POC - RN
		T;N, Once, NOW
IV Solutions
	Sodium Chloride 0.9%
		500 mL, IV, 20 ml/hr
			Comment: Continue until discharge. Start in Pre-op.
Medications
	fentaNYL
		25 mcg, Injection, IV Push, IN OR, Routine, duration: 1 Dose(s)/Time(s)
	midazolam
		1 mg, Injection, IV Push, IN OR, duration: 1 Dose(s)/Time(s)
	flumazenil
		0.2 mg, Injection, IV Push, Once, STAT
	naloxone
		0.4 mg, Injection, IV Push, Once, STAT
	ceFAZolin
		2,000 mg, Syringe, IV Push, PREOP, Indication: Surgical prophylaxis
			Comment: on call to OR to be given on entry to procedure
		1,000 mg, Syringe, IV Push, PREOP, Indication: Surgical prophylaxis
			Comment: on call to OR to be given on entry to procedure
	clindamycin IVPB
		900 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis
			Comment: on call to OR to be given on entry to procedure
		600 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis
			Comment: on call to OR to be given on entry to procedure
		For patients < 80kg, select 1000mg dose, For patients 80-120kg, select 1500mg dose, For patients >120kg select 2000mg dose(NOTE)*
	vancomycin IVPB
		1,500 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis
			Comment: For patients 80-120kg; infuse over 90 minutes.
		2,000 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis
			Comment: For patients >120kg; infuse over 90 minutes.
		1,000 mg, Injection-Premix, IVPB, PREOP, Indication: Surgical prophylaxis
			Comment: For patients <80kg; infuse over 1 hour.
Patient Care
	Obtain Consent/Permit for:
		Ablation Nerve Spine with moderate sedation
		Intracept Procedure with moderate sedation
		Minimally Invasive Lumbar Decompression with moderate sedation
		Ablation Nerve Spine
		Intracept Procedure
		Minimally Invasive Lumbar Decompression
	Patient Education
		T;N, Instructions: If IDDM take half dose of AM insulin on day of interventional procedure
		T;N, Instructions: Do not take anticoagulation, antiplatelet, or ASA as directed by pain management (surgeon) office. Questions should be directed to Physical Medicine and Rehabilitation office at (402)-354-0682.
Therapies

Oxygen Protocol
Respiratory Therapy
	Oxygen Therapy
		T;N
	Pulse Oximetry Spot Check RT
		T;N, BID
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID

Peripheral Lock - Access
Medications

	sodium chloride 0.9% flush injectable soln
		10 mL Syringe IV PUSH BID
		10 mL, Syringe, IV PUSH, Q5MIN, PRN, IV line flush
	lidocaine 1% injectable solution (MH/WH/FH)
		0.1 mL, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start
	sodium chloride bacteriostatic 0.9% injectable soln
		0.1 mL, Injection, IntraDermal, Q1H, PRN, see comment
			Comment: For IV start, use if patient has lidocaine allergy.
	Sodium Chloride 0.9% IVPB Flush
		25 mL, IVPB, Q1H, PRN, IV line flush, 5 min(s)
			Comment: Use if medication not compatible with primary line or there is no primary line;  infuse 25mL.
Patient Care
	Peripheral Lock-Insert
		T;N

*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