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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...
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...
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...
Rumination Disorder: Bobbi’s Story
Meet Bobbi Just try keeping up with Bobbi Horr. The junior at Holton High School, Holton, Kan., is on the school’s spirit squad, in band, plays volleyball, runs track, takes dance and gymnastics, and works...
Dietetic Internship
Program experience The Nutrition Services department at Children’s Mercy offers dietetic internships to students from universities that have a student affiliation agreement with the hospital. Limited...
Contact the Children's Mercy Comprehensive Colorectal Center
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Chlamydia Trachomatis
Among infants bom to untreated mothers with Chlamydia trachomafis infections, the overall risk of disease is estimated at 50 to 75% and typically involves the mucous membranes of the eye, oropharynx...
Swab Affected Eye(s) For Gonorrhea, HSV, and Chlamydia 2023
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Systematic Screening for Sepsis/Septic Shock
References Bonfide, C.P., Brady, P.W., Keren, R., Conway, P.H., Marsolo, K., & Daymont, C. (2013). Development of heart and respiratory rate percentile curves for hospitalized children. Pediatrics...
he Emergency Medical Services for Children Task Force recommends the following sequence for rapid assessment
“Doorway assessment” of the overall appearance, work of breathing, and perfusion Airway – Is the airway able to be maintained? Breathing – respiratory rate and effort (retractions, grunting, stridor...
Toddler Tibia Fracture: Inclusion and Exclusion
Inclusion Criteria: Patients aged 1 to 4 years. Not bearing weight. Low energy mechanism, defined as: Fall from standing. Trip and fall Injury at the bottom of a slide. Stable tibial shaft or distal tibia...
Myelomeningocele: Clean Intermittent Catheterization (CIC)
After 24 hours of life, check post void residuals. To check post void residual, perform clean intermittent catheterization immediately after wet diaper. If post void residual is consistently above 20 ml...
Catheter Directed Thrombolysis
tPA 0.1-0.3 mg/kg (max dose 10 mg) bolus followed by 0.01-0.03 mg/kg/hr (max 2 mg/hr) x 24-72 hrs. Administer heparin at 10 units/kg/hr or decrease direct thrombin inhibitor rate by 50%. These pathways do...
AOM – Mild Bulging of Tympanic Membrane (TM)
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...
Psychological Symptom Management
Symptoms Treatment Delirium Delirium is a disturbance in consciousness and cognition characterized by changes in mental status with impaired attention, awareness, and cognition. Hyperactive...
Epileptic Spasm Resources
Epileptic or Infantile Spasms | Epilepsy Foundation What Can Infantile Spasms Look Like? | Infantile Spasms Action Network Infantile Spasms | Child Neurology Foundation Infantile Spasms (West...
Acute Chest Syndrome: Severe or Rapidly Progressing ACS
Symptoms of Severe or Rapidly Progressing Acute Chest Syndrome: Oxygen saturation below 90% despite supplemental oxygen, Increasing respiratory distress, Progressive pulmonary infiltrates, and/or Decline...
Residents
2025-2026 Residency Class Postgraduate Year One Residents: Lacey Hunter, PharmD lhunter1@cmh.edu Ashley Lewis, PharmD amlewis5@cmh.edu Mallory Stoll, PharmD mestoll1@cmh.edu Postgraduate Year...
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...
Epidemiology
In most western countries, type 1 diabetes accounts for over 90% of childhood and adolescent diabetes, although less than half of individuals with type 1 diabetes are diagnosed before the age of 15 years.