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.

Guideline questions

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

Internal workflows (only accessible by team members)

CHoR clinical guidelines

Abdomen (High Risk) - Pediatric ED

Adrenal Insufficiency - Pediatric Emergency Medicine

Agitation - Pediatric ED

Airway Alert Internal use only

Ankyloglossia - Newborn Nursery

Appendicitis - Pediatric Emergency Medicine

Asthma - Pediatric Acute Care

Asthma- Pediatric ED

Blood Culture Contaminant: Pediatric ED Callback Procedure - 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

CMV Screening Protocol (Newborn Targeted)

Croup - Pediatric ED and Pediatric Acute Care

Delirium Prevention, Screening and Management - Pediatric Critical Care

Diabetic Ketoacidosis (DKA) - Pediatric ED and PICU

Difficult IV Access and Blood Draw (Inpatient) - Pediatric inpatient

Difficult IV Access and Blood Draw (ED) - Pediatric ED

Dihydroergotamine (DHE) Guidance - Inpatient Pediatrics and Pediatric ED

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

Foreign Body Ingestion - 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

Measles - Pediatric ED

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

Neonatal Graves Disease - Inpatient and Outpatient Management

Nephrolithiasis - Pediatric ED

Osteomyelitis (Acute Hematologic) - Pediatric ED and Acute Care

Pancreatitis (acute) - Pediatric Gastroenterology

Penicillin Allergy De-Labeling Pathway - Pediatric ED, Acute Care and Critical Care

Peripheral and Central Vasopressor and Medication Use - Pediatrics

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

Pneumothorax (spontaneous) - Pediatric ED, Pediatric Surgery

Sedation for mechanical ventilation - Pediatric Intensive Care Unit

Sepsis (ED) - Pediatric ED

Septic Arthritis/Acute Bacterial Arthritis - Pediatric ED and Acute Care

Sepsis - Pediatric inpatient

Sickle Cell Acute Chest Syndrome- Pediatric ED and Pediatric Hem-Onc

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

Small bowel obstruction (Adhesive) - Acute Care

Surgical Site Infection (SSI) Bundle - Pediatrics

Testicular/Scrotal Pain (Non-Traumatic) - Pediatric ED and Urology

Tonsillar Hemorrhage - Pediatric ED and Otolaryngology

Trauma manual Internal use only