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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...
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...
Bronchiolitis Synopsis
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...
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...
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...