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Sumatriptan
In the pediatric patient diagnosed with refractory migraine is sumatriptan an effective treatment for refractory migraine in the ED? Plain language summary from the office of evidence based practice: Based...
Indications For Hematology Consultation
Initiation of therapy for patients: Age < 30 days Baseline INR ≥ 1.2 prior to initiation of warfarin Impaired renal function Maintenance of anticoagulation therapy with: Delay in reaching therapeutic...
Recommended Partner Notification
Recommend that the patient notify sexual partners by: Partner notification card OR TellYourPartner.org Health Department involvement: Can assist with partner notification for Gonorrhea and Chlamydia upon...
Discharge
Can the patient be discharged? After each medication intervention the patient should be assessed to determine if the patient meets the following discharge criteria: Headache pain score ≤3 or decrease...
Troubleshooting Neurosurgical Shunts for Malfunction
Shunt malfunction may occur at ANY TIME after shunt placement with the risk of malfunction being the highest in the first 6 weeks post shunt surgery. Patient's symptoms are usually progressive, rarely...
Acetaminophen
For children who rate their pain as mild (<3), and do not meet the exclusion criteria of the Analgesia Standing Order, either acetaminophen or ibuprofen may be administered. Acetaminophen is preferred if...
Considerations for Allergy Referral
Reinforcement of anaphylaxis education Unknown cause of anaphylaxis Recurrent anaphylaxis These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is...
Febrile Infant: Lumbar Puncture Considerations
Clinicians may obtain a CSF analysis on infants 22 to 28 days of age even if all of the following criteria are met: Urinalysis result is negative or positive. Inflammatory Markers obtained are abnormal.
Pulmonary Embolism Risk Stratification
Low Risk: Acute PE and the absence of the clinical markers of adverse prognosis that define massive or submassive PE and oxygen requirement of less than 2L. Intermediate Risk (Submassive): Acute PE without...
Supportive Care Measures
Encourage non-caffeinated and non-carbonated fluids. For girls, encourage wiping after each void from front to back. Decrease discomfort with voiding by urinating while sitting in a warm bath tub. Provide...
Severe Cephalosporin Allergy
For patients at high risk for severe delayed reaction to cephalosporins or penicillins, do not administer beta-lactams. See alternatives below. Cystitis or pyelonephritis Ciprofloxacin: ...
Foreign Body Ingestion: Super-Absorbent Objects
Consult GI Consult Surgery if patient has symptoms of bowel obstruction Consider endoscopic removal Objects rapidly expand within the GI tract 30 - 60 times original volume Cause gastric outlet...
Academic Curriculum - Pediatric Pulmonology Fellowship
Fellows are expected to engage in meaningful scholarly activity leading to “the generation of a specific written work product” during the course of their fellowship training. Scholarly activity may include...
Clinical Experience - Pediatric Nephrology Fellowship
Inpatient time is split between supervision of primary renal resident service and nephrology consultation services. Fellows will become proficient in the prescribing and supervision of all modalities of...
Clinical Experience - Neonatal-Perinatal Medicine Fellowship
Year Clinical Months Elective Month Research Total 1 5 months 7 months* 12 months 2 5 months (1 month MFM) 7 months* 12 months 3 4 months 1 month 7 months* 12 months *Vacation eligible months...
Starting Doses of Opioids
Titrate dose and frequency to maintain adequate symptom control. Dose and frequency increases may need to be very aggressive during the active dying process. There is no absolute maximum dose for opioid...
Bolus Dosing of Home Anti-seizure Medications
Route Drug Dose Max IV Lacosamide 2 - 6 mg/kg 200 mg IV Phenobarbital 5 - 10 mg/kg Use blood level to determine dose if available; 1000 mg max IV Valproic Acid 10 - 20 mg/kg Use blood level to determine...
Discharge Recommendations
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...
Apply for the Pediatric Emergency Medicine Fellowship
Applicants interested in applying for the Pediatric Emergency Medicine Fellowship at Children's Mercy must be in their final year of residency training or have completed training in either pediatrics...
Research Opportunities: Developmental and Behavioral Pediatrics Fellowship
All fellows must complete a scholarly project as part of their training. The fellowship program director will appoint a chair for each fellow’s Scholarship Oversight Committee (SOC). The fellow will work...