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Chart body temperatures and water temperature q 1 hour on critical care flow sheet. Medications: Buspirone 10 mg PO q 8 hours, first dose now to prevent shivering. D/C when patient is 37 degrees or higher Fentanyl 50 mcg IV q 1 hour prn shivering Meperidine 50 mg IV q 1 prn shivering, if patient continues to shiver after 5 doses. Call ICU fellow. Norepinephrine-titrate to maintain MAP greater than ______mmHg Nicardipine-titrate to maintain MAP less than _______mmHg Contact ICU fellow for additional sedation orders. No sedation interruption for the 24 hours of cooling. Control cooling for 24 hours after attaining target temperature of 33 degrees. Begin rewarming over 12 hours targeting an increase of about 0.3 degrees every hour, or about 1 degree q 3 hours until normothermia is achieved. Keep arctic sun device on the patient after rewarming to 37 degrees for the next 24 hours. Place Bair Hugger on patient during cooling and rewarming. Set temperature to 43 degree Chem 6 and magnesium q 4 hours while cooling and rewarming. Initiate Electrolyte protocol. Watch for hypokalemia during cooling and hyperkalemia during rewarming. Finger sticks q 4 hours. Insulin drip protocol if FS greater than 150 for 2 measurements. i stat ABGs q 4 hours. Ensure that true body temperature is recorded in the device. Ventilator setting changes should be made from i stat results only. Call ICU team if: HR < 50 bpm or > 110 bpm Cooling device water temperature drops below 8 degrees after goal temperature has been attained. 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