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.

Guideline questions

Contact the clinical guidelines committee with questions or comments: chorclinicalguidelines@vcuhealth.org

Internal workflows (only accessible by team members)  

CHoR clinical guidelines

Acute Pancreatitis - Pediatric Gastroenterology

Adhesive small bowel obstruction - Acute Care

Airway Alert Internal use only

Ankyloglossia - Newborn Nursery

Appendicitis - Pediatric Emergency Medicine

Asthma - Pediatric Acute Care

Asthma - Pediatric ED

Bronchiolitis - Pediatric ED and Pediatric Acute Care

Button Battery Ingestion (NCPC) – Pediatric ED

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

Child Abuse Concerns Algorithm Internal use only

Complicated pneumonia 

Congenital Cytomegalovirus – Newborn Nursery

Croup – Pediatric ED and Pediatric Acute Care 

Difficult Intravenous Access and Blood Draw – Pediatric Inpatient

Diabetic Ketoacidosis (DKA) – Pediatric ED and PICU

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

Gastroenteritis – Pediatric ED and Pediatric Acute Care

Gastrostomy Tube Dislodgement – Pediatric ED and Pediatric Surgery 

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

Hyperbilirubinemia - Pediatric ED

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 

Peripheral IV Extravasation/Infiltration (PIVIE) Treatment - Inpatient and Outpatient Pediatrics

PICU discharge process map for new chronic invasive ventilation  Internal use only

PICU early mobilization  Internal use only

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

Spontaneous pneumothorax 

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

Trauma manual Internal use only

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

Ventilated Patients on Acute Care Pediatrics: Admission Criteria Internal use only