Download Prevention of Contrast Induced Nephropathy (CIN

PLACE LABEL HERE
PREVENTION OF CONTRAST
INDUCED NEPHROPATHY (CIN)
ORDERS
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
1.
Weigh patient and record: ______ Kg
2.
Procedure Name:__________________________________Date/Time of Procedure:_________/________
3.
If GFR < 30, notify physician to determine if holding contrast or using alternative study without contrast is
feasible.
MONITORING:
4.
Chem-7 daily x 2 days starting day after procedure, unless discharged.
5.
Monitor urine output post-procedure x 48 hrs or until discharge. Notify physician if urine output < 250 ml
per 8 hr shift.
HOLD MEDICATIONS:
6. Hold metformin containing medications on day of procedure and resume 48 hrs post-procedure.
7. Hold NSAIDs on day of procedure
8.  Hold diuretics on day of procedure
9.  Hold other meds on day of procedure: ______________________________________________________
MEDICATIONS:
10.  Inpatient Orders:
Normal Saline (NS) infusion:
Start NS infusion 12 hrs pre-procedure and continue 12 hrs post- procedure at a rate of:
 1 ml/kg/hr IV
or  0.5 ml/kg/hr IV (for patients with EF < 40% or CHF, max rate 65 ml/hr)
(Procedure does not need to be delayed if patient has not completed 12 hrs of pre-procedure IV fluids,
however, an additional fluid bolus pre-contrast may be warranted.)
11.  Outpatient or Emergent Orders:
Normal Saline infusion:
Pre-Procedure: 3 ml/kg/hr IV for 1-3 hrs prior to procedure (min of 300 ml pre-procedure is suggested),
then
Post-Procedure: Decrease rate to:
 1.5 ml/kg/hr IV x 4 hrs
or  1 ml/kg/hr IV x ____hrs (6-12 hrs depending on deposition)
______________
Date
______________
Time
_________________________________
Physician Signature
___________
PID Number
Copy to pharmacy
*1-18540*
FORM 1-18540 REV. 08/2014
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