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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...
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.
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...
Atopic Dermatitis: Infected - Group A Strep
Strep Pyogenes (Most common Group A Strep): Glazed, bright red appearance especially in skin folds suggests Group A strep. Patients may also experience yellow drainage. When appearing within...
ACL Return to Sport Testing
When student-athletes near completion of rehabilitation following an ACL injury, they will undergo evidence-based tests with their sports physical therapist to determine if they are ready to gradually...
Liver Cancer Treatment
The liver cancer treatment team at Children's Mercy combines the medical and surgical expertise of the Division of Hematology and Oncology with the Liver Care Center. This program provides specialized...
Isokinetic Testing
What is Isokinetic Testing? After a major knee injury, isokinetic testing is used to assess the strength of the quadricep and hamstring of each leg. During this type of strength test, the amount of force...