Docstoc

Sleep Apnea Orders

Document Sample
Sleep Apnea Orders Powered By Docstoc
					                                                                                              PLACE LABEL HERE
SLEEP APNEA
ORDERS
    The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.

 SUSPECTED SLEEP APNEA (BMI ≥ 35 and answers “YES” to one sleep problem question)
     1. Respiratory Care Sleep Apnea Referral /Sleep Apnea Assessment
     2. HOB elevated at 45 degrees (unless otherwise specified by physician order)
     3. Continuous pulse oximetry with telemetry until evaluation by Respiratory Care
             Exception for post-op patients - monitor for a minimum of 24 hrs
     4. Monitor Tech to notify Respiratory Care and Nurse of at-risk desaturation events:
             Five (5) desaturations lower than 88% in an hour,
             Any sustained desaturation lower than 88% for five (5) min
             One (1) desaturation lower than 80%, and/or
             Arrhythmias associated with desaturations
     5. Respiratory Care may initiate CPAP 8-10 cm H2O and FiO2 to maintain > 88% when patient is sleeping
        (q hs and prn) in response to at-risk desaturation events
             Call physician after 0700 to report initiation of CPAP or if condition does not improve
     6. Call physician if FiO2 > 40% needed to maintain O2 saturation > 88%
     7. Respiratory Care may discontinue pulse oximetry following assessment if no at-risk desaturation events
        are recorded, or when patient is successfully treated with PAP device
     8. Continue telemetry until discharge or unless otherwise discontinued by a physician order

OR:

 REPORTED HISTORY OF SLEEP APNEA
     1. Respiratory Referral for CPAP or BiPAP
     2. HOB elevated at 45 degrees (unless otherwise specified by physician order)
     3. Place on telemetry until discharge or unless otherwise discontinued by a physican order
             Exception for post-op patients - pulse oximetry with telemetry for the first 24 hrs, then telemetry
                 until discharge or until discontinued by a physician order
     4. May use home CPAP/BiPAP machine or hospital-supplied device at patient’s reported settings
        Patient’s Reported Settings:____________________________
        If settings not known,
             CPAP 8–10 cm H2O and FiO2 to maintain O2 sat > 88% until home settings can be obtained
     5. Call physician if FiO2 > 40% needed to maintain O2 saturation > 88%

ADDITIONAL ORDERS:
______________________________________________________________________________________
______________________________________________________________________________________

______________          ___________________             _________________________________             __________
Date                    Time                            Physician Signature                           PID Number


*1-21266*                         FORM 1-21266 REV. 03/2011                                                 Page 1 of
1

				
DOCUMENT INFO