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Febrile Infant: Antibacterial Therapy and Empiric HSV Therapy
Initial Empirical Antibacterial Therapy for Well-Appearing Infants 7 to 60 Days Old (These are INITIAL antimicrobial recommendations and should be re-evaluated for appropriateness at 48 hours after...
Acute Chest Syndrome: Is the Patient Exhibiting Signs Necessitating PICU Care?
Admission to PICU or Hem/Onc service depends on clinical status. If status indicates a more severe course, a PICU admission is warranted: Multilobar disease without pleural effusion Increased work of...
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...
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: Noninfected and Infected - Topical Steroids
Classification of Topical Steroids Most Potent - Class I, Least Potent - Class VII *High potency Class I: Super-potent: Clobetasol 0.05% ointment, cream, solution, and foam. Class II: High...
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. ...
Azithromycin
Rationale, current evidence, and consensus statement: The 2015 Red Book and the 2015 CDC Treatment Guidelines for STD's recommends that young infants with C. trachomafis conjunctivitis may be treated with...
Recommendations for Inclusion or Exclusion from Daycare/School
There is no evidence based support for exclusion or isolation of children with bacterial or viral conjunctivitis. Arguments in support of isolation include reports of epidemic outbreaks in enclosed...