ID

16003

Description

AAFP: Croup 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 ninth section ("Croup 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

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

AAFP: Croup Admission Order

English

AAFP: Croup 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

Admission
Description

Status

Data type

boolean

Observation in pediatric unit
Description

Status

Data type

boolean

Attending
Description

Attending

Name of attending physician
Description

Attending

Data type

text

Phone number of attending physician
Description

Attending

Data type

integer

Admitting Diagnosis
Description

Admitting Diagnosis

Croup 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

Clear liquids
Description

Diet

Data type

boolean

Diet for age
Description

Diet

Data type

boolean

Activity
Description

Activity

Bed rest
Description

Activity

Data type

boolean

Up ad lib
Description

Activity

Data type

boolean

Nursing
Description

Nursing

Vital signs per unit routine
Description

Nursing

Data type

boolean

Vital signs every 4 hrs if on oxygen therapy
Description

Nursing

Data type

boolean

I&O every shift
Description

Nursing

Data type

boolean

Lab
Description

Lab

CBC
Description

Lab

Data type

boolean

Lytes
Description

undefined item

Data type

boolean

AP/Lateral Neck X-ray
Description

AP/Lateral Neck X-ray

AP/Lateral Neck X-ray
Description

Indicated in atypical cases such as child > age 6, suspected foreign body or unresponsive to therapy

Data type

text

Respiratory
Description

Respiratory

If croup score > 5, notify MD
Description

Respiratory

Data type

boolean

If score 2 or greater: continue oximetry; racemic epinephrine (2.25%) nebulizer
Description

Respiratory

Data type

boolean

0.25 mL in 3 mL normal saline if < 1 year old or less than 20 kg
Description

Respiratory

Data type

boolean

0.50 mL in 3 mL normal saline if > 1 year old
Description

Respiratory

Data type

boolean

May repeat dose every 4 hrs; notify MD if child need more frequent doses
Description

Respiratory

Data type

boolean

O2 @ 2-4 L/min via nasal cannula or face mask to keep O2 sat > 95%
Description

Respiratory

Data type

boolean

Medications
Description

Medications

Medications
Description

Medications

Data type

text

Please specify amount of the chosen medication
Description

Specification amount of medication

Data type

integer

If Prelone elixir, please specify duration in days
Description

Specification duration of Prelone

Data type

integer

Medications
Description

Medications

Data type

text

If Tylenol, please specify amount
Description

Specification of Tylenol

Data type

integer

If Motrin, please specify amount
Description

Specification of Motrin

Data type

integer

IV
Description

IV

No IV required
Description

IV

Data type

boolean

Bolus with__mL normal saline over 1-2 hrs (10-20 mL/kg bolus)
Description

IV

Data type

boolean

If Bolus with normal saline, please specify amount
Description

Specification of saline

Data type

float

Maintenance IV with Dextrose 5% in 1/4 normal saline @___mL/hr; add 20 mEq KCL after first void
Description

IV

Data type

boolean

If Dextrose, please specify amount mL/hr
Description

Specification of Dextrose

Data type

integer

Other Orders
Description

Other Orders

Other Orders
Description

Other Orders

Data type

text

Signature
Description

Signature

Data type

text

Print Name
Description

Print Name

Data type

text

Date and Time
Description

Date and Time

Data type

datetime

Back to the top of the page

Similar models

AAFP: Croup 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
Status
Item
Admission
boolean
Status
Item
Observation in pediatric unit
boolean
Item Group
Attending
Attending
Item
Name of attending physician
text
Attending
Item
Phone number of attending physician
integer
Item Group
Admitting Diagnosis
Admitting Diagnosis
Item
Croup 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
Diet
Item
Clear liquids
boolean
Diet
Item
Diet for age
boolean
Item Group
Activity
Activity
Item
Bed rest
boolean
Activity
Item
Up ad lib
boolean
Item Group
Nursing
Nursing
Item
Vital signs per unit routine
boolean
Nursing
Item
Vital signs every 4 hrs if on oxygen therapy
boolean
Nursing
Item
I&O every shift
boolean
Item Group
Lab
Lab
Item
CBC
boolean
undefined item
Item
Lytes
boolean
Item Group
AP/Lateral Neck X-ray
AP/Lateral Neck X-ray
Item
text
Item Group
Respiratory
Respiratory
Item
If croup score > 5, notify MD
boolean
Respiratory
Item
If score 2 or greater: continue oximetry; racemic epinephrine (2.25%) nebulizer
boolean
Respiratory
Item
0.25 mL in 3 mL normal saline if < 1 year old or less than 20 kg
boolean
Respiratory
Item
0.50 mL in 3 mL normal saline if > 1 year old
boolean
Respiratory
Item
May repeat dose every 4 hrs; notify MD if child need more frequent doses
boolean
Respiratory
Item
O2 @ 2-4 L/min via nasal cannula or face mask to keep O2 sat > 95%
boolean
Item Group
Medications
Item
Medications
text
Medications
Code List
Medications
CL Item
Decadron __mg IM now (0.6mg/kg body weight) OR (1)
CL Item
Decadron elixir 0.5 mg/5mL___mg PO now (0.6 mg/kg body weight) OR (2)
CL Item
Prelone elixir 12mg/mL__mg PO BID for __ days (1mg/kg/dose) (3)
Specification amount of medication
Item
Please specify amount of the chosen medication
integer
Specification duration of Prelone
Item
If Prelone elixir, please specify duration in days
integer
Item
text
Medications
Code List
Medications
CL Item
Tylenol ___mg PO or PR every 4 hrs prn; temp > 100.4 (10-15 mg/kg/dose) OR (1)
CL Item
Motrin__ mg PO every 6 hrs prn; temp > 100.4 (10 mg/kg/dose) (2)
Specification of Tylenol
Item
If Tylenol, please specify amount
integer
Specification of Motrin
Item
If Motrin, please specify amount
integer
Item Group
IV
IV
Item
No IV required
boolean
IV
Item
Bolus with__mL normal saline over 1-2 hrs (10-20 mL/kg bolus)
boolean
Specification of saline
Item
If Bolus with normal saline, please specify amount
float
IV
Item
Maintenance IV with Dextrose 5% in 1/4 normal saline @___mL/hr; add 20 mEq KCL after first void
boolean
Specification of Dextrose
Item
If Dextrose, please specify amount mL/hr
integer
Item Group
Other Orders
Other Orders
Item
Other Orders
text
Signature
Item
Signature
text
Print Name
Item
Print Name
text
Date and Time
Item
Date and Time
datetime
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial