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Clinical Pathways promote evidence based, safe, and high-value care for patients with common or high-risk clinical conditions when national or international guidelines are not available or applicable. Clinical Pathways are informed by a methodical review of scientific literature and the consensus of a multidisciplinary committee of subject matter experts and key stakeholders at Children’s Mercy Kansas City. Processes within the clinical pathways may be specific to Children’s Mercy Kansas City and should be evaluated before applying to a different setting.

Algorithms associated with this Clinical Pathway for viewing as a PDF: 

Inclusion and exclusion criteria


  • Patient > 3 months of age
  • Diarrhea of recent onset < 7 days
  • With or without vomiting, fever, nausea, or abdominal pain


  • Immunocompromised  
  • Toxic appearance (consider sepsis)  
  • Vomiting with no diarrhea for > 24 hours 
  • Co-morbid conditions (such as medically complex children, renal failure, cardiac disease, IBD, liver disease)  
  • Bilious emesis (consider bowel obstruction) 
  • Acute surgical abdomen
  • Head injury
  • Chronic disease 
  • ICU admission

Committee members involved in the development: 

  • G. Abraham, MD | Emergency Department | Committee Chair 
  • R. Selvarangan, BVSc, PhD, D(ABMM), FIDSA, F(AAM) | Pathology and Laboratory Medicine | Committee member
  • E. Montgomery, MD | Urgent Care | Committee member
  • R. El Feghaly, MD, MSCI | Infectious Diseases | Committee member
  • A. Abdul-Rauf, MD, FAAP | Emergency Department | Committee member
  • J. Solano, MD | Hospital Medicine | Committee member
  • K. Berg, MD, FAAP | Hospital Medicine | Committee member
  • K. Linas, MD | Hospital Medicine | Committee member
  • L. Schroeder, MD | Emergency Department | Committee member
  • N. Allen, MS, MLS, RD, LD, CPHQ | Evidence Based Practice Department | Committee member
  • J. Dusin MS, RD, LD, CPHQ | Evidence Based Practice Department | Committee member

Publication dates: 

  • Finalized date: October 2020 
  • Next expected revision date: October 2023 

Concerns with content 

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This care process model does 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 their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare care process models for each. Accordingly, this care process model should guide care with the understanding that departures from them may be required at times.