Treatment
Using a medical directive, acetaminophen or ibuprofen can be ordered for adults or children who present with either of these two symptoms.
What is fever and/or pain?
Serum lactate is often indicated for patients suspected of sepsis. Lactate is elevated when tissues are deprived of this.
What is oxygen?
When entering an electronic order using a medical directive, the communication type in the "Ordering Physician" section is this.
What is 'medical directive'?
Using the appropriate medical directive, adult ED patients presenting with symptoms associated with acute coronary syndrome can be administered this medication.
What is ASA?
Using the associated medical directive, this is the dose of acetaminophen in mg/kg that can be administered to a child aged 3 months or older presenting with fever
What is 15 mg/kg?
These are the oxygen titration targets associated with the oxygen therapy medical directive.
What is 92% for patients without a COPD diagnosis or between 88-92% with a COPD diagnosis?
The "Diagnostic imaging" medical directive includes ordering of x-rays to rule out orthopedic fractures and includes these body parts.
What are toes, foot, ankle, knee, tib/fib, pelvis/hip, finger, hand, wrist, scaphoid, forearm, elbow, humerus, shoulder, clavicle, ribs?
All current medical directives can be found in this electronic database.
What is PolicyManager?
The IV initiation medical directive (specific for any MHA patient with a concerning presentation) includes the insertion of a saline lock or an IV infusing with this solution at this rate.
What is normal saline infusing at 75 mL/hour?
The 'laxative of choice PRN' medical directive includes these 2 medications and their associated dosages.
What is Lactulose 30 mL po daily prn and Senokot 2 tabs po daily prn?
Salbutamol and Ipratropium are included in an ED-specific medical directive indicated for patients with SOB and wheezing. This is the drug classification of salbutamol, and this is one of its common side effects.
What is Beta-2 adrenergic agonist (bronchodilator) and what is tachycardia?
When completing an ECG, if you place the RA electrode near the R wrist, the LA electrode should be placed here.
L wrist
The blood culture medical directive is indicated for patients with temperature equal to or greater than 38 or less than 36o C, have an actual or suspected infection and who present with any of these signs/symptoms (List 3).
What is: Tachypnea > 20 RPM; Tachycardia HR > 90 BPM; Hypotension with SBP < 90 mmHg; Altered LOC; Immunocompromised; Have an indwelling vascular access device
The ED 'Group and Screen' medical directive would be indicated for patients presenting with these symptoms/concerns (List 3).
What are: Major trauma patients; patients with actual or potential hemodynamic instability; pallor, known or suspected anemia; recent chemotherapy patient who appears anemic; patients with suspected major bleed; patients with abdominal pain and/or vaginal bleeding who may be pregnant
The ED medical directive LET involves the use of a topical anesthetic prior to suturing. These are the medications that are included in LET; therefore, LET cannot be applied to these parts of one's body.
What are lidocaine, epinephrine and tetracaine? What are digits?
This is one of three listed contraindications listed in the urinary catheter medical directive
What are: pelvic trauma; recent urethral surgery or bladder reconstruction; known strictures or previous difficult catheterizations
The only listed indication for completion of ED medical directive 'Serum coagulopathy - INR' is this.
What is current warfarin use?
As per the medical directive, intraurethral lidocaine would be applied prior to catheter insertion for this demographic of patients.
What is male and over the age of 16?
In the medical directive 'hypoglycemia with altered LOC' the order includes administration of dextrose 50% or this medication to be administered using this route.
What is glucagon 1 mg IM?
This medical directive would be indicated to treat patients presenting with chemical splash to eye.
What is eye irrigation?
These are two listed indications (in ED medical directive) for administration of IV dextrose
What are: POC glucose < 3mmol/l.; altered LOC felt to be due to suspected to be due to low blood sugar?
For patients presenting with acute coronary syndrome, completion of ECG would be one medical directive to complete. Another medical directive appropriate for ACS patients could be this.
What are: cardiac marker troponin, routine blood work, IV access, or administration of 160mg of ASA?
According to CNO, this information must be included in a medical directive.
What are: 1. the name and description of the procedure(s)/ treatment(s)/intervention(s) being ordered; 2. clinical conditions/ circumstances that must be met. 3. Listed contraindications. 4. Names of physicians/NPs approving directive. 5. Date/signature of administrative approval.
The ED medical directive 'Administration of Epinephrine - for Anaphylaxis" includes an assessment of this body system prior to an administration of this dose & concentration of epinephrine administered using this route.
What is respiratory, 1:1000 with 0.3-0.5 mL administered IM?
As per the medical directive, there are 2 major contraindications regarding application of ophthalmic eye drops. Allergy is one, this is the other.
What is a penetrating eye injury?