Ovarian Torsion Clinical Pathway Ovarian torsion is the complete or partial rotation of the ovary on its pedicle, leading to ischemia and potential loss of the ovary. Early diagnosis can be challenging as ovarian torsion accounts for only 3% of acute abdominal pain in females, and can mimic other more common
Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Clinical Pathway Posterior spinal fusion for adolescent idiopathic scoliosis is associated with significant pain and prolonged hospitalization. Standardizing care for posterior spinal fusion can allow early mobilization, decreased LOS, and minimize opioid related side effects. We also wish to
Renal Injury Clinical Pathway The kidney is the most frequently injured urologic organ, with 70% to 80% being a consequence of blunt trauma. Although few urologic injuries are immediately life-threatening, they do account for some of the more frequent complications of trauma. In the late 1990s, the American
Penicillin Allergy Delabeling – Pilot for PHM Patients Note: This clinical pathway is currently a pilot for Pediatric Hospital Medicine (PHM) patients at CT Children’s. Pathway Background and Objectives Inappropriate penicillin allergy labels are very common. Carrying a penicillin allergy label can result in use of overly broad
Peripheral Venous Access Clinical Pathway Peripheral venous access is a frequently performed procedure, and the most common source of pain, for children in the hospital. Pain control is a high priority for patients and families and pain experiences can have long term effects on children. The use of topical anesthetics
COVID-19 Clinical Pathway The COVID-19 pandemic continues to infect millions of people. Although the majority of children who are infected with COVID-19 have milder illnesses, particularly when fully vaccinated, some children can become seriously ill and require hospitalization. New SARS-CoV-2 variants
Agitation Acute agitation in the hospital setting can be dangerous and highly distressing for patients, families, and staff. Further, it can result in disruption of care, injury, and need for chemical or physical restraint. Management of agitation requires understanding of its etiology and
Antenatal Risk of Coarctation of the Aorta (ARCH) Clinical Pathway Coarctation of the aorta can develop as the ductus arteriosus closes after delivery. Because the ductus arteriosus is open in utero, diagnosis prenatally can be challenging. Coarctation of the aorta can never be completely ruled out in the presence of a patent ductus arteriosus
Blunt Liver and Spleen Injury Clinical Pathway Blunt abdominal trauma causing liver and/or spleen injury is one of the most common indications for hospital admission for injured children. In 2012, a pediatric trauma consortium, ATOMAC, developed a practice management guideline for blunt liver or spleen injury that is evidence
Brachial Plexus Palsy Management Clinical Pathway Brachial plexus palsies occur in about one in 1000 live births. Older literature quotes over 90% rate of recovery, however “recovery” has a broad definition that includes any reanimation of the limb. Recognizing secondary weakness and deformity, the actual recovery rate is closer
Evaluation and Management of Suspected Clostridioides difficile (C. difficile) Infection Clinical Pathway Clostridioides difficile is a significant infection that is becoming more common in children. Although most episodes can be treated with initial empiric first line therapies, some patients should receive a pre-emptive escalation of therapy. Further, when recurrence becomes an
Skin and Soft Tissue Infection Clinical Pathway Over the years, the increase in resistance to typical antibiotics has changed the approach to the management of skin and soft tissue infections (SSTIs) in children. In 2014, the Infectious Disease Society of America (IDSA) updated their SSTIs guidelines. Based on these changes
Eating Disorder Clinical Pathway Eating disorders are increasingly prevalent in pediatrics and represent a complex interaction between medical and psychiatric manifestations. The need for a standardized approach is critical, due to the high risk of the condition (eating disorders have the highest mortality of
