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)
[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)