creation date: 2026-08-14 21:51
tags: Reference
Admission Orders
Background
Admission orders are used when admitting a patient for inpatient care.
A common mnemonic is used for the components of the admission order is: ADC VANDISMAL.
Components
Admission
Where will the admission be to
- ICU
- Inpatient floor
Diagnosis
Admitting diagnosis
- COPD exacerbation
Condition & Code
The condition of the patient and the goals of care
- Stable vs. unstable
- Full code vs. no CPR vs. DNR
Vitals
Current vitals, monitoring frequencies, and parameters for notifying the provider.
- HR, BP, RR, SpO2
Activity
Activity level allowed for patient
- Bed rest vs. assistance required vs. ambulatory
- Fall risk
Nursing
Nursing instructions for daily tasks
- Weight measurements
- Wound care
- Urine output
If a patient is VTE low-risk or high risk of bleed, intermittent pneumatic compression may be indicated for VTE prophylaxis.
Diet
Diet during admission
- Low sodium
- Fluid restrictions
- Aspiration risk
Infusions
Infusions of blood/fluid
- Fluid type, rate, time
Specialists
Consults ordered or in progress
Medications
Patient medications
- Treatment
- Home medications
VTE prophylaxis is also ordered for most admissions. Options are as follows in order of preference:
- LMWH (enoxaparin) 40 mg (20 mg if eGFR <30)
- UFH if AKI, renal failure, or if rapid reversal may be needed (eg. pregnancy or imminent surgery)
- Fondaparinux if HIT
- Rivaroxaban if hip/knee surgery or post-stroke
If the patient is already on a DOAC, additional VTE is not necessary.
Allergy
Medication and food allergies, and reaction to allergen
Labs
Admission orders and any continuous testing required