GLUCOSE INSULIN DRIP

 D50W 50cc + 10 "u" Actrapid to run for 1 ESTIMATE VOLUME OF BLEED

hour x 3 cycles
 Repeat S. K 1 hour after the last cycle
OR:
 PNSS 250mL + 50 units Humulin R
 Concentration: 0.2 units/mL
 Drips of 5-50 ugtts/min (or mL/hour) is
equivalent to 1-10 units Humulin R/hour
 Count # of plates with bleed not <25%
of the largest bleed
 # of plates (cm) x length (cm) x width
(cm)
# of plates x length x width
-----------------------------------------------
2

 100 u Regular insulin in 1L PNSS @50

ugtts/min
 HGT qhourly
 Increase IVF rate
 S. K Q6H
 Close mainline

WEANING RESUSCITATION
Intubate patient now and hook to continuous
ambubagging with O2 at 10 LPM
 Prepare tracheal mask for Start CPR now
ECG now
weaning at the ff set up ___% Insert IV line: FD 200-300 cc then regulate to 125 cc/hr
FiO2, __ LPM Epinephrine 1 amp now
Suction secretions PRN
Dobu, Dopa, Levophed Drips
T Piece VR NaHCO3 50cc IV push now
Hook to pulse oximeter and cardiac monitor
 Cycle I 15 15 x 3 cycles If Bradycardic; Atropine 1 amp IV now
Refer for respiratory distress or CBG now
Insert NGT
02sat <93%, if tolerated proceed Hook to VR:
to: FiO2: 100%
TV: 450
 Cycle II 30 15 x 2 cycles PFR: 45
 Cycle III 45 15 BUR: 20
AC Mode
 Then ABG after 45 minutes prior Repeat ABG 30 mins after hooking to VR
to hooking to VR….. Repeat CXR post intubation
ETA GS, CS, KOH
NICARDIPINE DRIP
PNSS 1L + 1 amp nicardipine x 10 ugtts/min, titrate SCHEDULE FOR ERCP,
to increments of 5 ugtts/min to attain MAP
SPHINCTEROTOMY, STONE
EXTRACTION
AMINOPHYLLINE DRIP
D5W 500 cc + 2 amps aminophylline x 15 cc/hr (wt  Secure consent
x 0.3 cc/hr)  Inform endoscopy unit, x-ray
department and OR for use of
SOLUDEXIDE cautery
1 amp to incorporate with 50 cc PNSS in a soluset to
run for 1 hour  May have light breakfast
 Please prepare the ff:
FUROSEMIDE DRIP - Ultravist - 1 bottle
In a soluset 90 cc PNSS + 100 mg furosemide x 5
ugtts/min
- Dormicum 5 mg - 1 amp
- Buscopan 10 mg - 2 amps
HEPAMERZ DRIP
- Nalphine 10 mg - 1 amp
Hepamerz 4 amps + 250 D5W/ 500 D5W x 12H

R-CHOP (DR. TULIO) COLON CANCER

 Paracetamol 500 mg tab  Leucovorin + D5W x 2H
 Diphenhydramine 50mg cap  PNSS 1L + 5FU x 16H
 Tropisetron 1amp IV
ABSOLUTE
 Dexamethasone NEUTROPHIL
20mg slow IV 30COUNT
mins after  (FOLFOX)
pre meds Placebo x 90 mins
= Actual WBC x Segmenters
 Rituximab 100 mg in 100 cc PNSS x2 days Leucovorin + D5W 250cc
start at 5ugtts/min x 10 mins -Run simultaneously 2H (PUT
Neutropenia:
 If no untoward s/sx increase to 50cc x 10 OFF AIRCON)
Mild= mins
<1,500 cu mm
then 150 cc/H; 2nd bag at 150 cc/H  5FU M push
Moderate
V/S q=15<1,mins000 cu1stmm
for the H then qH  5FU + PNSS 1L x 46 H
 Follow
Severe = <500up with
cuRituximab
mm 500mg in 500 cc
PNSS @ 200 cc/H for the 1st H, then 200
cc/H
 Follow up with:
Vincristine 1 mg slow IV
Epirubicin 60mg in D5W 50 cc in soluset x
30 mins
 Cyclophosphamide 1g in D5W 250 cc x1 ½
H

ZOLEDRONIC ACID (ACLASTA) TOCILIZUMAB (ACTEMRA)

 Paracetamol 500mg 1 tab  PNSS 50000, discard 200 cc of IVF then
 CP status & vital signs FD 20000