MAKATI MEDICAL CENTER
Physician’s Order Sheet
Department: Medicine – Gastroenterology
Effective Date: February 11, 2008
Subject: Acute Pancreatitis
Revision No. 0
Page No.
ADMITTING ORDERS
Diagnosis: ACUTE PANCREATITIS






Please admit to room of choice under the service of Dr._____________
Secure consent for management
Vital signs q__ include progress of abdominal pain
Input and Output q shift
Diet: Nothing per orem
Diagnostics:
 CBC, Na, K, BUN, Creatinine,Calcium, LDH, CBG, PT,PTT
 AST,ALT, Alk PO4, TB, B1,B2
 Amylase, Lipase
 FBS, Triglycerides
 TPAG
 ABG
 Plain film of the abdomen
 CT scan of the whole abdomen with IV and oral contrast
 UTZ of Upper Abdomen
 12- L- ECG
 ERCP
Others:
 Therapeutics: Tick and sign the choice.
 IVF:
 Meperidine 50 mg IV q6 PRN for severe pain, defer for BP < 100
systolic
 ____________ 40 mg/IV q12 ( PPI)
 Ranitidine 50 mg/IV q8
 Metoclopramide 1 amp/IV q8
 Calcium gluconate ______ mg SIVP
 Vamin glucose 500 cc x 24 hours
 TPN:___________________________
 Others:__________________________
 Inform me of patient’s whereabouts once admitted
 Inform GI Fellow and MROD of admission
 Refer accordingly.
____________________, M.D.
MAKATI MEDICAL CENTER
Physician’s Order Sheet
Department: Medicine – Gastroenterology
Effective Date: February 11, 2008
Subject: Acute Pancreatitis
Revision No. 0
Page No.