BMT CERT EMERGENCY ORDERS		version 5/5/2023		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Nursing communication	Once	S	1 treatment	
		Place on supplemental oxygen (nasal cannula vs NRB based on scenario) and continuous pulse oximetry monitoring		
	☐	Nursing communication	Once	S	1 treatment	
		Establish IV access (large bore IV if possible)		
	☐	Nursing communication	Once	S	1 treatment	
		Place on monitor with leads		
	☐	Nursing communication	Once	S	1 treatment	
		Positioning instruction: If hypotensive, place in trendelenburg position		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	CBC with platelet and differential	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Send even if done earlier in clinic		
	☐	Comprehensive metabolic panel	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Send even if done earlier in clinic		
	☐	Prothrombin time with INR	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Send even if done earlier in clinic		
	☐	Partial thromboplastin time, activated	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Send even if done earlier in clinic		
	☐	D-dimer	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	NT-proBNP	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Troponin T	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Procalcitonin	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Lactic acid level	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	LDH	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Type and screen	Once	S	1 treatment	
		STAT, Normal, Clinic Collect		
	☐	Blood culture, aerobic & anaerobic	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	X 2		
	☐	Arterial blood gas	Once	S	1 treatment	
		Routine, Status: Future, Expected: S, Expires: S+366, Lab Collect
	if hypoxia SOB		
	☐	Urinalysis screen and microscopy, with reflex to culture	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Specimen Source: Urine
	Specimen Site: Clean catch		
	☐	C-reactive protein	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	IF CAR-T patients: C-reactive protein (not High sensitivity)		
	☐	Ferritin level	Once	S	1 treatment	
		Routine, Status: Future, Expected: S, Expires: S+366, Lab Collect
	IF CAR-T patients		
	☐	Respiratory pathogen panel with COVID-19 RT-PCR	Once	S	1 treatment	
		STAT, Normal, Clinic Collect, Nasopharyngeal
	if respiratory issues		

Procedures 	

	
	Interval	Defer Until	Duration	
	☐	ECG 12 lead	Once	S	1 treatment	
		Clinic Performed, Normal		

IV Fluids 	

	
	Interval	Defer Until	Duration	
	☐	sodium chloride 0.9 % infusion 1,000 mL	Once	S	1 treatment	
		1,000 mL, intravenous, at 999 mL/hr, once, Starting when released
	Wide open		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	cefepime (MAXIPIME) 2 g in dextrose 5% 50 mL IVPB	Once	S	1 treatment	
		2 g, intravenous, Administer over: 30 Minutes, once		
	☐	vancomycin (VANCOCIN) in dextrose 5% 500 mL IVPB	Once	S	1 treatment	
		intravenous, Administer over: 90 Minutes, once
	Dose based on Renal function.		
	☐	DAPTOmycin (PF) (CUBICIN) in sodium chloride 0.9% IVPB (RESTRICTED)	Once	S	1 treatment	
		intravenous, Administer over: 30 Minutes, Starting when released
	If allergic to Vancomycin
	Use ADJUSTED body weight if BMI is 30 or greater.		
	☐	meropenem (MERREM) IV 1 g	Once	S	1 treatment	
		1 g, intravenous, once, Starting when released
	If PCN allergy