Northbank Surgical Center
Physician's Order Sheet
Admit to Northbank Surgical Center
Check Medication Reconciliation sheet for allergies.
Routine admitting vital signs
Anesthesiologist to evaluate patient if MAC
Start saline lock. May use lidocaine 2%, 0.1 to 0.2 ml for local anesthesia for insertion of IV needle.
- Proparacaine 0.5% ophthalmic solution, 1-3 drops in operative eye PRN.
- Give 1 drop of Compounded DILATING ophthalmic solution [contents below] in operative eye;
repeat in 10 minutes PRN:
Give 0.5mg Versed IVP on call to OR.
Check blood glucose level preoperatively on all insulin dependent patients.
If lists, and/or patient reports EVER using an alpha adrenergic medication, give Atropine Sulfate 1% ophthalmic solution, 1 drop in operative eye; repeat in 5 minutes.
Routine per preference card
PHYSICIAN ORDER SHEET Rev. 06/17