Comfort Care Measures
(Last Updated - 7/5/2007)

-Dr. Smith's protocol

-Discontinue all lab draws and all meds except Morphine
-Start Morphine gtt @ 1mg/hr with 100 mg Morphine Sulfate in 100cc of NS
-Adjust Morphine gtt rate up or down in 50% increments Q30 Mins prn pain, agitation, dyspnea or discomfort
-Bolus w/ 4 mg Morphine IV Q15 Mins prn pain, agitation, dyspnea or discomfort
-Once modified Ramsay sedation score is >= 2 then set FiO2 to 21% and set PEEP to 0
-Place on IMV and keep rate and TV same as current
-Decrease IMV in 20% decrements Q30 Mins
-Once IMV is 20% of the starting value then extubate
-Remove oxygen once controlled after extubation
-Turn off the ventilator

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