Initial order and treatment for Pulmonary edema
- LMNOP and dobutamine(if needed)
- Chest x-ray
- EKG
- Oximeter
- Echocardiogram
A fib work up in CCS
- Echocardiography
- TSH and T4
- Electrolytes
- Troponin or CK-MB levels
Syncope Work up
- EKG
- Echocargiogram
- Troponin/CKMN
- Head CT
IBS work up
-Colonoscopy
-CT abdomen
-Stool guaiac,Stool white cell,culture,ova and parasite
-ESR
-Stool bacterial culture
-72 hour stool fat
-
GI bleeding initial orders in CCS
- Bolus of normal saline or ringer
- CBC
- PT/INR
- Type and Cross
- Consultation with Gastro
- EKG
when to move the patient out of the ER —> ICU
-When is stabilizaed and you have a presuntive diagnosios
DDX for SOB
CHF
pneumonia
acute MI
Pulmonary embolism
COPD exacerbation initial orders
Pulse oximetry oxygen ABG PEFR Chest x-ray AP and lat Vitals BMP CBC Cardiac monitor
COPD exarbation intial treatmetn
O2 Nebulized albuterol and ipatrooim IV Methyl predni empitic antibiotics Sputum stain NIPPV if PCO2>45 or PH>7.3 hopitalize if necesary
ER generic orders
- Vitals
- Oxygen
- pulse oxymeter
- IVA
- EKG
- Cardia monitor
- U/A
- BMP
- CBC
- Check interval Hx
- Blood culture
- Antiboitics (if necessary)
office management of first prenatal visit
- blood type and screen direct/indirect coombs
- CBC
- CMP
- Cervical pap
- Urinalysis, urine culture
- Rubella antibody
- Hepatitis B surface Ag
- VDRL or RPR
- HIV ELISA
- Cervical culture for chlamydia
- US
follow up in 4 weeks
SEPSIS Shock
Start Antibiotics withing 2 hours of presentation
- Arterial line
- Central line
- ABG
- Cultures
Fluids resistent low BP in shock
GIVE Pressors.
Tachycardia present: Noerpi
No tachy: Dopamin
monitor in shock once in stable in ICU
Daily
- CBC
- BMP
- Urine output
P2Y12 antagonist of choice for those going for angioplasty
Prasugrel
Emergency HTN initial work up
HEAD CT Chest X ray ECG BMP CBC UA lipid profile Cardiac monitor BP monitor
suspect MI initial orders
ECG cardiac enzymes chest x ray CBC BMP PT/INR PTT LFT
STEMI: Cath
non STEMI: MONAC BC hepatirin
Unstable angina: Cath
Chest pain DDX
MI PE Acute pneumothorax Aortic disecction Perciarditis
staging of lung cancer orders
- CT abdomen and pelvis
- MRI brain
- Bone scan
- PFT
- LFT
- consult onco
- consults radiation oncologist
DDX of acute right upper quadrant
Hepato-biliary
- Cholecystitis
- Cholangitis
- Choledocolithiasis
- Hepatitis
- Pancreatitis
- pyelonephritis
- Appendicitis
- Pneumonia
CURB 65
confusion urea>7 or BUN>19 Respiration >30 Blood pressure SBP<90 or DBP<60 Age >65
> 2=in patient
3=ICU
acute asthma initial orders
- O2
- Albuterol
- Ipatropium
- IV methyl prednisolione
- Mg
loud P2
sign of pulmonary fibrosis
prior toi surgery orders
Blood type and crossmatch CMP CBC PTT PT INR Chest x ray EKG
