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Options For Obtaining Warfarin Doses With Available Strength

Appendix I - Warfarin Dosing Adjustment Using One Tablet Strength 1 mg tablet strength Total weekly dosage Sunday Monday Tuesday Wednesday Thursday Friday Saturday 5.5 mg 1 tablet 0.5 tablet 1 tablet 0.5...

Dietary Considerations

Parents should notify physician for: Significant changes in diet with foods high in Vitamin K: Kale, spinach, broccoli, cauliflower, turnip greens, chick peas, brussel sprouts, green tea, soybean oil, liver...

Atopic Dermatitis: Infected - Group A Strep

Strep Pyogenes (Most common Group A Strep):  Glazed, bright red appearance especially in skin folds suggests Group A strep.  Patients may also experience yellow drainage.  When appearing within...

Multisystem Inflammatory Syndrome in Children (MIS-C): ED

An individual aged <21 years presenting with feveri, laboratory evidence of inflammationii, and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement...

Epidemiology

In most western countries, type 1 diabetes accounts for over 90% of childhood and adolescent diabetes, although less than half of individuals with type 1 diabetes are diagnosed before the age of 15 years.

Patients Undergoing a Surgical OR Endoscopy Procedure With a Presumed Risk for Adrenal Crisis

Situations in which operative steroid stress-dosing is necessary: Patient is taking steroids and exhibits Cushnoid features. Situations in which stress-dose steroids maybe necessary: Daily inhaled...

Hydration Considerations

Maintaining a high UOP with adequate hydration is the most important factor in preventing TLS. Improves renal perfusion, GFR and minimizes acidosis. This prevents precipitation of uric acid and Ca-P...

AOM – Penicillin Allergy

Mild/Moderate: Hives Single organ system Excludes side-effects such as vomiting and diarrhea Excludes family history but not individual history of penicillin allergy Severe: Drug reaction with eosinophilia...

Blisters

Children’s Mercy obtained permission to use this picture for educational purposes. These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is...

Patient is Suspected to Have TLS

Patients may present with metabolic derangements along (laboratory TLS) or both laboratory and clinical sequalae. Laboratory TLS (LTLS): Level above or below normal limits for age for 2 or more of the...

AOM - Special Considerations

Patients with anatomic/craniofacial abnormalities or cochlear implants are not candidates for “watchful waiting.” Recommend 10 days of antimicrobial treatment. Patients with immunodeficiencies may be at...

AOM – Otitis Externa

Otitis externa (“swimmer’s ear”) is inflammation of the external ear canal leading to severe otalgia and tenderness to palpation. Erythema, edema, drainage, and pruritis may be present. It is often preceded...

AOM – Role for Oral Cephalosporins

The AOM guidelines from the American Academy of Pediatrics include enteral second and third generation cephalosporins, including cefdinir and cefpodoxime, as alternative agents for initial treatment of...

Bylaws

Membership Members must: Currently be a patient at Children's Mercy. Be 13-18 years old. *Members may be older if they are still a patient at Children’s Mercy. Attend at least 40% of meetings and...

SSTI: Paronychia (Images)

For Children's Mercy providers: https://www-visualdx-com.ezproxy.cmh.edu/visualdx/diagnosis/bacterial+paronychia?moduleId=102&diagnosisId=52121&lang=en_US#view=text&gid=1&pid=2 https://

SSTI: Severe Infection

Patients who have failed incision and drainage plus oral antibiotics or those with systemic signs of infection such as fever, tachycardia for age, tachypnea for age, or abnormal white blood cell count (<12...

Febrile Infant: Observing Closely at Home

Infant may be managed at home if parent and clinician agree that the following are present: reliable phone and transportation, parent willingness to observe and communicate changes in condition, and...

Genotyping

CYP2C9 and VKORC1 genotype results may provide directional guidance for warfarin dosing in pediatric patients. Clinical genotyping is available through the CMH Laboratory. Approximately 50% of the...

Atopic Dermatitis: Infected - Eczema Herpeticum

Symptoms: widespread skin involvement, pain, fever. Rapidly spreading lesions. Likely history of exposure to HSV. Pustules or vesicles rapidly changing into painful erosions. Occasionally vesicles or...

Atopic Dermatitis: Infected - Impetigo (Staph Aureus)

Can be bullous (bullae forming) or non-bullous impetigo.   Often from secondary scratching.   Non-bullous impetigo: yellow, honey-colored crusting usually within areas of eczema. ...