medication

noradrenaline:
need to order everyday!!
shield from light!!
D5 56.4ml + noradrenaline 3.6 mg(3.6ml), total 60ml
2ml/hr


Heparin saline: 
1 unit of heparin in 1ml NS


Amphotercin B:
shield from light
350ml D5
flush with D5
inject pethidine before giving ampho B
2-6hr

Meropenem
500mg/ vial, dissolve 500mg in 10ml WFI( further dilute with D5 or NS, seems not follow in D6)
infuse over 30mins.

2gram >> 40ml WFI

Vancomycin
100ml
no specific rate


Dopamine:
200mg/5ml = 40mg/ml
if need 233.16 mg in 60ml NS
then = 5.83ml dopamine in 54.17ml NS

Doputamine:
250mg/20ml
if need 233.16 mg in 60ml NS,
then= 18.65ml dobutamine in 41.34ml NS

A line

set with dr:
micropore, set one " airplane", half tagaderm, splint

set a line with heprin saline
A line set
need to press the valve when full up the line
stick a line sticker x4, heprin sticker, drip set sticker
put a  pink blanket below it and stick it firmly( dont use micropore: not sticky enough)

Calibration:
close patient's side, then open to air and sensor.
press mon: Aline>> set zero
close sensor side, then open patient's side

Blood culture trolley

S25 dressing set
sterile glove
70% alcohol + betadine
culture bottle x 3 or more
5 ml syringe  x3 or more
500 ml NS
needle

week 7

urine x SG: use a syringe take some urine, then see it in that microscope , normal in 1.010, the higher the value, the more conc in the urine.
urine x osmolity : save in plain white bottle, send to lab.
urine x multistix need to enter into CIS flowsheet
ABG result need to enter into CIS flowsheet, chart at the time which the blood is taken.

GCSF: for white blood cell production( seems need to flush with D5)



TSH for new born: if can't test in cord blood, need to check on D5.
withdrawn sydrome:  convulsion if serious>> die
BB have 80ml/kg blood
mottling>> ?sepsis
cyanosis> ?tramatic cyanosis which can't reverse by O2 giving, need to observe lips to rule out tramatic cyanosis
acrocyanosis: peripheral cyanosis
jittery: can stop if u touch him, twitching: can't stop
lethargic=tired
Diaphram hernia: dont use mouth bagging.

Platelet conc transfusion.

blood transfusion set
plastic bag
NS + 3 way
2 NS in 5 ml syringe+ alcohol swab
can use syringe pump/ infusion pump
*remember to check how many ml in one pack!!

chart血紙，enter serial no of each platelet conc into CIS flowsheet, documentation( start time and end time), add MAR, if verbal order then document verbal order.

take temp before, 15 mins, and after

escort CT:

escort CT:
sedation consent
NPO<< IVF!!!
bring napkin,wet paper, NNS
call 3067 for lift
grey bag+ kardex

admit PICU

Before arrival: 
ask patient's age and KG>> print PICU reference list
get: ventilator, ETT(x6), suction tubing, larygoscope, lighter, steroscope, ambu bag, SpO2 monitor stand by mode,
E-trolly blasket for intubation, water for injection(500ml bottle), IV pump set x2, sringe pump

arrival:
1.first assessment( temp, spO2, GCS, U/O(weight), BP, cardiac mon, drip site, any abnormality)
2. hang over( with IC and 2nd), ask related question
3. call Dr (first if pt very serious)
4. follow treatment( blood taking, A/B, NPA(don't do NPA if pt resp not ok, wait till he stablize)...

After arrival:
enter kardex within one hr(admited fromXXX, escort by nurse...)
flowsheet
APT
assessment form

enter bed assignment, PICU book and milk file, assign Dr and milk formula in CMS.