DRUG AND TREATMENT Available ONLY at: BMC-W Nursing Orders Hold Sedation Train of Four, Assess Q4H, Clinical Instructions: Target Goal is one (1) out of four (4). Notify Provider if goal not met Bispectral Index Monitoring Continuous, Additional Instructions: Target Goal to. Notify Provider if goal not met. HOB 30 Degrees, Unless contraindicated Oral Care ASDIR, Q4H or ASDIR Medications dexmedetomidine (Precedex (pediatric)) 0.5 mcg/kg iv IVPB ONCE Comments: Must be given over 20-30 minutes dexmedetomidine (Precedex 200 mcg / 50 ml premix) IV premix 0.5 mcg/kg/hr fentanyl (pediatric) 0.5 mcg/kg inj IV PUSH (DEF)* 1 mcg/kg inj IV PUSH fentanyl IV drip (pediatric) IV syringe 0.5 mcg/kg/hr (DEF)* IV syringe 1 mcg/kg/hr ketamine (pediatric) 1 mg/kg inj IV PUSH Ketamine drip 2,500 mg/50 ml IV Set (pediatric) (IVS)* Dextrose 5% in Water IV bag Rate: 1 mg/kg/hr Ketamine IV drip 2,500 mg 25 ml propofol (pediatric) 1 mg/kg inj IV ONCE (DEF)* 2 mg/kg inj IV ONCE 3 mg/kg inj IV ONCE Propofol Infusion (pediatric) IV bottle Rate: 25 mcg/kg/min (DEF)* IV bottle Rate: 50 mcg/kg/min IV bottle Rate: 75 mcg/kg/min IV bottle Rate: 100 mcg/kg/min lorazepam (Ativan (pediatric)) 0.1 mg/kg inj IV PUSH ONCE Page 1 of 6
DRUG AND TREATMENT Lorazepam (Ativan) PICU Drip 100 mg / 50 ml (IVS)* Ativan IV Infusion (pediatric) 50 ml IV bag Rate: 0.05 mg/kg/hr Comments: 50 ml in evacuated container lorazepam (Ativan (pediatric)) 0.1 mg/kg inj IV PUSH Q4H, PRN Agitation (DEF)* 0.1 mg/kg inj IV PUSH Q4H 0.1 mg/kg inj IV PUSH Q2H, PRN Agitation 0.1 mg/kg inj IV PUSH Q2H 0.1 mg/kg inj IV PUSH Q6H, PRN Agitation 0.1 mg/kg inj IV PUSH Q6H 0.1 mg/kg inj IV PUSH Q12H, PRN Agitation 0.1 mg/kg inj IV PUSH Q12H morphine (pediatric) 0.05 mg/kg inj IV PUSH ONCE (DEF)* 0.05 mg/kg inj IV PUSH Q2H, PRN Pain Severe 0.05 mg/kg inj IV PUSH Q3H, PRN Pain Severe 0.05 mg/kg inj IV PUSH Q4H, PRN Pain Severe 0.1 mg/kg inj IV PUSH ONCE 0.1 mg/kg inj IV PUSH Q3H, PRN Pain Severe 0.1 mg/kg inj IV PUSH Q4H, PRN Pain Severe Morphine Infusion (pediatric) 100 ml IV bag Rate: 0.01 mg/kg/hr PENTobarbital (Nembutal) 1000 mg / NS 250 ml (pediatric) (IVS)* Sodium Chloride 0.9% IV bag Rate: 1 mg/kg/hr pentobarbital IV drip 1,000 mg 20 ml midazolam (Versed (pediatric)) 0.05 mg/kg inj IV PUSH (DEF)* Comments: Bolus 0.1 mg/kg inj IV PUSH Comments: Bolus midazolam (Versed IV (pediatric)) IV syringe 0.1 mg/kg/hr methadone (Dolophine (Pediatric)) mg elixir NG TUBE Q6H (DEF)* mg elixir NG TUBE Q8H mg elixir NG TUBE Q12H mg elixir NG TUBE DAILY mg elixir PO Q6H mg tab PO Q8H Page 2 of 6
DRUG AND TREATMENT mg tab PO Q12H mg tab PO DAILY 0.1 mg patch TOPICAL QWEEK, Clinical Instructions: 1 Patch TTS-1 Occlude patch with tegaderm, Do Not Cut patch (DEF)* 0.05 mg patch TOPICAL QWEEK, Clinical Instructions: 1/2 Patch TTS-1, Occlude patch with tegaderm, Do Not Cut patch 0.025 mg patch TOPICAL QWEEK, Clinical Instructions: 1/4 Patch TTS-1, Occlude patch with tegaderm, Do Not Cut patch Comments: 1/4 Patch TTS-1 0.2 mg patch TOPICAL QWEEK, Clinical Instructions: 1 Patch TTS-2 0.3 mg patch TOPICAL QWEEK, Clinical Instructions: 1 Patch TTS-3 3.3 mcg/kg susp NG TUBE Q8H acetaminophen (pediatric) 15 mg/kg susp PO Q4H, PRN Other (see comment) (DEF)* 15 mg/kg supp PR Q4H, PRN Other (see comment) 325 mg tab PO Q4H, PRN Other (see comment) 650 mg tab PO Q4H, PRN Other (see comment) ibuprofen (pediatric) 10 mg/kg susp PO Q6H, PRN Other (see comment) (DEF)* Comments: PRN pain mild/moderate OR fever GREATER than 38.5 degrees Celsius. Age 6 months and GREATER. MAX dose 800 mg/dose. If Tylenol not administered or ineffective. If last dose of acetaminophen given GREATER than 1 hour or LESS than 4 hours, may give ibuprofen. 200 mg tab PO Q6H, PRN Other (see comment) Comments: PRN pain mild OR fever GREATER than 38.5 degrees Celsius. Age 6 months and GREATER. MAX dose 800 mg/dose. If Tylenol not administered or ineffective. If last dose of acetaminophen given GREATER than 1 hour or LESS than 4 hours, may give ibuprofen. 400 mg tab PO Q6H, PRN Other (see comment) Comments: PRN pain mild OR fever GREATER than 38.5 degrees Celsius. Age 6 months and GREATER. MAX dose 800 mg/dose. If Tylenol not administered or ineffective. If last dose of acetaminophen given GREATER than 1 hour or LESS than 4 hours, may give ibuprofen. 800 mg tab PO Q6H, PRN Other (see comment) Comments: PRN pain mild OR fever GREATER than 38.5 degrees Celsius. Age 6 months and Page 3 of 6
DRUG AND TREATMENT GREATER. MAX dose 800 mg/dose. If Tylenol not administered or ineffective. If last dose of acetaminophen given GREATER than 1 hour or LESS than 4 hours, may give ibuprofen. diazepam (Valium (pediatric)) 1 mg soln PO Q6H, PRN Muscle Spasms, Clinical Instructions: For Children Greater Than 6 Months of Age (DEF)* 2 mg soln PO Q6H, PRN Muscle Spasms, Clinical Instructions: For Children Greater Than 6 Months of Age tramadol (Ultram) 50 mg tab PO Q6H, PRN Pain Severe Comments: For patients greater than 45 kg acetaminophen-hydrocodone (Norco (Hydrocodone 5mg/APAP 325mg) Pediatric) 1 tab PO tab Q6H, PRN Pain Moderate (DEF)* 2 tab PO tab Q6H, PRN Pain Moderate acetaminophen-hydrocodone (Norco (Hydrocodone 7.5mg/APAP 325mg) Pediatric) 1 tab PO tab Q6H, PRN Pain Moderate (DEF)* 2 tab PO tab Q6H, PRN Pain Moderate acetaminophen-hydrocodone (Norco (Hydrocodone 10mg/APAP 325mg) Pediatric) 1 tab PO tab Q6H, PRN Pain Moderate (DEF)* 2 tab PO tab Q6H, PRN Pain Moderate acetaminophen-hydrocodone (Hycet (Hydrocodone 2.5mg - Acetaminophen 108mg per 5mL) pediatric) 0.1 mg/kg liquid PO Q6H, PRN Pain Moderate (DEF)* Comments: Dosing hydrocodone component 0.2 mg/kg liquid PO Q6H, PRN Pain Moderate Comments: Dosing hydrocodone component cetylpyridinium topical (KimVent Oral Care Kit) 1 dose PO kit ASDIR, PRN Other (see comment) Comments: Cetylpyridinium Chloride 0.05% (antiplaque solution):bid at 2400/1200. Change suction catheter at 2400/1200, change yankaeur QD at 2400Hydrogen Peroxide 1.5% (oral debriding agent):q4h at 0400/0800/1200/1600/2000. Change yankaeur QD at 2400Alcohol-Free Mouthwash:Q4H at 0200/0600/1000/1400/1800/2200. Change Yankauer QD at 2400 Paralytics Succinylcholine (pediatric) 1 mg/kg inj IV PUSH ASDIR, PRN Other (see comment) (DEF)* 2 mg/kg inj IV PUSH ASDIR, PRN Other (see comment) Rocuronium (pediatric) 1 mg/kg inj IV PUSH ASDIR, PRN Other (see comment) Page 4 of 6
DRUG AND TREATMENT vecuronium (pediatric) 0.1 mg/kg inj IV PUSH ASDIR, PRN Other (see comment) cisatracurium (pediatric) 0.2 mg/kg inj IV PUSH ASDIR, PRN Other (see comment) Pancuronium (pediatric) 0.1 mg/kg inj IV PUSH ASDIR, PRN Other (see comment) Vecuronium 100 mg / 100 ml IV Set (pediatric) (IVS)* vecuronium iv drip (undiluted) IV bag 0.1 mg/kg/hr IV bag Rate: 1 mcg/kg/min IV bag Rate: 2 mcg/kg/min IV bag Rate: 3 mcg/kg/min IV bag Rate: 4 mcg/kg/min Ophthalmic Medications erythromycin ophthalmic ointment 1 dose EYE BOTH oint Q2H (DEF)* 1 dose EYE BOTH oint Q4H ocular lubiricant (Celluvisc ophthalmic suspension) 1 drop EYE BOTH susp Q2H, PRN Other (see comment), Clinical Instructions: Dry Eyes (DEF)* Comments: Dryness 1 drop EYE BOTH susp Q4H, PRN Other (see comment), Clinical Instructions: Dry Eyes Comments: Dryness Page 5 of 6
DRUG AND TREATMENT erythromycin ophthalmic (Ilotycin Ophthalmic Ointment (pediatric)) 1 dose EYE BOTH oint Q2H (DEF)* 1 dose EYE BOTH oint Q4H erythromycin ophthalmic (Ilotycin Ophthalmic Ointment (pediatric)) 1 dose EYE BOTH oint Q2H, PRN Other (see comment) Comments: Dry eyes ocular lubricant (Lacri-Lube S.O.P. (pediatric)) 1 drop EYE BOTH susp Q2H (DEF)* 1 drop EYE BOTH susp Q4H ocular lubricant (Lacri-Lube S.O.P. (pediatric)) 1 drop EYE BOTH susp Q2H, PRN Other (see comment) Comments: While neuromuscular blockade in use ocular lubricant (Puralube) 1 dose EYE BOTH oint Q2H Comments: While neuromuscular blockade in use Page 6 of 6