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Confidential Documentation
Recommend confidential provider note type If test are still pending, must ensure Confidential Information Form is complete with patient's contact information Search for form as an order Once entered...
IV Contrast for MRI and CT: Population at Risk for Acute Kidney Injury
Stem cell transplant Acute or past treatment of oncologic disease Congenital heart disease Undergoing cardiopulmonary bypass Single ventricle physiology History of heart transplant Solid organ transplant...
IV Contrast for MRI and CT: Contrast-associated Acute Kidney Injury
Any acute kidney injury (AKI) occurring within 48 hours after the administration of contrast media. The term post-contrast acute kidney injury (PC-AKI) is synonymous with contrast-associated acute kidney...
IV Contrast for CT & MRI in Kidney Disease
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 subject...
IV Contrast for MRI and CT: Risks and Benefits of Contrast Administration
The potential risks for developing serious skin conditions such as nephrogenic systemic fibrosis (NSF) related to the modern gadolinium-based contrast agents are extremely low even in patients with...
IV Contrast for MRI and CT: Order or Calculate eGFR-CR
CMH Order: "eGFR-Cr" OR Estimate eGFR-CR (link) *Current height and serum creatinine needed These pathways do not establish a standard of care...
Abdominal Pain: Metronidazole
Do not take on an empty stomach Even a small amount of food will decrease the chances of getting nausea with the medication Avoid alcohol while taking the medication, as this can cause vomiting Be sure...
Abdominal Pain: PPIs Maximum Starting Doses
Omeprazole (Prilosec): 40 mg daily Esomeprazole (Nexium): 40 mg daily - Available in powder form Lansoprazole (Prevacid): 30 mg daily Rabeprazole (AcipHex): 20 mg daily Pantoprazole (Protonix): 40 mg daily...
Newly Diagnosed Solid Tumor
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 subject...
Empiric STI Treatment:
While tests are pending, empiric treatment for Chlamydia and Gonorrhea should be provided for those at increased risk (e.g., women <25 years, new sex partner, known STI exposure), if follow-up cannot be...
Croup - Evidence Based Strategies - November 2022
Although it takes time to provide additional doses of racemic epinephrine with observation following each administration in the emergency department or urgent care setting, this strategy may allow time for...
Childhood Vaccination Rates Drop - Wide World of Vaccines - November 2022
From 2019 to 2021, WHO and UNICEF reported the largest sustained decline in childhood vaccinations in 30 years due to missed appointments during the COVID-19 pandemic.
Recommended Partner Notification
Recommend that the patient notify sexual partners by: Partner notification card OR TellYourPartner.org Health Department involvement: Can assist with partner notification for Gonorrhea and Chlamydia upon...
What's the Diagnosis - November 2022
A 2-year-old female presents with a one-week history of fever up to 39.3 C, cough, malaise and decreased oral intake. She is fussy and tired on exam, but not toxic appearing. The family denies history of...
STIs in Adolescents and Young Adults - Hot Topics - November 2022
Less engagement in health care services following the pandemic coupled with rising STI infection rates make this a crucial time to lean into screening, testing and treating AYA in need of these services.
Pectus Bar Repair with Bar Placement ERAS
Enhanced Recovery After Surgery (ERAS) pathways promote an evidence based, multidisciplinary approach to patient care aimed at facilitating faster recovery from surgery, decreasing hospital length of stay...
Poliomyelitis - Hot Topics - September 2022
Cases of poliovirus type 2 have been detected in wastewater samples from Rockland and Orange Counties in New York. Despite ongoing efforts at eradication, sustained and increased immunization coverage is...
SSTI: Abscess (Images)
For Children's Mercy providers: https://www-visualdx-com.ezproxy.cmh.edu/visualdx/diagnosis/skin+bacterial+abscess?moduleId=102&diagnosisId=51001&lang=en_US#view=text&gid=1&pid=2...
7. Treating Modifiable Risk Factors
References: Quinto, Kenneth B. Environmental tobacco smoke exposure in children aged 3-19 years with and without asthma in the United States, 1999-2010. no. 2013. US Department of Health and Human...
Obesity and Asthma
The relationship between obesity and asthma is complex and linked to biologic, physiologic, environmental factors. There is an increased prevalence of asthma in children with obesity as well as a...