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Bioethics: Addressing the Burdens That Newborn Screening Imposes on Underserved Communities
Newborn screening (NBS) began in the 1960s with testing for phenylketonuria (PKU), which, when identified and treated early, significantly reduces morbidity. While NBS is rightly viewed as a public health...
Allergic Bronchopulmonary Aspergillosis (ABPA)
Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction within airways occurring almost exclusively in patients with asthma or cystic fibrosis. Less commonly reported in patients with...
Can You Keep a Secret?
Column Author: Sunny Jeong, BScN, RN, MBE | Pediatric Fellow Column Editor: Brian Carter, MD | Neonatal/Perinatal Medicine, Bioethics; Neonatologist; Pediatric Bioethicist; Interim Director...
September
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August
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Metoclopramine With or Without diphenhydrAMINE
In the pediatric patient diagnosed with refractory migraine, is metoclopramide an effective treatment? Plain language summary from the office of evidence based practice: Based on very low quality evidence...
Febrile Infant: Observing Closely at Home
Infant may be managed at home if parent and clinician agree that the following are present: reliable phone and transportation, parent willingness to observe and communicate changes in condition, and...
Abdominal Pain: Metronidazole
Do not take on an empty stomach Even a small amount of food will decrease the chances of getting nausea with the medication Avoid alcohol while taking the medication, as this can cause vomiting Be sure...
FDA Approved Long-Acting Reversible Contraception
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...
Azithromycin
Rationale, current evidence, and consensus statement: The 2015 Red Book and the 2015 CDC Treatment Guidelines for STD's recommends that young infants with C. trachomafis conjunctivitis may be treated with...
Myelomeningocele: Antibiotics
UTI prophylaxis if any hydronephrosis on renal US: Amoxicillin 20 mg/kg/dose enterally once a day. Cephalexin 20 mg/kg/day either once or divided twice a day. If patient is NPO the IV equivalents are...
Shock
Shock is defined as use of vasoactive agents such as: -Epinephrine/norepinephrine, dopamine, dobutamine, milrinone, nitroprusside.
High Dose Systemic Thrombolysis
tPA 0.1-0.6 mg/kg/hr x6 hrs Adult dosing for pts >16 yrs and > 60 kg: Alteplase 100 mg over 2 hrs IV (if no concurrent anticoagulation therapy). These pathways do not establish a standard of care to...
Automatic Reflex Aerobic Eye Culture Recommendations
The Conjunctivitis Team along with the Red Book and the Children's Mercy Department of Infectious Diseases recommends eye culture in the low risk group for GC, Chlamydia, and HSV. This recommendation is...
Constipation: RED FLAGS for Underlying Disease Causing Constipation
RED FLAGS to consider: Meconium not passed in first 48 hours as a newborn. Family history of Hirschsprung disease. Blood in the stools with fever. Failure to thrive (chronically low weight for height).
Steven Leeder, PharmD, PhD
J. Steven Leeder, PharmD, PhD, is Deputy Director of the Children's Mercy Research Institute and leads the Precision Therapeutics Area of Emphasis.
Febrile Infant: Ill Appearing Infant Workup and Treatment
Ill appearing infants require full evaluation for serious neonatal infections. We recommend obtaining the following studies and initiating empiric treatment: Diagnostic evaluation: CBC with differential, C...
AOM – Otitis Externa
Otitis externa (“swimmer’s ear”) is inflammation of the external ear canal leading to severe otalgia and tenderness to palpation. Erythema, edema, drainage, and pruritis may be present. It is often preceded...
Anaphylaxis – Tryptase
Tryptase levels may be elevated in the setting of anaphylaxis. However, this lab is not rapidly available and is not useful in the immediate management of the patient. It may be useful in case of recurrent...