The Panels

At my hospital:

cardiac = cardiac enzymes, metabolic panel, CBC, coags and BNP. Possibly TSH/T4 if indicated.

sepsis = metabolic panel, CBC, probably cardiac enzymes & coags if elderly or has a cardiac hx, blood cultures x 2.

Cardiac: CBC, Lytes, BUN/Creat, PT/PTT, Troponin, CK/CKMB. Sometimes D-Dimer or BNP, if indicated

Sepsis: CBC, Lytes, BUN/Creat, UA/Urine Culture, Blood Cultures x2.

Standing orders at the hospital I work at--

Chest Pain/Cardiac:

CBC, CMP, CK, Troponin, PT/PTT, saline lock, PCXR/CXR, EKG, cardiac monitor, continuous SPO2, oxygen at 2L/min via NC

Fever-- R/O Sepsis:

CBC, CMP, UA/C&S, blood cultures x2 if temp >101`F, saline lock, continuous SPO2, oxygen at 2L/min via NC, PCXR/CXR (probably cardiac monitor and EKG depending on the age)

The techs and nurses can initiate these labs and treatments as soon as the patient hits the bed as the medical director has signed off on them. It really sped up the turn around time once these standing orders went into place... we don't have to wait on the doctor to write the orders. Usually by the time the doctor gets to the patient, some of the results have started to come back. We have others for abdominal pain, asthma, diabetics with altered mental status, extremity injuries, GI bleeds, lacerations, overdose/ETOH, psychiatric, seizures, shortness of breath--CHF, shortness of breath--pneumonia, possible stroke, hip fx, urinary sx/UTI, and lady partsl bleeding.

Cardiac-CBC, BMP, PT/PTT, PCXR EKG ASA and A Saline lock.

Sepsis-CBC, CMP, Urine and cx, BC x 3 Chest PA (lat if stable) and fluids.

CHF is Cardiac plus a BNP

We also have abd pain, psych etc. that we use. IT speeds up the process a lot!