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The Value of Kindness
Giving back and acts of kindness have been a part of the fabric of Children’s Mercy since our very beginning, starting with the spirit of our Founding Berry Sisters. Another example is lifelong Children’s...
Atopic Dermatitis: Noninfected - Wet Wraps
Wet wraps: Are used to help moisturize and soothe the skin. TO BE USED WITH TOPICAL STEROIDS AND MOISTURIZERS ONLY (not with Protopic or Elidel). For a demonstration of how to apply wet wraps...
Delayed Treatment Option
In children greater than 8 weeks with suspected bacterial conjunctivitis, is delayed treatment a valid option? We RECOMMEND based on low quality evidence consideration for delayed treatment or delayed...
Patient's Pain
Is the patient's pain assessed to be >3? Assess the patient's comfort level using an age and developmentally appropriate pain scale. Children's Mercy Kansas City uses the following pain...
Discharge Recommendations and Follow-up
If the patient meets the discharge criteria, discharge after providing the patient with the discharge information. The Headache Action Plan may be helpful in creating a discharge plan. The patient...
Case Definition for Multisystem Inflammatory Syndrome in Children (MIS-C)
If you are concerned you may have a patient with MIS-C, please consult ID. An individual aged <21 years presenting with feveri, laboratory evidence of inflammationii, and evidence of clinically severe...
Heparin Antidote
Termination of the IV infusion generally will terminate the anticoagulant effect. If immediate reversal is required protamine sulfate will result in neutralization of heparin. The dose of protamine...
Maintenance and Monitoring
Once a therapeutic standard heparin level is obtained draw CBC, PT, aPTT and/or heparin level at least daily. Measure platelet counts daily. If platelet count decreases below 150,000/microL or drops by ≥
Initiation of Therapy Days 1-4
Warfarin is generally started on day 1 or 2 of heparin or low molecular weight heparin (LMWH) therapy. Heparin or LMWH administration should overlap with warfarin for a minimum of 6 days and until INR is...
Low Dose Systemic Thrombolysis
tPA 0.03-0.06 mg/kg/hr x 24 hours (max hourly dose 2 mg/hr) If on heparin: decrease heparin dose to 5-10 units/kg/hr. If on direct thrombin inhibitor (DTI) decrease rate by 50%. Heparin and/or DTI lab...
Bruising
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...
Empiric STI Treatment:
While tests are pending, empiric treatment for Chlamydia and Gonorrhea should be provided for those at increased risk (e.g., women <25 years, new sex partner, known STI exposure), if follow-up cannot be...
Hypertension
For Children's Mercy Kansas City providers: Skills: Blood Pressure Measurement (Pediatric) - CE (elsevierperformancemanager.com) For providers without Children's Mercy privileges, tables...
Signs and Symptoms
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Heavy Menstrual Bleeding
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Micrognathia
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...
LMW Heparin Antidote
Antidote: Termination of the subcutaneous injection generally will terminate the anticoagulant effect. If immediate reversal is required protamine sulfate will result in partial neutralization. If the...
Hyperleukocytosis/Leukapheresis
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...
Alteplase Dosing
Low Dose Systemic Thrombolysis Alteplase 0.03-0.06 mg/kg/hr x 24 hours (max hourly dose 2 mg/hr) If on heparin: decrease heparin dose to 5-10 units/kg/hr If on direct thrombin inhibitor (DTI), decrease...
ADHD Patient / Caregiver Resources
National resources: CDC CHADD Understood.org Local resources: CHADD Local Chapter (ADHDKC) Behavioral Parent Training Groups: Understanding and Managing ADHD (CMH) ADHD Services (CMH) Lift up KC...