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Hydration Considerations
Maintaining a high UOP with adequate hydration is the most important factor in preventing TLS. Improves renal perfusion, GFR and minimizes acidosis. This prevents precipitation of uric acid and Ca-P...
Common Endocrinology Conditions
Recommendations for pediatricians regarding abnormal menstrual patterns, abnormal thyroid, growth failure and pediatric obesity.
Blisters
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...
Febrile Infant: Antibacterial Therapy and Empiric HSV Therapy
Initial Empirical Antibacterial Therapy for Well-Appearing Infants 7 to 60 Days Old (These are INITIAL antimicrobial recommendations and should be re-evaluated for appropriateness at 48 hours after...
HIV Testing: Alternate Testing
CDC guideline for ARV medications Disclaimer 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...
Dietary Considerations
Parents should notify physician for: Significant changes in diet with foods high in Vitamin K: Kale, spinach, broccoli, cauliflower, turnip greens, chick peas, brussel sprouts, green tea, soybean oil, liver...
SSTI: Abscess (Images)
For Children's Mercy providers: https://www-visualdx-com.ezproxy.cmh.edu/visualdx/diagnosis/skin+bacterial+abscess?moduleId=102&diagnosisId=51001&lang=en_US#view=text&gid=1&pid=2...
Pneumococcal Vaccines
Use of PCV 15 (pneumococcal 15-valent conjugate vaccine) as an alternative to PCV 13 (pneumococcal 13-valent conjugate vaccine) is anticipated to further reduce pneumococcal disease incidence in children...
Poliomyelitis - Hot Topics - September 2022
Cases of poliovirus type 2 have been detected in wastewater samples from Rockland and Orange Counties in New York. Despite ongoing efforts at eradication, sustained and increased immunization coverage is...
Hepatitis - Outbreaks July 2022
The World Health Organization is tracking severe acute hepatitis cases of unknown etiology in pediatric patients worldwide. This outbreak was first identified in April 2022.
Patients Undergoing a Surgical OR Endoscopy Procedure With a Presumed Risk for Adrenal Crisis
Situations in which operative steroid stress-dosing is necessary: Patient is taking steroids and exhibits Cushnoid features. Situations in which stress-dose steroids maybe necessary: Daily inhaled...
Perioperative Steroid Stress Dosing
Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject...
Options For Obtaining Warfarin Doses With Available Strength
Appendix I - Warfarin Dosing Adjustment Using One Tablet Strength 1 mg tablet strength Total weekly dosage Sunday Monday Tuesday Wednesday Thursday Friday Saturday 5.5 mg 1 tablet 0.5 tablet 1 tablet 0.5...
Obesity and Asthma
The relationship between obesity and asthma is complex and linked to biologic, physiologic, environmental factors. There is an increased prevalence of asthma in children with obesity as well as a...
Atopic Dermatitis: Infected - Group A Strep
Strep Pyogenes (Most common Group A Strep): Glazed, bright red appearance especially in skin folds suggests Group A strep. Patients may also experience yellow drainage. When appearing within...
COVID-19 Resources
The Children’s Mercy Bioethics Center has collected resources addressing some of the ethical issues that we've encountered during the COVID-19 pandemic. We would like to share this information with you...
Wide World of Vaccines September 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...
Evidence-Based Strategies for Common Clinical Questions April 2021
As was discussed in last month’s LINK column on evidence-based practice, children are disproportionately affected by secondhand smoke, and this exposure is detrimental to children’s health. The Surgeon...
Wide World of Vaccines October 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...
Evidence Based Strategies for Common Clinical Questions March 2022
As was discussed in last month’s LINK column on evidence-based practice, children are disproportionately affected by secondhand smoke, and this exposure is detrimental to children’s health. The Surgeon...