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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...
Hodgkin lymphoma: Miqueas' Story
The moment Terrie Flatt, DO, MA, Director of the HOPE Clinic, the Children’s Mercy Spanish-Speaking Cancer Clinic, walked into the exam room where Miqueas Valdez Cisneros was waiting for him, he knew the...
Abstract: Exploring Motivation Behind Engagement in Mealtime Bolus Behavior in Adolescents with Type 1 Diabetes (T1D): A Behavioral Economics Approach
E. DeWit1, S. Tsai2,1, M. Clements2,1, B. Spartz1, L. Lartey1, K. Evans1, L. Sainz Y Diaz1, E. Hurley2,1 1Children’s Mercy, Kansas City, United States, 2University of Missouri Kansas City, Pediatrics...
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...
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...
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...
Swab Affected Eye(s) For Gonorrhea, HSV, and Chlamydia 2023
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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...
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...