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Use of Nebulized Hypertonic Saline
Bronchiolitis Clinical Pathway Committee recommendation: Based on very low quality evidence, a conditional recommendation is made against use of nebulized 3% hypertonic saline (HS) for routine management...
Signs and Symptoms
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Supplemental Oxygen
The Bronchiolitis CPG Committee recommends using supplemental oxygen to maintain an oxygen saturation ≥ 90%, based on the American Academy of Pediatrics (AAP, 2006) statement for the care of the patient...
Laboratory Tests and Chest X-rays
The Bronchiolitis CPG Committee recommends not routinely obtaining laboratory tests such as CBC & differential, basic metabolic panel, blood culture, RSV PCR, Flu A&B PCR, or chest x-ray for the infant...
Fluid Choice and Blood Products
These pathways 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...
Respiratory Support
These pathways 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...
Intubation and Sedation Medications
References Children's Hospital of Philadelphia (2023). Intubation/sedation medications. https://www.chop.edu/clinical-pathway/sepsis-emergency-department-inpatient-picu-clinical-pathway Vet, N.J., Kleiber...
IV Escalation Plan
References Children's Hospital of Philadelphia (2023). Immediate IV access, IV escalation plan. https://www.chop.edu/clinical-pathway/sepsis-immediate-iv-access-iv-escalation-plan-ed-inpatient-picu Weiss...
Link Newsletter - May 2023
Our May issue features the latest news and updates on pediatric care from Children's Mercy clinicians. We want to hear from you! Do you have ideas, questions or suggestions for future articles in The...
State of the Art Pediatrics: What Can You Do About Food Allergies?
Food allergy is a common complaint. The most common food allergies in children are milk, eggs, peanuts and tree nuts. The best test for food allergy is a history of what happens when the food is...
Outbreaks, Alerts and Hot Topics: Rabies in Bats
Human rabies infection is a rare event in the United States. However, post-exposure prophylaxis (PEP) must often be considered for many individuals who have potential exposures to rabies.
Evidence Based Strategies: ECG Screening for Sports Physicals
A thorough history and physical exam can often detect indications for an ECG or other testing in pediatric athletes prior to sports participation. A screening ECG may identify a patient at risk of SCD...
Micrognathia
Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of...
Laboratory Studies
Consider Inflammatory Conditions That May Manifest With Fever and Shock Kawaski Disease While rare, shock may be present in children with Kawasaki disease (Çakan et al., 2016) Multisystem Inflammatory...
Systematic Screening for Sepsis/Septic Shock
References Bonfide, C.P., Brady, P.W., Keren, R., Conway, P.H., Marsolo, K., & Daymont, C. (2013). Development of heart and respiratory rate percentile curves for hospitalized children. Pediatrics...
Fluid Resuscitation
Fluid Therapy Administer a LR or NS fluid bolus of 10-20 mL/kg if shock present Monitor response to fluids (Vital Sign Targets and Clinical Goals for Initial Resuscitation) Tailor fluid therapy to the...
Sepsis Huddle
(can be initiated by any member of the care team at any time when there is a concern) Intended to identify evidence of organ dysfunction Conduct huddle at beside, if possible Discuss clinical exam findings...
Link Newsletter - April 2023
Our April issue features the latest news and updates on pediatric care from Children's Mercy clinicians. We want to hear from you! Do you have ideas, questions or suggestions for future articles in The...
Outbreaks, Alerts and Hot Topics: Undescended Testicles: Steps to Follow Prior to Urology Referral
Scrotal exams should be performed at all well-child checks to ensure testicles are descended. Any undescended testicles that persist after 6 months of age are unlikely to descend spontaneously and need to...
Emergency Declarations Are Expiring. What Does This Mean for COVID-19 Vaccines?
The emergency declarations related to COVID-19 are expiring. If they have not already, patients and families may ask you what this means for them. Are you prepared to respond?