ID

16001

Description

AAFP: Childhood Bacterial Meningitis 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 seventh section ("Childhood Bacterial Meningitis 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: Childhood Bacterial Meningitis Admission Order

English

AAFP: Childhood Bacterial Meningitis 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

Childhood Bacterial Meningitis Associated Diagnoses
Description

Admitting Diagnosis

Data type

text

Condition
Description

Condition

Condition
Description

Condition

Data type

text

Allergies
Description

Allergies

Allergies
Description

Allergies

Data type

text

Diet
Description

Diet

Diet
Description

Diet

Data type

text

Activity
Description

Activity

Routine for age
Description

Activity

Data type

boolean

Crib
Description

Activity

Data type

boolean

Bassinet
Description

Acitivity

Data type

boolean

Bed rest
Description

Activity

Data type

boolean

Nursing
Description

Nursing

Vital signs with BP: every __ hrs
Description

Nursing

Data type

boolean

Neuro vitals: every __ hrs
Description

Nursing

Data type

boolean

If Vital signs with BP, please specify frequency
Description

Specification of Vital signs with BP

Data type

float

Measurement units
  • hrs
hrs
If Neuro vitals, please specify frequency
Description

Specification of Neuro vitals

Data type

float

Measurement units
  • hrs
hrs
Medications
Description

Medications

< 1 month of age: ampicillin 50 mg/kg/dose IVPB every 8 hrs; gentamicin 2.5 mg/kg/dose IVPB every 12 hrs
Description

Medications

Data type

boolean

Age 1-3 month: ampicillin (50mg/kg)__ mg IVPB every 8 hrs; cefotaxime (50mg/kg)__ mg IVPB every 6 hrs
Description

Medications

Data type

boolean

> 3 months: cefotaxime (50mg/kg)__ mg IVPB every 6 hrs
Description

Medications

Data type

boolean

Other
Description

Medications

Data type

boolean

If ampicillin at the age of 1-3 month, please specify amount
Description

Age 1-3 month, specification of ampicillin

Data type

float

If cefotaxime at the age of 1-3 month please specify amount
Description

Age 1-3 month, specification of cefotaxime

Data type

float

If cefotaxime at the age of > 3 month, please specify amount
Description

Age > 3 month, specification of cefotaxime

Data type

float

If cefotaxime at the age of > 3 month, please specify amount
Description

Age > 3 month, specification of cefotaxime

Data type

float

If Other, please specify
Description

Specification of Other

Data type

text

IV
Description

IV

Normal saline @__mL/hrs with 5 mEq KCI/250mL should be 2/3 maintenance
Description

IV

Data type

boolean

Maintenance: 100 mL/kg/day up to 10 kg plus 50 mL/kg/day for each kg between 10-20 plus 20 mL/kg/day for each kg > 20 kg
Description

IV

Data type

boolean

If Saline, please specify amount
Description

Specification of Saline

Data type

integer

Measurement units
  • mL/hrs
mL/hrs
Lab
Description

Lab

Send CSF for: tube 1: C&S, gram stain on centrifuge spun specimen; tube 2: glucose, protein; tube 3: cell count and diff; tube 4: hold
Description

Lab

Data type

boolean

Blood cultures X2, CBC, basal metabolic profile
Description

Lab

Data type

boolean

UA, Urine C&S
Description

Lab

Data type

boolean

If concerned about SIADH: serum Lytes every 8 hrs, urine Lytes with Osm every day, urine SG every shift
Description

Lab

Data type

boolean

Consult
Description

Consult

Consult
Description

Consult

Data type

text

Signature
Description

Signature

Data type

text

Name
Description

Name

Data type

text

Date and Time
Description

Date and Time

Data type

datetime

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Similar models

AAFP: Childhood Bacterial Meningitis 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
ICU (1)
CL Item
Pediatrics (2)
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
Childhood Bacterial Meningitis 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 Group
Allergies
Allergies
Item
Allergies
text
Item Group
Diet
Item
Diet
text
Diet
Code List
Diet
CL Item
NPO (1)
CL Item
Age appropriate diet (2)
Item Group
Activity
Activity
Item
Routine for age
boolean
Activity
Item
Crib
boolean
Acitivity
Item
Bassinet
boolean
Activity
Item
Bed rest
boolean
Item Group
Nursing
Nursing
Item
Vital signs with BP: every __ hrs
boolean
Nursing
Item
Neuro vitals: every __ hrs
boolean
Specification of Vital signs with BP
Item
If Vital signs with BP, please specify frequency
float
Specification of Neuro vitals
Item
If Neuro vitals, please specify frequency
float
Item Group
Medications
Medications
Item
< 1 month of age: ampicillin 50 mg/kg/dose IVPB every 8 hrs; gentamicin 2.5 mg/kg/dose IVPB every 12 hrs
boolean
Medications
Item
Age 1-3 month: ampicillin (50mg/kg)__ mg IVPB every 8 hrs; cefotaxime (50mg/kg)__ mg IVPB every 6 hrs
boolean
Medications
Item
> 3 months: cefotaxime (50mg/kg)__ mg IVPB every 6 hrs
boolean
Medications
Item
Other
boolean
Age 1-3 month, specification of ampicillin
Item
If ampicillin at the age of 1-3 month, please specify amount
float
Age 1-3 month, specification of cefotaxime
Item
If cefotaxime at the age of 1-3 month please specify amount
float
Age > 3 month, specification of cefotaxime
Item
If cefotaxime at the age of > 3 month, please specify amount
float
Age > 3 month, specification of cefotaxime
Item
If cefotaxime at the age of > 3 month, please specify amount
float
Specification of Other
Item
If Other, please specify
text
Item Group
IV
IV
Item
Normal saline @__mL/hrs with 5 mEq KCI/250mL should be 2/3 maintenance
boolean
IV
Item
Maintenance: 100 mL/kg/day up to 10 kg plus 50 mL/kg/day for each kg between 10-20 plus 20 mL/kg/day for each kg > 20 kg
boolean
Specification of Saline
Item
If Saline, please specify amount
integer
Item Group
Lab
Lab
Item
Send CSF for: tube 1: C&S, gram stain on centrifuge spun specimen; tube 2: glucose, protein; tube 3: cell count and diff; tube 4: hold
boolean
Lab
Item
Blood cultures X2, CBC, basal metabolic profile
boolean
Lab
Item
UA, Urine C&S
boolean
Lab
Item
If concerned about SIADH: serum Lytes every 8 hrs, urine Lytes with Osm every day, urine SG every shift
boolean
Item Group
Consult
Consult
Item
Consult
text
Signature
Item
Signature
text
Name
Item
Name
text
Date and Time
Item
Date and Time
datetime
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