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Kirby Bauer Testing
In January 2010, the Clinical and Laboratory Standards Institute (CLSI) published new minimum inhibitory concentration (MIC) breakpoints for cefazolin against Enterobacteriaceae (Wayne, 2010). These new...
Distal Radius Fracture
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...
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...
Vulvar Aphthous
Non-sexually acquired genital ulceration (NSGU) refers to complex aphthous ulcers in genital areas. NSGU occurs more commonly in young women. NSGU may be preceded by flu-like symptoms and is possibly...
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...
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.
Febrile Infant: Antibacterial Therapy and Empiric HSV Therapy
Initial Empirical Antibacterial Therapy for Well-Appearing Infants 7 to 60 Days Old (These are INITIAL antimicrobial recommendations and should be re-evaluated for appropriateness at 48 hours after...
Options For Obtaining Warfarin Doses With Available Strength
Appendix I - Warfarin Dosing Adjustment Using One Tablet Strength 1 mg tablet strength Total weekly dosage Sunday Monday Tuesday Wednesday Thursday Friday Saturday 5.5 mg 1 tablet 0.5 tablet 1 tablet 0.5...
Hydration Considerations
Maintaining a high UOP with adequate hydration is the most important factor in preventing TLS. Improves renal perfusion, GFR and minimizes acidosis. This prevents precipitation of uric acid and Ca-P...
Complete History and Physical Exam
The patient with refractory headache will typically present with: Headache attack lasting 1-72 hours. Headache has at least two of the following four features: Either bilateral or unilateral...
Blisters
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...
AOM – Penicillin Allergy
Mild/Moderate: Hives Single organ system Excludes side-effects such as vomiting and diarrhea Excludes family history but not individual history of penicillin allergy Severe: Drug reaction with eosinophilia...