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Triptan
DHE cannot be given if the patient has received triptans with the previous 24 hours (Lexi-Comp, 2016). These pathways do not establish a standard of care to be followed in every case. It is recognized that...
Abdominal Pain: Metronidazole
Do not take on an empty stomach Even a small amount of food will decrease the chances of getting nausea with the medication Avoid alcohol while taking the medication, as this can cause vomiting Be sure...
FDA Approved Long-Acting Reversible Contraception
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...
Nonviable Tissue
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...
Patella Tendonitis
USNWR Ortho Media Block Tendons are like ropes which connect muscles to bone. The patellar tendon connects the kneecap (the patella) to the shinbone (the tibia). Patellar tendonitis is the condition that...
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...
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...
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...
Bronchiolitis Feeding
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Migraine Therapy in the ED
Guideline inclusion criteria: Children up to 18 years of age. Physical exam normal. History consistent with primary headache. Guideline exclusion criteria: Abnormal physical exam normal. History...
Antihypertensive(s) and/or Lifestyle Modifications
Severe BP elevation means a BP consistently ≥ 99th percentile. Consult Nephrology if ≥ 2 doeses in 24 hours required to normalize BP.
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...
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...
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...
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...
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...
Delivering Complex Medical Care Via Telemedicine: TJ’s Story
Meet TJ At a time when social distancing and remote living are more in-demand than ever, 9-year-old TJ DeCow and his family are trendsetters. “We live on a little farm in the middle of a field near a small...
Epidermolysis Bullosa Simplex: Jaciel’s Story
Jaciel Lemus was born with epidermolysis bullosa simplex, a condition that causes the skin to be very fragile and blister easily. He was treated at the Children's Mercy Level IV NICU.