Clinical guidelines

Clinical guidelines based on the best available evidence have been shown to improve care and shorten hospital stays for children.

The guidelines below are the result of experts from many specialties across CHoR coming together to review evidence and suggest best practice. 

Since all children are different, it is often appropriate to adapt the recommendations listed below to the special needs of each child. These guidelines are not meant as a substitute for thoughtful clinical judgment. 

Please send any questions or comments to the CHoR Clinical Guidelines Committee at chorclinicalguidelines@vcuhealth.org.

Acute Pancreatitis - Pediatric Gastroenterology

Ankyloglossia - Newborn Nursery

Appendicitis - Pediatric Emergency Medicine

Asthma - Pediatric Acute Care

Asthma - Pediatric ED

Bronchiolitis - Pediatric ED and Pediatric Acute Care

Congenital Cytomegalovirus - Newborn Nursery

Croup - Pediatric ED and Pediatric Acute Care

Difficult Intravenous Access

• Difficult Intravenous Access and Blood Draw - Pediatric Inpatient
• Difficult Vascular Access - Pediatric ED

Diabetic Ketoacidosis (DKA) - Pediatric ED and PICU

Fever and Central Line (non-oncology) – Pediatric ED

Gastroenteritis - Pediatric ED and Pediatric Acute Care

High-Flow Nasal Cannula in Bronchiolitis - Pediatric ED and Pediatric Acute Care

Hyperglycemic Hyperosmolar Syndrome and Hyperosmolar DKA

Hypoglycemia - Newborn Nursery

Ileocolic Intussusception - Pediatric ED, Surgery and Hospital Medicine

Migraine - Pediatric ED and Inpatient Neurology

Multisystem Inflammatory Syndrome in Children (MIS-C), initial evaluation - Pediatric ED, Inpatient Pediatrics and General Pediatrics

Multisystem Inflammatory Syndrome in Children (MIS-C), management - Inpatient Pediatrics

Neonatal Fever - Pediatric ED and Pediatric Acute Care

Nephrolithiasis - Pediatric ED 

Pneumonia

• Community Acquired Pneumonia - Pediatric ED and Pediatric Acute Care
• Complicated Pneumonia - Pediatric ED, Pediatric Acute Care and Pediatric Critical Care Medicine

Sedation for mechanical ventilation - Pediatric Intensive Care Unit

Sepsis (ED) - Pediatric ED

Sepsis - Pediatric inpatient

Sickle Cell Vaso-occlusive Crisis - Pediatric ED and Pediatric Heme-Onc

Urinary Tract Infection (suspected) – Pediatric ED, Pediatric Outpatient and Inpatient Pediatrics

Links to other guidelines (internal use only):

Care coordination for patients with multiple surgery teams (surgery and hospital medicine MOU)

Child Abuse Concerns Algorithm

PICU discharge process map for new chronic invasive ventilation 

Trauma manual

Ventilated Patients on Acute Care Pediatrics: Admission Criteria