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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...
Wide World of Vaccines May 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...
Abstract: Impact of Moderate-to-vigorous Physical Activity on Continuous Glucose Monitor-derived Metrics in Youth with Type 1 Diabetes
Kelsey Panfil1, Erin M. Tallon1, Brent Lockee1, David D. Williams1, Susana R. Patton2, Mark A. Clements1 1Children’s Mercy (Kansas City, MO), 2Nemours Children's Health, (Jacksonville, FL) Background...
Valproic Acid
In the pediatric patient diagnosed with refractory migraine, is valproic acid an effective treatment? Plain language summary from the office of evidence based practice Migraine in the ED Team...
Febrile Infant: Lumbar Puncture Considerations
Clinicians may obtain a CSF analysis on infants 22 to 28 days of age even if all of the following criteria are met: Urinalysis result is negative or positive. Inflammatory Markers obtained are abnormal.
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...
Supportive Care Measures
Encourage non-caffeinated and non-carbonated fluids. For girls, encourage wiping after each void from front to back. Decrease discomfort with voiding by urinating while sitting in a warm bath tub. Provide...
Necrotizing Fasciitis
Swollen limb with pain out of proportion history or exam Frequently with overlying warmth on palpation, +/- cellulitis or ecchymosis Surgical emergency: debridement in OR necessary Consult Infections...
Autism and/or Developmental Delay: AAP Guidelines
AAP Clinical Report – Autism Spectrum Disorder: https://pediatrics.aappublications.org/content/145/1/e20193447 AAP Developmental Surveillance and Screening Guidelines...
Blood Flow Restriction (BFR) Training
Blood flow restriction training, also known as occlusion training, uses a specialized device to help athletes rehabilitate injured muscles and limbs.
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...
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...
Discharge
Can the patient be discharged? After each medication intervention the patient should be assessed to determine if the patient meets the following discharge criteria: Headache pain score ≤3 or decrease...
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...
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...
Considerations for Allergy Referral
Reinforcement of anaphylaxis education Unknown cause of anaphylaxis Recurrent anaphylaxis These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is...
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...
Sumatriptan
In the pediatric patient diagnosed with refractory migraine is sumatriptan an effective treatment for refractory migraine in the ED? Plain language summary from the office of evidence based practice: Based...
Severe Cephalosporin Allergy
For patients at high risk for severe delayed reaction to cephalosporins or penicillins, do not administer beta-lactams. See alternatives below. Cystitis or pyelonephritis Ciprofloxacin: ...
Torn ACL: Hartwell’s Story
Meet Hartwell As a high school junior, Hartwell Taylor had a goal—to wrestle his way to the Kansas state championships in the 126-pound weight class—and win! “I was drawn to wrestling as a child because it’s...