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Neisseria Gonorrhea
Similar to infection with C. trachomatis, infection from N. gonorrhea among neonates results from perinatal exposure to the mother’s infected cervix. Acute illness typically is seen between 2 and 5 days...
Ketorolac
In the pediatric patient diagnosed with refractory migraine is ketorolac an effective treatment? Plain language summary from the office of evidence based practice: Based on very low quality evidence...
Acetaminophen
For children who rate their pain as mild (<3), and do not meet the exclusion criteria of the Analgesia Standing Order, either acetaminophen or ibuprofen may be administered. Acetaminophen is preferred if...
Diagnostic Testing
Does a head CT scan compared to no head CT scan change the management of a child with migraine? Plain language summary from the office of evidence based practice: Based on moderate quality evidence, the...
Troubleshooting Neurosurgical Shunts for Malfunction
Shunt malfunction may occur at ANY TIME after shunt placement with the risk of malfunction being the highest in the first 6 weeks post shunt surgery. Patient's symptoms are usually progressive, rarely...
Contraindications to Alteplase IV for Acute Stroke in Childhood
Patient last seen well more than 4.5 hours previously. Patients in whom time of symptom onset is unknown. Prior stroke, major head trauma or intracranial surgery within the last 3 months. History of prior...
Family Education
When there is a concern that a child may be at risk for sepsis, it is important to start communicating with the family. Here are some talking points to share with parents/caregivers: Our staff is going to...
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...
Flu Season - Wide World of Vaccines - October 2022
As we prepare for the upcoming flu season, it is vital to inform our patients that it may be a very strong flu season and to emphasize the importance of getting vaccinated.
SSTI: Impetigo (Images)
For Children's Mercy providers: https://www-visualdx-com.ezproxy.cmh.edu/visualdx/diagnosis/non-bullous+impetigo?moduleId=103&diagnosisId=51763&lang=en_US#view=text&gid=1&pid=7 https://
Exclusion Criteria
Concern for sepsis: Sepsis - ED/Inpatient Sepsis - ICU Chronic kidney disease. Suspected OR known genitourinary abnormalities, such as (but not limited to): previous genitourinary surgery (other than...
16. Asthma Education Resources
External website for families Medication Access and Co-Pay Assistance Programs Pippin the Puffin Asthma Price Cap Guide Preferred Asthma Combination and Biologic Products by Insurance 16. Asthma...
Fast Facts
Low molecular weight heparin (LMWH) is the anticoagulant of choice for most pediatric patients Advantages include: Minimal monitoring requirements Reduced interference of other drugs and diet Reduced...
Treatment/Plan Greater than 3 Days
If unsure at 24-48 hours, it is not necessary to obtain a trough level before 72 hours. Reassess entire patient daily for any changes that may lead down a different pathway in the algorithm.
Elevated Serum Creatinine
1) An increase of >0.5mg/dL from baseline OR 2) Greater than or equal to 50% increase in serum creatinine from baseline OR 3) Any patient with an elevated serum creatinine based on normal range for patient...
AOM – Moderate/Severe Bulging of Tympanic Membrane (TM)
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...
AOM – Tympanic Membrane Perforation
Images for AOM Tympanic Membrane Perforation: Children’s Mercy Providers Providers without Children’s Mercy privileges These pathways do not establish a standard of care to be followed in every...
1. Introduction to Asthma
Brief definition “Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. In susceptible individuals, this inflammation causes recurrent episodes...
Allergic Bronchopulmonary Aspergillosis (ABPA)
Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction within airways occurring almost exclusively in patients with asthma or cystic fibrosis. Less commonly reported in patients with...
10. Yellow Zone Therapy Options
Yellow zone therapies are hotly debated in regard to treatment. In the EPR 4, the expert panel reviewed the use of intermittent ICS and looking at three critical outcomes (exacerbations, asthma control and...