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Constipation: RED FLAGS for Underlying Disease Causing Constipation
RED FLAGS to consider: Meconium not passed in first 48 hours as a newborn. Family history of Hirschsprung disease. Blood in the stools with fever. Failure to thrive (chronically low weight for height).
AOM – Otitis Externa
Otitis externa (“swimmer’s ear”) is inflammation of the external ear canal leading to severe otalgia and tenderness to palpation. Erythema, edema, drainage, and pruritis may be present. It is often preceded...
Anaphylaxis – Tryptase
Tryptase levels may be elevated in the setting of anaphylaxis. However, this lab is not rapidly available and is not useful in the immediate management of the patient. It may be useful in case of recurrent...
Febrile Infant: HSV Studies
HSV Studies: Less than 46 Days Old HSV blood PCR HSV CSF PCR HSV cutaneous lesions PCR – unroof one or more vesicular lesions and obtain vesicular fluid on an appropriate swab HSV surface swabs PCR – swab...
High Flow Nasal Cannula Holiday
This algorithm is part of the Children's Mercy High Humidity/High Flow Nasal Cannula Administration policy. Refer to policy for more information. These pathways do not establish a standard of care...
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...
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...
Patient is Suspected to Have TLS
Patients may present with metabolic derangements along (laboratory TLS) or both laboratory and clinical sequalae. Laboratory TLS (LTLS): Level above or below normal limits for age for 2 or more of the...
Seizure: First, Non-Febrile
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What's the Diagnosis? April 2021
A previously healthy, 12-month-old female presents with a rash. Parents first noticed red papules and vesicles on her trunk two days ago which have now spread in a clustered pattern to her face, back and...
Outbreaks, Alerts and Hot Topics: Typhoid Update
Typhoid fever remains a significant concern worldwide, primarily in low- and middle-income countries. Antibiotic resistance and poor sanitation contribute to higher rates, though vaccine distribution in...
Pulse Oximetry and Skin Pigmentation
This article examines the evidence surrounding the role of skin pigmentation and other factors in the accuracy of pulse oximetry as a diagnostic tool.
Unsure of the COVID-19 Vaccine?
Children's Mercy understands that you may be hesitant for your child to receive the COVID-19 vaccine. Watch a short video on why the vaccine is safe for your child.
Pharyngitis Images
For Children's Mercy providers: Streptococcal pharyngitis image 1 (tonsils with palatal petechiae) Streptococcal pharyngitis image 2 (palatal petechiae) Streptococcal pharyngitis image 3 (tonsillar...
Outbreaks, Alerts and Hot Topics October 2021
Clinicians should be aware of recent human brucellosis cases in the United States caused by an antibiotic-resistant RB51 bovine vaccine strain and related to raw milk consumption.
Wide World of Vaccines November 2021
I recently watched an episode of 20/20 featuring children who developed OCD, outbursts and tantrums, seizures, catatonia, and paranoia following a diagnosis of streptococcal pharyngitis. Some of the...
Wise Use of Antibiotics August 2021
I recently watched an episode of 20/20 featuring children who developed OCD, outbursts and tantrums, seizures, catatonia, and paranoia following a diagnosis of streptococcal pharyngitis. Some of the...
Outbreaks, Alerts and Hot Topics February 2021(2)
Clinicians should be aware of recent human brucellosis cases in the United States caused by an antibiotic-resistant RB51 bovine vaccine strain and related to raw milk consumption.
Visual Diagnosis: Eye Movement
A 4-year-old male is brought to the emergency department by his mother for further evaluation of ear pain and headache.