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Treatment/Plan Greater than 3 Days

If unsure at 24-48 hours, it is not necessary to obtain a trough level before 72 hours.  Reassess entire patient daily for any changes that may lead down a different pathway in the algorithm.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.