HOWARD COUNTY MEDICAL CENTER
1113 SHERMAN ST PO BOX 406
ST PAUL NE 68873
DATE
ORDERED
TIME
ORDERED
ORDERS – ORDERED BY
PROGRESS NOTES
Ventilator orders.
Place patient on telemetry
Start 2 IV sites with 18-20g needles
NG tube placed on low intermittent suction
Foley placed (with temperature sensing probe)
Monitor output every 4 hours call
End tidal CO2monitoring (continuous) and
continuous pulse oximeter
Call MD if output less than ____mls/hr
Tidal volume setting on the ventilator of patients ideal
body weight (see attached sheet for a setting round to
nearest setting n our ventilator.)
RASS score goal ______________ (usually 0 to -2)
assess 15 minutes after each titration and when stable
every hour
Mode______: VT _____: respiratory rate______
FiO2_____:PEEP_____:PS_____-
Ventilator settings
Head to toe exam/ Neuro checks every 2 hours
monitor for skin integrity
0.9% Sodium Chloride 1000ml IV at 30ml/hr in
one line if no other IV is running.
Propofol infusion: Initiate at 10 mcg/kg/min. May
titrate by 10 mcg/kg/min every 5 minutes to a maximum
of 50 mcg/kg/min to achieve RASS goal (use 3 X 20ml
amps in an empty IV BAG) do not dilute.
Fentanyl 500mcg in 50ml NS(conc 10mcg/ml) start
IV at 0.5mcg/kg/hr (in elderly start at
0.25mcg/kg/hr) titrate every 15 minutes
Propofol is the preferred this is an option and may
be used with or without propofol
Midazolam 50mg/50ml NS start at 2mg/hr titrate
up every 15minutes to a max of 20mg/hr
IF BP is too low call MD and consider starting a
norepinephrine drip per protocol
PT/OT to evaluate daily for mobility,strength,ROM
Bed rest elevate head of bed 30degrees unless
contraindicated
Provide oral care every 2 hours
Patient is NPO
Vital signs every 15 minutes until stable then every
30 minutes T-P-R-BP-Ox
DOB
PHYSICIAN’S ORDER SHEET/PROGRESS NOTES
Patient Name:__________________
______
Room#_____ ___Hospital #_____________
Doctor:______________ ______________
Date:__________________