دستورات اولیه برای آپاندیسیت حاد

1. NPO
2. CVS q6h
3. Serum NS 1000 cc / IV / stat free
4. Serum half Saline 1 lit / IV / tds
5. CBC, Na, K, BUN, Cr, BS, UA, Grav index (for women)
6. Abd.X-ray (supine)>> not necessary (if clinical Dx is highly suspected)7. CXR
8. ECG & Cardiology consult if age>40 y/o
9. Abdominopelvic sonography (esp. for women)
10. OB/GYN consult if gynecologic problems may not be ruled out

After Diagnosis is made:

1. Ready for OR (shave, gown)
2. stat serum if dehydrated
3. analgesic (e.g. MS 5 mg / IM / stat)
4. stat dose of ABs for prophylaxis (Ceftriaxon & Metronidazol)

دستورات اولیه در پریتونیت ژنرالیزه

1. NPO
2. CVS q1h + Chart I/O
3. Serum NS 1000 cc / IV / stat (or more stat serum depending on hydration state)
4. CBC, Na, K, BUN, Cr, BS, PT, PTT, INR, Amylase, LFT, UA
5. Foley cath fixed
6. Amp Ceftriaxon 1 gr / IV / bd
7. Vial Metronidazol 500 mg / IV / qid
8. Amp Ranitidin 50 mg / IV / bd
9. Reserve 4 units PC
10. CXR (upright)
11. Abdominal X-rays (upright & supine)
12. Abdominopelvic sonography
13. ECG
14. ABG
15. Cadriology consult (for males > 40 y/o and females > 45 y/o)
16. Supplemental O2, Cardiac monitoring & Pulse oximetry (if very ill)

دستورات اولیه بیمار Multiple Trauma

[NPO]

1. CVS q30min for 3 hrs, then q3h if stable

2. IV line * 2 (large bore)

3. cardiac monitoring & pulse oximerty & ICU admission à if very ill

4. serum NS 1000cc IV free   à repeat another 1 liter if unstable

5. supplemental O₂ 4-5 lit/min

6. reserve 6 units PC

7. CBC serial q6h

8. Check Na, K, BUN, Cr, BS, PT, PTT, INR, UA

9. Foley catheter fixed

10. Chart I/O

11. NG tube fixed (contraindicated in skull base fx)

12. ECG

13. ABG

14. CXR

15. Pelvic X-ray (AP)

16. Neck view (AP&Lat) including C7-T1

17. abdominopelvic sonograpgy

18. Amp Ranitidin 50 mg / IV / bd

19. Tetanous prophylaxis (if applicable)

20. Orthopedic X-rays (if applicable)

21. Brain CT scan (if GCS<15, head trauma, vomiting, amnesia)

22. Orthopedic consult (if applicable)

23. Neurosurgery consult (if applicable)