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Clinical Pathways promote evidence-based, safe, and high-value patient care by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members. 

 

Clinical Pathway: 

 Additional tools associated with this Clinical Pathway:

Exclusion Criteria: 

  • Animal bites - refer to Animal Bites (Mammal) Clinical Pathway 
  • Collagen connective tissue diseases (e.g., Ehlers-Danlos syndrome)
  • Surgical incisions 
  • Open fracture 
  • Significant genital trauma - consult specialist 

 

Committee members involved in the development: 

  • James Garner, MD | Urgent Care | Committee Chair
  • Ayman Abdul-Rauf, MD, FAAP | Emergency Department | Committee Member
  • Rohan Akhouri, MD, MPH, MS | Emergency Department | Committee Member
  • Ali Fowler, MD | Emergency Department, Fellow | Committee Member
  • Shao Jiang, MD | Plastic and Reconstructive Surgery | Committee Member 

 

EBP Committee Members: 

  • Kathleen Berg, MD, FAAP | Evidence Based Practice
  • Kori Hess, PharmD | Evidence Based Practice 

 

Publication dates: 

  • Finalized date: November 2025
  • Next expected revision date: 2028 

 

Concerns with content:

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu. 

 

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 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 a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.