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Bruising

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...

October

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Genomic Answers for Kids: Sharing Project Data

Genomic Answers for Kids uses new and innovative ways to share project data, publications, and guide researchers on accessing the data.

Atopic Dermatitis: Noninfected - Wet Wraps

Wet wraps: Are used to help moisturize and soothe the skin. TO BE USED WITH TOPICAL STEROIDS AND MOISTURIZERS ONLY (not with Protopic or Elidel). For a demonstration of how to apply wet wraps...

Mary Ann Queen, MD | Children's Mercy Research Institute

Mary Ann Queen, MD, is the Interim Chair of the Department of Pediatrics at Children’s Mercy and at the University of Kansas Medical Center. At the University of Missouri – Kansas City School of Medicine...

Summer Scholar Program

The Department of Orthopedic Surgery at Children’s Mercy is offering a summer research experience to 2 medical students with an interest in orthopedic surgery. This program allows the students to build...

Tympanic Membrane Perforation

Tympanic membrane (TM) perforation A hole in the eardrum is called a tympanic membrane (TM) perforation. If your child has a TM perforation, they still may get ear infections. The infection will look...

Oral Cephalosporins - Wise Use of Antibiotics - October 2022

Oral broad-spectrum cephalosporins, such as cefdinir, are some of the most inappropriately prescribed antibiotic classes in pediatrics. They should not be used routinely to escalate therapy for patients...

SSTI: Cellulitis or Erysipelas (Images)

For Children's Mercy providers: https://www-visualdx-com.ezproxy.cmh.edu/visualdx/diagnosis/cellulitis?moduleId=103&diagnosisId=51263&lang=en_US#view=text&gid=1&pid=2...

SSTI: Antibiotic Dosing

Abscess: PO: Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose). Alternative therapy: TMP-SMX 4-6 mg/kg/dose (trimethoprim component) PO BID (max 160 mg TMP/dose). IV: Clindamycin. Cellulitis or Erysipelas...

6. Asthma Outpatient Management

Initial visit tables/ Follow-up tables/ Step therapy tables Initial visit Tables/ Follow up Tables/ Step Therapy tables are included. These tables are used to highlight the similarities and differences...

Severity of Asthma Exacerbation

    Mild Moderate Severe Respiratory Rate  2-3 yrs: <34/min  4-5 yrs: <30/min 6-12 yrs: <26/min >12 yrs: <23/min 2-3 yrs: 35-39/min 4-5 yrs: 31-35/min 6-12 yrs: 27-30/min...

Antihypertensive(s) and/or Lifestyle Modifications

Severe BP elevation means a BP consistently ≥ 99th percentile. Consult Nephrology if ≥ 2 doeses in 24 hours required to normalize BP.

Initiation and Maintenance

Initiation of enoxaparin therapy: Obtain blood for baseline CBC, PT, PTT. Calculate enoxaparin dose (mg) based on age, weight and indication. See Table 1. Table 1 - Initial Dosing of Enoxaparin...

Continuation Of Therapy - Day 5 Forward

Target INR for patient who have completed Day 1 - 4 of the initiation protocol: 2.5 - 3.5 for patients with mechanical /prosthetic valves or recurrent thrombotic events 2 - 3 for ...

Automatic Reflex Aerobic Eye Culture Recommendations

The Conjunctivitis Team along with the Red Book and the Children's Mercy Department of Infectious Diseases recommends eye culture in the low risk group for GC, Chlamydia, and HSV. This recommendation is...

Constipation: RED FLAGS for Underlying Disease Causing Constipation

RED FLAGS to consider: Meconium not passed in first 48 hours as a newborn. Family history of Hirschsprung disease. Blood in the stools with fever. Failure to thrive (chronically low weight for height).

Dihydroergotamine (DHE)

In the pediatric patient diagnosed with a refractory migraine, what is the efficacy of DHE IV to decrease migraine pain in the Emergency Department? Plain language summary from the office of evidence based...

Triptan

DHE cannot be given if the patient has received triptans with the previous 24 hours (Lexi-Comp, 2016). These pathways do not establish a standard of care to be followed in every case. It is recognized that...

Migraine Therapy in the ED

Guideline inclusion criteria:  Children up to 18 years of age. Physical exam normal. History consistent with primary headache. Guideline exclusion criteria: Abnormal physical exam normal. History...