ID

15999

Description

AAFP: Chest Pain 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 fifth section ("Chest Pain 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: Chest Pain Admission Order

German ( localization.languageCode.DE ) English

AAFP: Chest Pain 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

If Other, please specify
Description

Other

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

Chest pain; R/O acute coronary syndrome Associated Diagnoses
Description

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

Other

Data type

text

Activity
Description

Activity

Bed rest with bedside commode
Description

Activity

Data type

boolean

Bathroom privileges
Description

Activity

Data type

boolean

Up ad lib
Description

Activity

Data type

boolean

Nursing
Description

Nursing

Vital signs every 1 hr for 4 hrs then every 4 hrs
Description

Nursing

Data type

boolean

Notify MD for: T > 101.5, P > 120, BP < 90/60 or > 180/110, abnormal lab results
Description

Nursing

Data type

boolean

Weight on arrival
Description

Nursing

Data type

boolean

Continous cardiac monitoring; arrythmia orders
Description

Nursing

Data type

boolean

Stat ECG for significant chest pain
Description

Nursing

Data type

boolean

O2 at 2 L nasal cannula, notify MD if Pulse ox < 93%
Description

Nursing

Data type

boolean

Medications
Description

Medications

Nitropaste 0.5 inch topically every 8 hrs
Description

Medications

Data type

boolean

Enteric coated aspirin 325 mg PO now and every morning
Description

Medications

Data type

boolean

NTG 1/150 SL prn CP, may repeat 15 min until pain free or max three tabs per episode
Description

Medications

Data type

boolean

Morphine sulfate 5 mg slow IVP every 30 min prn severe chest pain
Description

Medications

Data type

boolean

Tylenol 500mg 2 PO every 4 hrs prn headache/fever/pain
Description

Medications

Data type

boolean

Ambien 10 mg PO at bedtime prn for insomnia
Description

Medications

Data type

boolean

MOM 30 mL PO BID prn for constipation
Description

Medications

Data type

boolean

Maalox 30 mL PO every 4 hrs prn for indigestion
Description

Medications

Data type

boolean

IV
Description

IV

IV lock; flush per routine
Description

IV

Data type

boolean

IV__@mL/hr
Description

IV

Data type

boolean

If IV__@mL/hr, please specify amount of mL/hr
Description

Specification of mL/hr

Data type

integer

Lab
Description

Lab

Admission: CBC, basal metabolic profile, TSH, Troponin I every 8 hrs x2
Description

Lab

Data type

boolean

Lipid profile in a.m.
Description

Lab

Data type

boolean

Diagnostic Studies
Description

Diagnostic Studies

CXR if not done
Description

Diagnostic Studies

Data type

boolean

ECG every morning
Description

Diagnostic Studies

Data type

boolean

Cardiolite stress test
Description

Diagnostic Studies

Data type

boolean

Adenosine cardiolite stress test
Description

Diagnostic Studies

Data type

boolean

Echocardiogramm - to be read by __
Description

Diagnostic Studies

Data type

boolean

Echocardiogram-to be read by___?
Description

Echocardiogram

Data type

text

Consult
Description

Consult

Consult
Description

Consult

Data type

text

Signature
Description

Signature

Data type

text

Print Name
Description

Name

Data type

text

Date and Time
Description

Date and Time

Data type

datetime

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Similar models

AAFP: Chest Pain Admission Order

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
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
Monitored Bed (4)
CL Item
Other (5)
Other
Item
If Other, please specify
text
Item Group
Attending
Name
Item
Name of attending physician
text
Phone
Item
Phone number of attending physician
integer
Item Group
Admitting Diagnosis
Diagnosis
Item
Chest pain; R/O acute coronary syndrome 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 (3)
CL Item
Other (4)
Specification of calories
Item
If diet according to ADA, please specify amount of calories
integer
Other
Item
If Other, please specify
text
Item Group
Activity
Activity
Item
Bed rest with bedside commode
boolean
Activity
Item
Bathroom privileges
boolean
Activity
Item
Up ad lib
boolean
Item Group
Nursing
Nursing
Item
Vital signs every 1 hr for 4 hrs then every 4 hrs
boolean
Nursing
Item
Notify MD for: T > 101.5, P > 120, BP < 90/60 or > 180/110, abnormal lab results
boolean
Nursing
Item
Weight on arrival
boolean
Nursing
Item
Continous cardiac monitoring; arrythmia orders
boolean
Nursing
Item
Stat ECG for significant chest pain
boolean
Nursing
Item
O2 at 2 L nasal cannula, notify MD if Pulse ox < 93%
boolean
Item Group
Medications
Medications
Item
Nitropaste 0.5 inch topically every 8 hrs
boolean
Medications
Item
Enteric coated aspirin 325 mg PO now and every morning
boolean
Medications
Item
NTG 1/150 SL prn CP, may repeat 15 min until pain free or max three tabs per episode
boolean
Medications
Item
Morphine sulfate 5 mg slow IVP every 30 min prn severe chest pain
boolean
Medications
Item
Tylenol 500mg 2 PO every 4 hrs prn headache/fever/pain
boolean
Medications
Item
Ambien 10 mg PO at bedtime prn for insomnia
boolean
Medications
Item
MOM 30 mL PO BID prn for constipation
boolean
Medications
Item
Maalox 30 mL PO every 4 hrs prn for indigestion
boolean
Item Group
IV
IV
Item
IV lock; flush per routine
boolean
IV
Item
IV__@mL/hr
boolean
Specification of mL/hr
Item
If IV__@mL/hr, please specify amount of mL/hr
integer
Item Group
Lab
Lab
Item
Admission: CBC, basal metabolic profile, TSH, Troponin I every 8 hrs x2
boolean
Lab
Item
Lipid profile in a.m.
boolean
Item Group
Diagnostic Studies
Diagnostic Studies
Item
CXR if not done
boolean
Diagnostic Studies
Item
ECG every morning
boolean
Diagnostic Studies
Item
Cardiolite stress test
boolean
Diagnostic Studies
Item
Adenosine cardiolite stress test
boolean
Diagnostic Studies
Item
Echocardiogramm - to be read by __
boolean
Echocardiogram
Item
Echocardiogram-to be read by___?
text
Item Group
Consult
Consult
Item
Consult
text
Signature
Item
Signature
text
Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime
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