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Pulmonary Embolism Risk Stratification
Low Risk: Acute PE and the absence of the clinical markers of adverse prognosis that define massive or submassive PE and oxygen requirement of less than 2L. Intermediate Risk (Submassive): Acute PE without...
Redness
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...
Toddler Tibia Fracture: Mepilex Foam Secured With Tape
Cleanse wound with sterile saline and gauze. Dry thoroughly with gauze. Apply a square of Mepilex® over the wound (silicone side touches wound). Secure with 1-2 pieces of Primafix™ tape. Change every other...
What's the Diagnosis - October 2022
An 11-day-old male presents to the emergency department with his mother for concerns of intermittently increased respiratory rate. He started having some subcostal retractions with increased work of...
Kirby Bauer Testing
In January 2010, the Clinical and Laboratory Standards Institute (CLSI) published new minimum inhibitory concentration (MIC) breakpoints for cefazolin against Enterobacteriaceae (Wayne, 2010). These new...
4. Goals of Asthma Therapy and Management
The complete EPR 4 working group report and GINA reports are widely available for review. In this reference guide we will only highlight key aspects of these guidelines. EPR-4 Update report GINA 2020...
Caregiver Tobacco and Smoking Cessation Support
Children's Mercy Kansas City smoking cessation support process Medical team training National resources Local/state resources Caregiver Smoking Cessation Support at CM - Instructions for Medical Team...
Febrile Infants: CSF Studies
Cell count. Bacterial culture. Gram stain. Protein. Glucose. Enterovirus PCR (summer and fall) or evidence of viral meningitis. HSV PCR (if pleocytosis). These pathways do not establish a standard of care...
Acute Chest Syndrome: Severe or Rapidly Progressing ACS
Symptoms of Severe or Rapidly Progressing Acute Chest Syndrome: Oxygen saturation below 90% despite supplemental oxygen, Increasing respiratory distress, Progressive pulmonary infiltrates, and/or Decline...
Atopic Dermatitis: Infected - Practical Guidelines to Obtain Skin Cultures
Aerobic Culture Perform hand hygiene. Obtain e-swab. If needed, gently clean affected site with sterile saline on sterile 4x4 gauze pad. Avoid using alcohol to clean specimen site. ...
Chlamydia Trachomatis
Among infants bom to untreated mothers with Chlamydia trachomafis infections, the overall risk of disease is estimated at 50 to 75% and typically involves the mucous membranes of the eye, oropharynx...
Constipation: Rome IV Criteria for Constipation
Neonate/Toddler Child/Adolescent 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...
Prochlorperazine With or Without diphenhydrAMINE
In the pediatric patient diagnosed with a refractory migraine, is prochlorperazine an effective treatment compared to ketorolac, metoclopramide, sodium valproate, IV magnesium? Plain language summary from...
Decrease Environmental Stimuli
Minimization of environmental stimuli no: Bright lights. Strong smells. Excessive loud noises. Cell phone/text message usage in room. Television usage. Keep patient door closed. Minimal visitation. Level...
Myelomeningocele: MRI and Renal Ultrasound
Infant may be on back and swaddled for MRI. Protect large lesion with donut as needed. These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is...
Myelomeningocele: Recommendation if Born at Outside Hospital Post-natal Repair
Immediate transfer to Children's Mercy. Post-natal repair care: Keep moist with saline gauze. Cover with Tegaderm®. These pathways do not establish a standard of care to be followed in every case.
Catheter Directed Thrombolysis
tPA 0.1-0.3 mg/kg (max dose 10 mg) bolus followed by 0.01-0.03 mg/kg/hr (max 2 mg/hr) x 24-72 hrs. Administer heparin at 10 units/kg/hr or decrease direct thrombin inhibitor rate by 50%. These pathways do...
Insulin Drip
For algorithms related to this topic, please visit our complete list of Clinical Practice Guidelines and Care Process Models. BUTTON: 10/2022 See all algorithms Insulin Drip...
Cerebral Edema Therapy
Those at increased risk include younger age (<5 y/o), new onset diabetes, and longer duration of symptoms. Additional risk factors at diagnosis or during treatment include - more severe acidosis or very...
Toddler Tibia Fracture: Inclusion and Exclusion
Inclusion Criteria: Patients aged 1 to 4 years. Not bearing weight. Low energy mechanism, defined as: Fall from standing. Trip and fall Injury at the bottom of a slide. Stable tibial shaft or distal tibia...