ID

16003

Beschrijving

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

Trefwoorden

Versies (1)
  1. 26-06-16 26-06-16 -
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26 juni 2016

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Creative Commons BY-NC 3.0
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AAFP: Croup Admission Order

Engels

AAFP: Croup Admission Order

1 Formulieren  
Default Itemgroup
Beschrijving

Default Itemgroup

Name
Beschrijving

Name

Datatype

text

Age
Beschrijving

Age

Datatype

integer

Date of Birth
Beschrijving

Date of Birth

Datatype

date

Medical record
Beschrijving

Medical record

Datatype

integer

Status
Beschrijving

Status

Admission
Beschrijving

Status

Datatype

boolean

Observation in pediatric unit
Beschrijving

Status

Datatype

boolean

Attending
Beschrijving

Attending

Name of attending physician
Beschrijving

Attending

Datatype

text

Phone number of attending physician
Beschrijving

Attending

Datatype

integer

Admitting Diagnosis
Beschrijving

Admitting Diagnosis

Croup Associated Diagnoses
Beschrijving

Admitting Diagnosis

Datatype

text

Condition
Beschrijving

Condition

Condition
Beschrijving

Condition

Datatype

text

Allergies
Beschrijving

Allergies

Allergies
Beschrijving

Allergies

Datatype

text

Diet
Beschrijving

Diet

Clear liquids
Beschrijving

Diet

Datatype

boolean

Diet for age
Beschrijving

Diet

Datatype

boolean

Activity
Beschrijving

Activity

Bed rest
Beschrijving

Activity

Datatype

boolean

Up ad lib
Beschrijving

Activity

Datatype

boolean

Nursing
Beschrijving

Nursing

Vital signs per unit routine
Beschrijving

Nursing

Datatype

boolean

Vital signs every 4 hrs if on oxygen therapy
Beschrijving

Nursing

Datatype

boolean

I&O every shift
Beschrijving

Nursing

Datatype

boolean

Lab
Beschrijving

Lab

CBC
Beschrijving

Lab

Datatype

boolean

Lytes
Beschrijving

undefined item

Datatype

boolean

AP/Lateral Neck X-ray
Beschrijving

AP/Lateral Neck X-ray

AP/Lateral Neck X-ray
Beschrijving

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

Datatype

text

Respiratory
Beschrijving

Respiratory

If croup score > 5, notify MD
Beschrijving

Respiratory

Datatype

boolean

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

Respiratory

Datatype

boolean

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

Respiratory

Datatype

boolean

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

Respiratory

Datatype

boolean

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

Respiratory

Datatype

boolean

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

Respiratory

Datatype

boolean

Medications
Beschrijving

Medications

Medications
Beschrijving

Medications

Datatype

text

Please specify amount of the chosen medication
Beschrijving

Specification amount of medication

Datatype

integer

If Prelone elixir, please specify duration in days
Beschrijving

Specification duration of Prelone

Datatype

integer

Medications
Beschrijving

Medications

Datatype

text

If Tylenol, please specify amount
Beschrijving

Specification of Tylenol

Datatype

integer

If Motrin, please specify amount
Beschrijving

Specification of Motrin

Datatype

integer

IV
Beschrijving

IV

No IV required
Beschrijving

IV

Datatype

boolean

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

IV

Datatype

boolean

If Bolus with normal saline, please specify amount
Beschrijving

Specification of saline

Datatype

float

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

IV

Datatype

boolean

If Dextrose, please specify amount mL/hr
Beschrijving

Specification of Dextrose

Datatype

integer

Other Orders
Beschrijving

Other Orders

Other Orders
Beschrijving

Other Orders

Datatype

text

Signature
Beschrijving

Signature

Datatype

text

Print Name
Beschrijving

Print Name

Datatype

text

Date and Time
Beschrijving

Date and Time

Datatype

datetime

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Similar models

AAFP: Croup Admission Order

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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
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