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IV Contrast for MRI and CT: Population at Risk for Acute Kidney Injury
Stem cell transplant Acute or past treatment of oncologic disease Congenital heart disease Undergoing cardiopulmonary bypass Single ventricle physiology History of heart transplant Solid organ transplant...
Local Processes for Patients Lost to Follow-Up:
First check for Confidential Information Form in the Patient Information Form (found in orders or ad hoc form) If a test returns positive on a discharged patient and attempts to contact them are...
Doxycycline for treatment of chlamydia
Changing treatment recommendations for Chlamydia trachomatis from single dose azithromycin to 7 days of treatment with doxycycline has opened the door of adherence concerns for young adult and adolescent...
Distal Radius Fracture - Surgical Indications
Initial evaluation for suspected wrist fracture: History and Physical Exam Radiographs of the wrist AND forearm Signs and Symptoms concerning for wrist fracture include one or more of the following: History...
Criteria for Transfer to Higher Level of Care
Hypotension Impending airway obstruction Need for Epi drip >1 dose of Epi given These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is...
Sepsis Huddle
(can be initiated by any member of the care team at any time when there is a concern) Intended to identify evidence of organ dysfunction Conduct huddle at beside, if possible Discuss clinical exam findings...
Supplemental Oxygen
The Bronchiolitis CPG Committee recommends using supplemental oxygen to maintain an oxygen saturation ≥ 90%, based on the American Academy of Pediatrics (AAP, 2006) statement for the care of the patient...
Albuterol
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Patient Education
Children’s Mercy inpatients: Patient education on rivaroxaban will be provided and documented by Children’s Mercy inpatient pharmacists. Education will include potential for adverse drug reactions and...
Valproic Acid
In the pediatric patient diagnosed with refractory migraine, is valproic acid an effective treatment? Plain language summary from the office of evidence based practice Migraine in the ED Team...
Febrile Infant: Lumbar Puncture Considerations
Clinicians may obtain a CSF analysis on infants 22 to 28 days of age even if all of the following criteria are met: Urinalysis result is negative or positive. Inflammatory Markers obtained are abnormal.
ADHD Treatment: Medications
CHADD ADHD Quick Facts: Medications in Treatment CDC ADHD Treatment Healthy Children ADHD Medications ADHD Medication Guide When deciding to start medications, prescribers should take into account the...
Pulmonary Embolism Risk Stratification
Low Risk: Acute PE and the absence of the clinical markers of adverse prognosis that define massive or submassive PE and oxygen requirement of less than 2L. Intermediate Risk (Submassive): Acute PE without...
Supportive Care Measures
Encourage non-caffeinated and non-carbonated fluids. For girls, encourage wiping after each void from front to back. Decrease discomfort with voiding by urinating while sitting in a warm bath tub. Provide...
Assure Pregnancy Test is Negative
LexiComp (2016) places valproic acid in Category X for migraine prophylaxis and Category D for all other indications when assessing Pregnancy Risk Factors. For medications that are in either category X or...
Necrotizing Fasciitis
Swollen limb with pain out of proportion history or exam Frequently with overlying warmth on palpation, +/- cellulitis or ecchymosis Surgical emergency: debridement in OR necessary Consult Infections...
Autism and/or Developmental Delay: AAP Guidelines
AAP Clinical Report – Autism Spectrum Disorder: https://pediatrics.aappublications.org/content/145/1/e20193447 AAP Developmental Surveillance and Screening Guidelines...
Endometriosis in Teens
Children’s Mercy is here to help girls having symptoms of endometriosis by offering several treatment options from a team of experts trained specifically to address endometriosis in teens.
Acute Promyelocytic Leukemia: Teo's Story
Meet Teo Teenagers are famous for burning the candle at both ends, and Teo Rosales was no exception to that rule. In May 2018, he was busy with his classwork and involved in the school’s robotics team, a...
Rett Syndrome: Quinn's Story
Living with Rett syndrome Angie Cunningham will readily admit that having a child diagnosed with Rett syndrome makes life a bit more complex. This rare neurodevelopmental disorder begins to show its effects...