Back

Admission Orders

Edit

Admission Orders:

  1. General Admission Orders (NEUROLOGY GENERAL ADMISSION MSH IP)

  2. Discuss PLEX versus IVIG with attending

  3. IVIG:

    • Check IgA first to avoid anaphylaxis in pts who are IgA depleted, use IgA depleted formulation while awaiting IgA results.

    • Baseline and Daily CBC, LFT’s, Chem-7, mag, phos

    • Dose is 0.4g/kg/day X5 days; give with 500cc NS bolus before and after

    • Risks: aseptic meningitis, rash, renal failure (from sucrose), hyperviscosity stroke, volume overload

  4. Plasmaphoresis (PLEX):

    • Contact blood bank attending who oversees PLEX

    • Shiley placement

    • Number of sessions determined by attending

    • Baseline and Daily CBC, LFT’s, Chem-7, PT/PTT, Fibrinogen

    • Risks: hypotension, sepsis

  5. Consider Tensilon test, LP, EMG, Antibody assays (see below for details)

  6. NIF/VC at least BID

  7. Discuss administration of steroids and mestinon w/attending. Note: mestinon 1mg IV = 30mg PO

  8. Immunization w/inactivated vaccines only