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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...
November
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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...
Constipation: Rome IV Neonate/Toddler Criteria for Constipation
Rome IV Criteria for Constipation -Neonate/Toddler, Benninga et al. (2016) One month of at least 2 of the following in infants up to 4 years of age: Two or fewer defecations per week. History of excessive...
Metoclopramine With or Without diphenhydrAMINE
In the pediatric patient diagnosed with refractory migraine, is metoclopramide an effective treatment? Plain language summary from the office of evidence based practice: Based on very low quality evidence...
Typical Laboratory Findings in Sickle Cell Disease
Genotype Hb* (g/dL)† HbS* (%) HbA* (%) HbA2* (%) HbF *(%) HbC* (%) SS 6–9 >90 0 <3.5 <10 0 Sβ0-thalassemia 7–9 >80 0 >3.5 <20 0 Sβ+-thalassemia 9–12 >60 10–30 >3.5 <20...
Children’s Mercy Research Institute Leadership
Meet the leadership team at the Children’s Mercy Research Institute, an integrated research environment where no boundaries exist between science and medicine.
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Children’s Mercy Research Institute advances pediatric health through integrated, collaborative studies and clinical trials aimed at bringing the fruits of scientific discovery right to a child’s bedside.
Severe Penicillin Allergy
Avoid cephalexin due to same side-chain as penicillin. Other cephalosporins may be tolerated: Ceftriaxone: Cystitis or pyelonephritis: 50 mg/kg/dose IV or IM q24h (max: 2000 mg/dose). OR Cefixime: 8 mg/kg PO...
2. Asthma Diagnosis
The diagnosis of asthma is clinical. Asthma is defined by: Chronic recurrent respiratory symptoms (coughing, wheezing, chest tightness, shortness of breath) Variable airflow limitation (evidenced in...
13. Special Asthma Considerations for Inpatient
Patients who present with status asthmaticus that meet admission criteria are admitted to the General Pediatrics service. Both an Asthma Exacerbation clinical practice guideline and a powerplan are...
15. Respiratory Support for Asthma Exacerbation
Oxygen Support Oxygen can be provided through several modalities; an overview is provided below. Nasal Cannula (NC) Nasal cannula is a low flow set up. Flow range: 1/32 LPM to 4 LPM using oxygen from the...
LMW Heparin Antidote
Antidote: Termination of the subcutaneous injection generally will terminate the anticoagulant effect. If immediate reversal is required protamine sulfate will result in partial neutralization. If the...
Heparin Antidote
Termination of the IV infusion generally will terminate the anticoagulant effect. If immediate reversal is required protamine sulfate will result in neutralization of heparin. The dose of protamine...
Initiation of Therapy Days 1-4
Warfarin is generally started on day 1 or 2 of heparin or low molecular weight heparin (LMWH) therapy. Heparin or LMWH administration should overlap with warfarin for a minimum of 6 days and until INR is...