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Focal Intracranial Infection
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...
Bivalent COVID-19 Boosters - Wide World of Vaccines - September 2022
On Aug. 31 the United States Food and Drug Administration amended the emergency use authorization of the Moderna COVID-19 and the Pfizer-BioNTech COVID-19 vaccines to authorize bivalent formulations for...
Dyslexia Screening - Pediatric Bioethics - October 2022
Identifying and helping children with dyslexia early can drastically improve their chance of reading at grade level. Pediatricians and schools need to work together to identify and screen these kids early...
Severe Cephalosporin Allergy
Trimethoprim-sulfamethoxazole: Cystitis or Pyelonephritis: 6-12 mg TMP/kg/day PO (max: 160 mg TMP/dose). OR Ciprofloxacin: Cystitis: Oral: Immediate release tablet or oral suspension: 20 – 40 mg/kg/day...
Asthma Reference Guide
The goal of this asthma care reference guide is to help clinicians provide quality care to children with asthma across the care continuum at Children's Mercy. This was done by summarizing national...
Asthma Control Tests
Questionnaires used at CM to assess asthma control Test for Respiratory and Asthma Control in Kids (TRACK) Test for Respiratory and Asthma Control in Kids (TRACK) for under 5 years of age AND has a history...
8. Treating Co-Morbid Conditions
Common co-morbid conditions that complicate the care of asthma include are reviewed here. These should be assessed as they may worsen asthma severity and complicate control of asthma. Allergic...
Four Extremity Blood Pressure
The clinical diagnosis of coarctation of the aorta is initially on characteristic blood pressure findings. The characteristic findings are based on the location of the aorta coarct. Most commonly, systolic...
Indications For Hematology Consultation
Initiation of therapy for patients: Age < 30 days Baseline INR ≥ 1.2 prior to initiation of warfarin Impaired renal function Maintenance of anticoagulation therapy with: Delay in reaching therapeutic...
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...
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...