ID

15997

Description

AAFP: Asa Overdose Admission Order, Standardizes Admission Orders, Author: Robert M. Wiprud, MD The primary purpose of these Ordersets is to decrease unnecessary variability and to improve quality through standardized Admission Orders. Developed by the Scott & White Clinic at College Station, Texas. Copyright © 2006 American Academy of Family Physicians. Physicians may photocopy or adapt for use in their own practices; all other rights reserved. Wiprud RM. Providing consistent care with standardized admission orders. Fam Pract Manag. September 2006: 49-52 See http://www.aafp.org/fpm/2006/0900/p49.html This ODM Form includes the third section ("Asa Overdose Admission Order").

Link

http://www.aafp.org/fpm/2006/0900/p49.html

Keywords

Versions (1)
  1. 6/26/16 6/26/16 -
Uploaded on

June 26, 2016

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License

Creative Commons BY-NC 3.0
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AAFP: Asa Overdose Admission Order

German ( localization.languageCode.DE ) English

AAFP: Asa Overdose Admission Order

1 forms  
Default Itemgroup
Description

Default Itemgroup

Name
Description

Name

Data type

text

Age
Description

Age

Data type

integer

Date of Birth
Description

Date of Birth

Data type

date

Medical record
Description

Medical record

Data type

integer

Status
Description

Status

Status
Description

Status

Data type

text

Attending
Description

Attending

Name of attending physician
Description

Name

Data type

text

Phone number of attending physician
Description

Phone

Data type

integer

Admitting Diagnosis
Description

Admitting Diagnosis

ASA Overdose Associated Diagnoses
Description

Admitting Diagnosis

Data type

text

Condition
Description

Condition

Condition
Description

Condition

Data type

text

Code Status
Description

Code Status

Data type

text

Allergies
Description

Allergies

Allergies
Description

Allergies

Data type

text

Diet
Description

Diet

Diet
Description

Diet

Data type

text

If diet according to ADA, please specify amount of calories
Description

Specification of calories

Data type

integer

If Other, please specify
Description

Andere

Data type

text

Activity
Description

Activity

Bed rest with bathroom privileges
Description

Activity

Data type

boolean

Nursing
Description

Nursing

Vital signs every 4 hrs for 24 hrs then every 4 hrs if stable
Description

Nursing

Data type

boolean

Suicide precautions
Description

Nursing

Data type

boolean

Gastric lavage in ER with activated charcoal
Description

Nursing

Data type

boolean

Consider dialysis if serum salicylate greater than 70 mg/dl
Description

Nursing

Data type

boolean

Medications
Description

Medications

Vitamin K 10 mg IM now
Description

Medications

Data type

boolean

Guaiac all stools
Description

Medications

Data type

boolean

Other
Description

Medications

Data type

boolean

Other
Description

If Other, please specify

Data type

text

IV
Description

IV

Dextrose 5% in 1/2 normal saline with 44mEq bicarbonate/L @ 300mL/hr (forced alkaline diuresis)
Description

IV

Data type

boolean

Lab
Description

Lab

ABGs
Description

Lab

Data type

boolean

Hemogram
Description

Lab

Data type

boolean

Lytes
Description

Lab

Data type

boolean

Glucose
Description

Lab

Data type

boolean

Salicylate level, if not done in ER
Description

Lab

Data type

boolean

Consult
Description

Consult

Psych
Description

Consult

Data type

boolean

Social services
Description

Consult

Data type

boolean

MHMR
Description

Consult

Data type

boolean

Signature
Description

Signature

Data type

text

Print Name
Description

Print Name

Data type

text

Date and time
Description

Date and Time

Data type

datetime

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Similar models

AAFP: Asa Overdose Admission Order

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Default Itemgroup
Name
Item
Name
text
Age
Item
Age
integer
Date of Birth
Item
Date of Birth
date
Medical record
Item
Medical record
integer
Item Group
Status
Item
Status
text
Status
Code List
Status
CL Item
Observation (1)
CL Item
Admission (2)
CL Item
Medical Floor (3)
CL Item
ICU (4)
CL Item
Other telemetry (5)
Item Group
Attending
Name
Item
Name of attending physician
text
Phone
Item
Phone number of attending physician
integer
Item Group
Admitting Diagnosis
Admitting Diagnosis
Item
ASA Overdose Associated Diagnoses
text
Item Group
Condition
Item
Condition
text
Condition
Code List
Condition
CL Item
Stable (1)
CL Item
Fair (2)
CL Item
Serious (3)
CL Item
Critical (4)
Item
Code Status
text
Code Status
Code List
Code Status
CL Item
Full Code (1)
CL Item
DNR (2)
Item Group
Allergies
Allergies
Item
Allergies
text
Item Group
Diet
Item
Diet
text
Diet
Code List
Diet
CL Item
NPO (1)
CL Item
Clear liquid (2)
CL Item
AHA step 2  (3)
CL Item
ADA __ calories (4)
CL Item
Other (5)
Specification of calories
Item
If diet according to ADA, please specify amount of calories
integer
Andere
Item
If Other, please specify
text
Item Group
Activity
Activity
Item
Bed rest with bathroom privileges
boolean
Item Group
Nursing
Nursing
Item
Vital signs every 4 hrs for 24 hrs then every 4 hrs if stable
boolean
Nursing
Item
Suicide precautions
boolean
Nursing
Item
Gastric lavage in ER with activated charcoal
boolean
Nursing
Item
Consider dialysis if serum salicylate greater than 70 mg/dl
boolean
Item Group
Medications
Medications
Item
Vitamin K 10 mg IM now
boolean
Medications
Item
Guaiac all stools
boolean
Medications
Item
Other
boolean
Other
Item
text
Item Group
IV
IV
Item
Dextrose 5% in 1/2 normal saline with 44mEq bicarbonate/L @ 300mL/hr (forced alkaline diuresis)
boolean
Item Group
Lab
Lab
Item
ABGs
boolean
Lab
Item
Hemogram
boolean
Lab
Item
Lytes
boolean
Lab
Item
Glucose
boolean
Lab
Item
Salicylate level, if not done in ER
boolean
Item Group
Consult
Consult
Item
Psych
boolean
Consult
Item
Social services
boolean
Consult
Item
MHMR
boolean
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and time
datetime
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