Sunday, September 22, 2013

the see, I'm so sick they put an IV in me ORDER SET

It took me years to realize this.  It hit me the other day.  ER docs, NPs, PAs have a DEFAULT ORDER SET. 

What is a DEFAULT ORDER SET?

Here it is: 

CBC
Lytes
Troponin
UA
CXR
EKG
Normal saline 1000 cc bolus

This set of orders can be justified for many, many complaints.  From tummy ache to chest pain to weakness to dizziness.  Labs are basic.  Pretty much any woman who comes to ER gets a UA and those who are of childbearing age always get a UPT.   Any pain from groin to the neck could justify a EKG and CXR.  As far as fluids, everybody could use a liter of fluid.  It makes the patient think you are really doing something.  It justifies, in their mind, that they should have come in:  See,,,I'm so sick they gave me an IV. 

If any of the tests come back positive: NIRVANA!  More tests...yea!  Ever wonder why you wait for hours in the lobby, this is part of the reason. 
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3 comments:

  1. Anonymous10:10 PM

    So true!
    -whitecap nurse

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  2. Anonymous10:05 AM

    Without the DEFAULT ORDER SET it's just the ooga booga game. Raise your arms, palms down. wave them over the patient...chant oooooga....booooga... and voila! NOTHING. Like it or not, those test tell us a lot. And yes, they they take time.

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  3. Mark p.s.211:02 PM

    I would suggest sticking a line in the patient keeps them more in control, as they can't run around so easy dragging the IV bag/pole with them. And if they do act nuts it is much more quick n easy to inject them with a sedative.

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