Scribd
Upload
41 views2 pages

Pearls

This clinical pathway provides guidelines for the treatment of patients presenting with blunt abdominal trauma and signs of peritonitis at Negros Oriental Provincial Hospital. It outlines orders for vital sign monitoring, diagnostic tests, IV fluids, antibiotics, and a diet of nothing by mouth. It also specifies a plan for exploratory laparotomy surgery, pre-op evaluation, informed consent, post-op care, and discharge instructions once the patient has normal GI function. The pathway is to be activated upon signing by the surgical resident on duty and nurse in charge, and discontinued if the patient's condition changes or fails to meet outcomes within 24-48 hours.

Uploaded by

patriciaatan1497
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
41 views2 pages

Pearls

This clinical pathway provides guidelines for the treatment of patients presenting with blunt abdominal trauma and signs of peritonitis at Negros Oriental Provincial Hospital. It outlines orders for vital sign monitoring, diagnostic tests, IV fluids, antibiotics, and a diet of nothing by mouth. It also specifies a plan for exploratory laparotomy surgery, pre-op evaluation, informed consent, post-op care, and discharge instructions once the patient has normal GI function. The pathway is to be activated upon signing by the surgical resident on duty and nurse in charge, and discontinued if the patient's condition changes or fails to meet outcomes within 24-48 hours.

Uploaded by

patriciaatan1497
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

ccDEPARTMENT OF SURGERY

Negros Oriental Provincial Hospital

CLINICAL PATHWAY FOR


BLUNT ABDOMINAL TRAUMA

PHYSICIAN’S ADMITTING ORDER SHEET

Inclusion criteria: All patients presenting with blunt abdominal trauma WITH CLINICAL SIGNS OF PERITONITIS
Expected LOS: _____ Days
Exclusion criteria: no signs of peritonitis, significant comorbidities
Date : : Day ______

Patient’s Name Age : Weight: Hospital #:


Height:
BMI:
Last Name First name Middle Name
ORDERS
PHYSICIAN’S NOTES: Admit to _______ under the service of Variance Sign
S: Subjective Complaints/ Symptoms Dr. __________________________

Vital Signs Monitoring q

Diagnostics/ Procedures:
▪ Bloodtyping
● HBsAg
€ ABG
O: Objective, Physical/ Lab Findings € PROTIME
VS: € CBC
BP: HR: RR: T:
IVF with double line using PLR @ 30 gtts/min
Pain Score: each

C/L: Start meds:


▪ Cefuroxime 750mg IVTT q 8h
Abd: ▪ Metronidazole 500 mg IV drip q 8h
€ Ranitidine 50 mg IVTT q 8h
€ Tramadol 50 mg IVTT q 6h
Rectal:
€ Insert NGT Fr16 open to drain
€ Insert FBC Fr16 attach to urobag

A: Assessment/ Working Impression/ Diet: NPO


Clinical Diagnosis Activity: Complete bed rest without toilet
privileges
Acute Abdomen sec to Blunt abdominal trauma
Consults/ Co-management orders:
€ Refer to Anesthesia for pre-op evaluation
P: Plan of Care
Procedures:
Diagnostics/ Imaging: Direct to OR for Exploratory Laparotomy
Blood typing, HBsAg Secure consent for procedure and
photodocumentation

Therapeutics: Provide for psychosocial needs


● Patient appraised of the clinical
Surgery situation and the need for emergency
Exploratory laparotomy surgery and also appraised of the
Antibiotic therapy risk, benefit and possible
complications

Provide patient/Family education


Patient’s family appraised of current situation

Discharge Plan:
Discharge if without complications once with
normal GI function
Take home medications, wound care and follow
up instructions to be given

Activated by: Acknowledged by:


______________________ _________________________
Surgical Resident on Duty Nurse in charge

NOTE: THIS PATHWAY WILL BE ACTIVATED ONCE SIGNED BY THE SURGICAL RESIDENT ON DUTY AND NURSE IN
CHARGE AND SHOULD BE STOPPED WHEN AN ADVERSE REACTION IS NOTED.

● Both AP and NIC must sign at the bottom of the pathway form to activate it
● The pathway will be discontinued by anyone whenever:
1. The patient’s primary diagnosis changes
2. The patient’s condition significantly worsens
3. The patient fails to meet clinical outcomes for 24-48 hours
● Variance codes:

A. PATIENT/FAMILY B. CLINICAL C. SYSTEM D. COMMUNITY


a.1 Non-adherence to b.1 Development of a c.1 Lack of available d.1 Unable to contact
plan of care new medical Equipment / Community Health
a.2 Patient or family /surgical problem Medicines Service
refuses discharge b.2 Exacerbation of c.2 Failure to perform a d.2 Delay in availability
a.3 Financial constraints underlying condition recommended of recommended
a.4 Home per b.3 Delay in response to procedure support
request/against medical treatment c.3 Delay in response to
medical advice interdepartmental
a.5 Absconded referral (co-
management,
consult, or transfer
of service)

You might also like