Unique Plan Description: Peds Rounds
Plan Selection Display: Peds Rounds
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-19 22:37:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-01-26 08:41:05
Available at all facilities: Yes

Peds Rounds
Vital Signs
	Vital Signs
		Q4H
		Q6H
		Q8H
		Q12H
		Q4HAWAKE
Laboratory
Today's Lab
	CBC with Diff
		Routine, spec type = Blood
	Basic Metabolic Panel
		Routine, spec type = Blood
	Comprehensive Metabolic Panel
		Routine, spec type = Blood
	Respiratory Syncytial Virus (RSV) PCR
		T;N, Routine, spec type = Nasopharynx
	Influenza A and B Screen PCR
		Routine, spec type = Nasopharynx
	Pertussis and Parapertussis PCR
		Routine, spec type = Nasopharynx
	Strep Group A PCR
		T;N, Routine, spec type = Throat
	Fecal Lactoferrin
		T;N, Routine, spec type = Stool
	Stool Pathogen Panel (PCR)
		T;N, Routine, spec type = Stool
		Includes targets for: Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Shiga Toxins 1 and 2, Norovirus and Rotavirus.(NOTE)*
	Occult Blood Stool - JE
		Routine, spec type = Stool
	Occult Blood - MH/WH/FH
		T;N, Routine, spec type = Stool
	Sputum Culture
		Routine, spec type = Sputum
	MRSA Nasal Screen Rapid - JE
		Routine, spec type = Swab, Nares
	MRSA/Staph Aureus Nasal Screen by PCR - FH
		T;N, Routine, spec type = Nasal
	Staph (Skin/Tissue) Rapid - JE
		Routine, spec type = Swab, Swab everything but Nares, Skin
	MRSA Screen
		T;N, Routine, Scrapings
			Comment: Swab everything but Nares, Skin
	Blood Gases Capillary (CBG) - MH/WH/JE
		
	Blood Gases Capillary (CBG) - FH
		
Tomorrow's Lab
	CBC with Diff
		T+1;0400, Routine, spec type = Blood
	Basic Metabolic Panel
		T+1;0400, Routine, spec type = Blood
	Sed Rate
		T+1;0400, Routine, spec type = Blood
	hsCRP
		T+1;0400, Routine, spec type = Blood
	UA (Culture if Positive)
		T+1;0400, Routine, Routine, spec type = Urine, Clean Catch
		T+1;0400, Routine, Routine, spec type = Urine, Bag
		T+1;0400, Routine, Routine, spec type = Urine, Catheter
Diagnostic Tests

	Chest 1 View
		T;N, Routine, SOB
		T+1;0600, Routine, SOB
	Chest 2 View
		T;N, Routine, SOB
		T+1;0600, Routine, SOB
	KUB
		T;N, Routine
		T+1;0600, Routine
	CT Abd w & w/o Contrast
		T;N, Routine
		T+1;0600, Routine
	CT Chest w & w/o Contrast
		T;N, Routine
		T+1;0600, Routine
	CT Pelvis w & w/o Contrast
		T;N, Routine
		T+1;0600, Routine
	CT Head w & w/o Contrast
		T;N, Routine
		T+1;0600, Routine
	CT Mastoids w & w/o Contrast
		T;N, Routine
		T+1;0600, Routine
	CT Sinus w/o Contrast
		T;N, Routine
		T+1;0600, Routine
	US Renal Retro Complete
		T;N, Routine
		T+1;0600, Routine
	US Renal Retro Limited
		T;N, Routine
		T+1;0600, Routine
IV Solutions
	Sodium Chloride 0.9% Intravenous Solution (Bolus)
		20 mL/kg, IVPB, Once, STAT, 1 Dose(s)/Time(s), 1 hr
			Comment: Bolus
		10 mL/kg, IVPB, Once, STAT, 1 Dose(s)/Time(s), 1 hr
			Comment: Bolus in ED
Medications
	Rocephin IVPB
		50 mg/kg, Injection-Premix, IVPB, Q12H
		100 mg/kg, Injection-Premix, IVPB, Q12H
			Comment: ___ mg in 50 mL water
	Rocephin IVPB (FH)
		50 mg/kg, INT, IVPB, Q12H
		100 mg/kg, INT, IVPB, Q12H
	azithromycin
		10 mg/kg, Suspension, BY MOUTH, DAILY
	Zithromax IVPB
		10 mg/kg, INT, IVPB, Q24H
	vancomycin - Pharmacy to Dose
		
	ampicillin IVPB
		50 mg/kg, INT, IVPB, Q6H
		100 mg/kg, INT, IVPB, Q12H
	Cleocin IVPB
		10 mg/kg, INT, IVPB, Q8H
	nafcillin
		25 mg/kg, INT, IVPB, Q6H
		50 mg/kg, INT, IVPB, Q6H, Other- type in, meningitis
	Unasyn IVPB
		75 mg/kg, INT, IVPB, Q6H
	Unasyn IVPB (FH)
		75 mg/kg, INT, IVPB, Q6H
	Tamiflu
		30 mg, Suspension, BY MOUTH, Q12H, 5 Day(s)
			Comment: For weight <16kg and > 3 months of age
		45 mg, Suspension, BY MOUTH, Q12H, 5 Day(s)
			Comment: For 16-23 kg
		60 mg, Suspension, BY MOUTH, Q12H, 5 Day(s)
			Comment: For 24-40kg
		75 mg, Suspension, BY MOUTH, Q12H, 5 Day(s)
			Comment: For > 40kg
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL, Solution-Nebulization, NEBULIZED, Q4H, PRN, wheezing
			Comment: or for shortness of breath.
	levalbuterol 1.25 mg/0.5 mL inhalation solution
		0.5 mL, Solution-Nebulization, Inhalation, Q6H, PRN, wheezing
			Comment: or shortness of breath.
	budesonide 0.5 mg/2 mL inhalation suspension
		2 mL, Solution-Nebulization, NEBULIZED, BID
	ipratropium 0.02% inhalation solution
		2.5 mL, Solution-Nebulization, NEBULIZED, Q4H
	morphine  IV
		0.05 mg/kg, Syringe, IV PUSH, Q2H, PRN, pain-severe
			Comment: Maximum 4mg/dose.
		0.1 mg/kg, Syringe, IV PUSH, Q3H, pain-severe
			Comment: Maximum 15mg/dose.
		0.2 mg/kg, Syringe, IV PUSH, Q4H, pain-severe
			Comment: Maximum 15mg/dose.
	acetaminophen-hydrocodone 108 mg-2.5 mg/5 mL oral liquid
		0.2 mL/kg, Elixir, By Mouth, Q4H, PRN for pain-moderate
			Comment: Not for children <2 years of age; Max of 5mg.
		0.4 mL/kg, Elixir, By Mouth, Q4H, PRN for pain-moderate
			Comment: Not for children <2 years of age; Max of 10mg.
	nystatin-triamcinolone 100,000 units/g-0.1% topical cream
		1 appl, Cream, TOPICAL, BID, PRN, diaper rash
	nystatin topical 100,000 units/gm ointment
		1 appl, Ointment, TOPICAL, BID, PRN, diaper rash
			Comment: for severe diaper rash.
	nystatin topical 100,000 units/gm cream
		1 appl, Ointment, TOPICAL, BID, PRN for diaper rash
			Comment: for severe diaper rash.
	zinc oxide 20% topical ointment
		1 appl, Ointment, TOPICAL, Q1H, PRN, diaper rash
			Comment: for mild diaper rash.
	mupirocin 2% topical ointment
		1 appl, Ointment, TOPICAL, TID
	selenium sulfide 1% topical shampoo
		1 appl, Shampoo, TOPICAL, Q72H, PRN, see comment
			Comment: Soak scalp with baby oil overnight before using Selsun Blue the next morning.  Repeat until clear.
Patient Care
Therapies
	Oxygen Therapy
		Titrate->Keep Sats>/= to 88%
Consults/Follow-up
	Consult General Surgery
		
	Consult Urology
		
	Consult Infectious Disease
		
	Consult Pulmonologist
		
	Consult Ear Nose and Throat
		
	Consult Social Work
		T;N
	Consult Care Management
		
	Consult Wound Care

CSF Panel (Pediatric) (FH JE)
Laboratory
	Protein CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
			Comment: Save CSF
	Glucose CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
			Comment: Save CSF
	Cell Count and Diff CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Enterovirus PCR CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Herpes Simplex Virus 1/2 PCR. Other than blood
		T;N, Stat, spec type = Cerebrospinal Fluid
	Culture Routine
		T;N, Stat, Body Fluid, spec type = Cerebrospinal Fluid
			Comment: Save CSF

cefTRIAXone IM Pediatric Dose / lidocaine 1% MPF (
Medications
	Rocephin IM
		25 mg/kg, Injection, IM-Intramuscular, Once, STAT
			Comment: Routine is 25 to 50 mg/kg/dose
		50 mg/kg, Injection, IM-Intramuscular, Once, STAT
			Comment: Routine is 25 to 50 mg/kg/dose
	Xylocaine-MPF 1% preservative-free injectable solution
		mL, Injection, IM-Intramuscular, Once, STAT
			Comment: Use 2.1mL lidocaine to dissolve 1,000mg vial to yield 350mg/mL  Use 1mL lidocaine to dissolve 500mg vial to yield 350mg/mL.  Use 0.9mL lidocaine to dissolve 250mg vial to yield 250mg/mL.

Peds IV Convert to Peripheral Lock with flush
	sodium chloride 0.9% flush injectable soln
		3 mL, Syringe, IV PUSH, BID
		3 mL, Syringe, IV Push, Q5MIN, PRN, IV line flush

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

racemic epinephrine-NS (racepinephrine)
Medications

	racepinephrine 2.25% inhalation soln
		0.5 mL, Solution-Nebulization, NEBULIZED, Once, NOW
			Comment: Mix with 3 mL sodium chloride 0.9% inh soln.
	sodium chloride 0.9% inhalation solution
		3 mL, Solution-Nebulization, NEBULIZED, Once, NOW
			Comment: Mix with 0.5 mL racemic EPINEPHrine

CSF/Meningitis Panel (MH WH FH)
Laboratory
	Protein CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Glucose CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Cell Count and Diff CSF
		T;N, Stat, spec type = Cerebrospinal Fluid
	Culture Routine
		T;N, Stat, Body Fluid, spec type = Cerebrospinal Fluid

Blood Culture Set
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	.Blood Culture.
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		Timed, spec type = Blood
		T+1;0400, Routine, spec type = Blood
	.Blood Culture
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		Timed, spec type = Blood
		T+1;0400, Routine, spec type = Blood

*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