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High Dose Systemic Thrombolysis

tPA 0.1-0.6 mg/kg/hr x6 hrs Adult dosing for pts >16 yrs and > 60 kg: Alteplase 100 mg over 2 hrs IV (if no concurrent anticoagulation therapy). These pathways do not establish a standard of care to...

Triptan

DHE cannot be given if the patient has received triptans with the previous 24 hours (Lexi-Comp, 2016). These pathways do not establish a standard of care to be followed in every case. It is recognized that...

Pharyngitis Images

For Children's Mercy providers: Streptococcal pharyngitis image 1 (tonsils with palatal petechiae) Streptococcal pharyngitis image 2 (palatal petechiae) Streptococcal pharyngitis image 3 (tonsillar...

Outbreaks, Alerts and Hot Topics: Typhoid Update

Typhoid fever remains a significant concern worldwide, primarily in low- and middle-income countries. Antibiotic resistance and poor sanitation contribute to higher rates, though vaccine distribution in...

Pulse Oximetry and Skin Pigmentation

This article examines the evidence surrounding the role of skin pigmentation and other factors in the accuracy of pulse oximetry as a diagnostic tool.

Outbreaks, Alerts and Hot Topics October 2021

Clinicians should be aware of recent human brucellosis cases in the United States caused by an antibiotic-resistant RB51 bovine vaccine strain and related to raw milk consumption.

Shock

Shock is defined as use of vasoactive agents such as: -Epinephrine/norepinephrine, dopamine, dobutamine, milrinone, nitroprusside.

Nonviable Tissue

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...

Toddler Tibia Fracture

Apply for the Pediatric Optometry Residency Program

The Children's Mercy Pediatric Optometry Residency Program is affiliated with the University of Missouri - St Louis College of Optometry. This program uses the Optometry Residency Match (ORMatch). All...

3.5

Continue to provide public policy leadership to initiatives that promote healthy lifestyles in childhood. Key documents posted to the public website: Childhood Obesity Metrics Report and Systems Map MO...

Bronchiolitis Feeding

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Criteria for Insulin Drip Discontinuation

Discontinue insulin when: Bicarbonate level is ≥17mmol/L. Anion gap is normalized. And/or blood ketones are negative to small. Once the insulin drip is stopped, discontinue D10NS with additives ...