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VIDEO: Sepsis in Kids

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VIDEO: DKA in Kids

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MyHEARTSMAP - Mental Health Self-Assessment Tool and information

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MyHEARTSMAP is a digital tool that will help families, children and youth self-assess their mental health needs. Once the self-assessment is completed, the tool will recommend appropriate resources. This tool has been found to be highly reliable and can provide options for seeking care other than the emergency department or can provide doctors with valuable information in the ED.

View MyHEARTSMAP 

 
 

Bottom Line: Autism and the Hospital Emergency Room: A Practical Guide for Health Professionals to Meet the Needs of Individuals with Autism Spectrum Disorders

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Center for Autism & Related Disabilities (CARD)

A practical guide for health professionals to meet the needs of individuals with Autism Spectrum Disorder.

Bottom Line Recommendations: Fractures

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Boutis K & TREKK Network

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and treatment of fractures in children. Original (version 1.0) published online: November 2015. Updated (version 2.0) published online: February 2018. Updated (version 3.0) published online: May 2021.

Bottom Line Recommendations: Anaphylaxis

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Alqurashi W and TREKK Network

Bottom line recommendations for the treatment and management of pediatric anaphylaxis - version 1.2. Published online: December 2018.

Bottom Line Recommendations: Constipation

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Eltorki, M., Landy, P.and TREKK Network

Bottom line recommendations for the treatment and management of pediatric constipation - version 2.0. Published online: November 2021.

Fact Sheet: Pediatric COVID-19

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TREKK Network

Fact sheet for the treatment and management of pediatric COVID-19 (novel coronavirus)

The 2019 Novel Coronavirus (COVID-19)

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Information on COVID-19 from Caring for Kids for parents and families. 

COVID-19 information and resources for paediatricians

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COVID-19 and Canadas Kids

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Canadian Association of Emergency Physicians - COVID-19 Information, Resources and Advocacy Centre

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Emergency Medicine Cases: Practical COVID-19 resources for front line healthcare professionals

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Bottom Line Recommendations: Procedural Pain

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Ali, S, Drendel A & TREKK Network

Bottom line recommendations for the treatment and management of procedural pain. Published online: November 2016, update May 2021

Bottom Line Recommendations: Pediatric Thermal Burns

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Crombie T & Malic C and TREKK Network

Bottom line recommendations for the treatment and management of pediatric thermal burns - version 1.0. Published online: February 2021.

Aerosol Generating Medical Procedure (AGMP)

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Dr. Kate Maki

Aerosol-generating medical procedures (AGMPs) are procedures that can generate aerosols when an infected person’s airway is manipulated.

VIDEO: Croup in Kids

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VIDEO: Gastroenteritis in Kids

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Shannon D Scott, RN, PhD; Lisa Hartling, PhD; Pediatric Parent Advisory Group...

Gastroenteritis, or the stomach flu, is an infection of the intestines caused by a virus or bacteria that can cause diarrhea and vomiting. It is common in infants and children and can lead to dehydration. This video was developed by ECHO, ARCHE, and TREKK.

Bottom Line Recommendations: Pain Treatment

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Ali, S, Drendel A and TREKK Network

Bottom line recommendations for pediatric pain treatment. Published online: May 2018, updated May 2021.

Opioids- Information for Parents

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Opioids- Information for Youth

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Opioids- Information for Clinicians

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Bottom Line Recommendations: Suicidal Risk Screening and Assessment

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Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurenc...

Bottom Line Recommendations for screening and assessment of suicide risk. September 2021, Version 1.0

Bottom Line Recommendations: Cannabis Intoxication

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Dr. Kaitlin Hogue, Dr. Neil Desai and TREKK Network

Bottom line recommendations for cannabis intoxication. Published online: December 2021

Formulations and Methods of Delivery: Cannabis

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Dr. Kaitlin Hogue, Dr. Neil Desai, Danica Irwin and TREKK Network

Formulations and methods of delivery table for cannabis. Uploaded 2021-12-06

High-flow nasal cannula oxygen therapy in children

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Nagler J, Torrey SB, Wiley JF

This topic will focus on the use of high-flow nasal cannula (HFNC) in pediatric patients, including discussion of equipment, proposed mechanisms of action, comparison with other oxygen delivery devices, indications and contraindications, approach to initiation, assessment of effectiveness, and potential complications.

Bottom Line Recommendations: Gastroenteritis

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Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis

Bottom Line Recommendations: Croup

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Johnson, DW. & TREKK Network

Bottom line recommendations for the treatment and management of croup.

Bottom Line Recommendations: Bronchiolitis

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Plint, A & TREKK Network

Bottom line recommendations for the treatment and management of bronchiolitis. Posted online: January 14, 2021, Version 3.0.

Bottom Line: Management of Acute Symptoms Algorithm

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Ontario Neurotrauma Foundation

This document is intended to guide health care professionals in diagnosing and managing pediatric concussion. See Page 48 of this document for the Management of Acute Symptoms Algorithm (Tool 2.1).

Sepsis Order Set

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TREKK Sepsis PedsPac

This order set is for management of severe sepsis in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than 28 days of age. Published online: Feb 2020, Version 1.2.

Status Epilepticus Algorithm

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TREKK Status Epilepticus PedsPac

This point of care algorithm is to guide initial management of pediatric status epilepticus in the Emergency Department. Published online: June 2020, Version 3.0.

Status Epilepticus Pocket Card

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TREKK Status Epilepticus PedsPac

This pocket card contains tips to manage pediatric patients with suspected status epilepticus. Reverse side of pocket card includes pediatric considerations for febrile and non-febrile patients. Published online: June 2020, Version 2.0.

Status Epilepticus Order Set

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TREKK Status Epilepticus PedsPac

This order set is for management of pediatric status epilepticus in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 2.0.

Status Epilepticus References and Development Team

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TREKK Status Epilepticus PedsPac

This document outlines the references used and team involved in the development of the status epilepticus PedsPac. Published online: December 2020

Anaphylaxis Order Set

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TREKK Anaphylaxis PedsPac

This order set is for management of pediatric anaphylaxis in the ED. This document is adaptable to your hospitals form policy. Published online: March 2020, Version 1.2.

Diabetic Keotacidosis Algorithm

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TREKK Diabetic Ketoacidosis PedsPac

An algorithm for recognizing and managing pediatric diabetic ketoacidosis

Diabetic Ketoacidosis Pocket Card

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TREKK Diabetic Ketoacidosis PedsPac

A pocket guide to red flags for pediatric diabetic ketoacidosis

Diabetic Ketoacidosis Order Set

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TREKK Diabetic Ketoacidosis PedsPac

This order set is for management of pediatric diabetic ketoacidosis in the ED. This document is adaptable to your hospitals form policy. Published online: March 2020, Version 1.3.

Asthma Order Set

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TREKK Asthma PedsPac

This order set is for management of pediatric severe asthma in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than or equal to 12 months of age. Published online: February 2020, Version 1.1.

Critically Ill Neonate Order Set

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TREKK Critically Ill Neonate PedsPac

This order set is for management of the critically ill neonate in the ED and is adaptable to your hospitals form policy. This algorithm is intended for infants 0-28 days.  At birth, please refer to NRP guidelines. Not intended for preterm infants. Published: January 2021, version 1.2.

UNDER REVIEW: Critically Ill Neonate Algorithm

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TREKK Critically Ill Neonate PedsPac

This point of care algorithm is to guide initial management of critically ill neonates in the Emergency Department. This algorithm is intended for infants 0-28 days.  At birth, please refer to NRP guidelines. Not intended for preterm infants. Published online: January 2021, Version 1.2.

Bottom Line Recommendations: Urinary Tract Infection

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Le Saux N, Neto G, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of urinary tract infection. Version 1.1

World Health Organization: Parenting in the time of COVID-19

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World Health Organization

To help parents interact constructively with their children during this time of confinement, the World Health Organization created these six one-page tips for parents cover planning one-on-one time, staying positive, creating a daily routine, avoiding bad behaviour, managing stress, and talking about COVID-19. 

 

 

Clinical management of patients with moderate to severe COVID-19 - Interim guidance

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Government of Canada

Multisystem Trauma Algorithm

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TREKK Multisystem Trauma PedsPac

This point of care algorithm is to guide initial management of pediatric multisystem trauma in the Emergency Department. Published online: June 2020, Version 1.0.

Multisystem Trauma Order Set

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TREKK Multisystem Trauma PedsPac

This order set is for management of pediatric multisystem trauma in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 1.0.

Multisystem Trauma Checklist

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TREKK Multisystem Trauma PedsPac

This checklist is for management of pediatric multisystem in the ED pre-arrival and post-departure. Published online: June 2020, Version 1.0.

Bottom Line Recommendations: Multisystem Trauma

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Beno S, TREKK Network

The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of multisystem trauma in children in the emergency department. Published online: January 14, 2021, Version 3.0.

Recommendations de Base: Polytrauma

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Beno S, TREKK Network

Le but du present document est de fournir aux professionnels de la sant les faits et recommandations cles pour le diagnostic et le traitement du polytrauma chez les enfants dans un service durgence. Published online: January 14, 2021, Version 3.0.

Bottom Line: Application of topical local anesthetic for potentially painful skin-breaking procedures

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Alberta Health Services

Objectives: To provide direction to health care professionals on the timely and safe application of topical local anesthetics prior to a painful skin-breaking procedure for in-patients and outpatients.

eMagazine No Mercy for the Coronas

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Looking for resources to understand the scientific realities of the COVID-19 virus and pandemic? Check out this children's science magazine, No Mercy for the Coronas, an engaging and accessible illustrated resource for kids (and parents!) to better understand viruses like COVID-19.
 
This e-magazine was created by La Liberté and POP Comm, and developed with the participation of scientists and researchers at Children’s Hospital Research Institute of Manitoba (CHRIM), University of Manitoba and St. Boniface Hospital Albrechtsen Research Centre’s Youth BIOlab Jeunesse.

No Mercy for the Coronas! is for all those who wish to offer children a scientifically reliable resource during this global health crisis affecting all ages and all aspects of society. You can read or download this free magazine in English or French.

Bottom Line Recommendations: Fever in Young infants

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Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants. Published online: June 2019, Version 2.0.

Diabetic Ketoacidosis References and Development Team

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TREKK Diabetic Ketoacidosis PedsPac

This document outlines the references used and team involved in the development of the diabetic ketoacidosis PedsPac. Published online: January 2019.

Bottom Line Recommendations: Caring for Children with Developmental and Intellectual Disabilities in the ED

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Hanlon-Dearman, A, Stevenson, M and TREKK Network

Bottom line recommendations for caring for children with developmental and intellectual disabilities in the ED. Published online: Feb 2020, v 1.1

Bottom Line Recommendations: Acute Otitis Media

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Le Saux N, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of AOM. Posted online May 2020, Version 2.1

Burns Centre Consultation Guidelines

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CritiCall Ontario

Guidelines for burns centre consultations.

Suicide Prevention, Risk Assessment & Management, AMH

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Alberta Health Services

Suicide Prevention, Risk Assessment & Management (SPRAM) is a web-based, interactive e-Learning series designed to respond to the foundational learning needs of health practitioners working in Addiction and Mental Health (AMH).

Bottom Line Recommendations: Diabetic Ketoacidosis

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Reid S, and TREKK Network

Bottom line recommendations for the treatment and management of diabetic ketoacidosis (DKA).

UNDER REVIEW: Bottom Line Recommendations: Procedural Sedation

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Evered L, Bhatt M & TREKK Network

Bottom line recommendations for pediatric procedural sedation. Published online: March 2018.

UNDER REVIEW: Bottom Line Recommendations: Severe Head Injury

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Beno S and the TREKK Network

Updated bottom line recommendations for the treatment and management of severe head trauma. Published online: October 2017.

Bottom Line Recommendations: Intussusception

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Timmons Z, Bulloch B & TREKK Network

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and management of intussusception in children. Original (Version 1.0) published online in 2016. Update (Version 2.0) published online in June 2018.

Acute Otitis Media- Emergency Management in Children - Flowchart

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Children's Health Queensland Hospital and Health Service

Flowchart of emergency management in children for acute otitis media.

Sepsis Algorithm

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TREKK Sepsis PedsPac

This point of care algorithm is to guide initial management of pediatric sepsis in the Emergency Department. This algorithm is intended for use on patients greater than 28 days of age. Published online: December 2018, Version 2.2.

Sepsis Pocket Card

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TREKK Sepsis PedsPac

This pocket card contains tips to recognize early shock, indications of poor perfusion, and management considerations for patients with suspected sepsis. Reverse side of pocket card includes pediatric definition of hypotension. This pocket card is intended for use on patients greater than 28 days of age. Published online: December 2018, Version 1.1.

UNDER REVIEW: Bottom Line Recommendations: Suspected Physical Child Maltreatment

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Boutis, K, Ornstein A, Coombs C & TREKK Network

Bottom line recommendations for the treatment and management of suspected physical child maltreatment. Published online: August 2018.

Bottom Line Recommendations: Sepsis

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Thompson G, Jabbour M and TREKK Network

Bottom line recommendations for the treatment and management pediatric sepsis. Published online: September 2018.

Anaphylaxis References and Development Team

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TREKK Anaphylaxis PedsPac

This document outlines the references used and team involved in the development of the anaphylaxis PedsPac. Published online: October 2018.

Asthma Algorithm

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TREKK Asthma PedsPac

This point of care algorithm is to guide initial management of pediatric severe asthma in the Emergency Department. This algorithm is intended for use on patients greater than or equal to 12 months of age. Published online: March 2020, Version 1.2.

Asthma Pocket Card

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TREKK Asthma PedsPac

This pocket card contains tips to manage pediatric patients with severe asthma. This pocket card is intended for use on patients greater or equal to 12 months of age. Published online: March 2020, Version 1.3.

Anaphylaxis Algorithm

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TREKK Anaphylaxis PedsPac

This point of care algorithm is to guide initial management of pediatric anaphylaxis in the Emergency Department. Published online: December 2018, Version 1.1.

Anaphylaxis Pocket Card

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TREKK Anaphylaxis PedsPac

This pocket card contains tips to manage pediatric patients with anaphylaxis. Updated online: April 2019, Version 1.2.

Sepsis Vital Signs Pocket Card

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TREKK Sepsis PedsPac

This pocket card outlines pediatric heart rate and pediatric respiratory rate guidelines and was reviewed in October 2018. Posted online December 2018, version 2.0.

Asthma References and Development Team

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TREKK Asthma PedsPac

This document outlines the references used and team involved in the development of the asthma PedsPac. Published online: December 2018, Version 1.0.

Bottom Line Recommendations: Concussion

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Zemek R & TREKK Network

Bottom line recommendations for the treatment and management of concussion. Updated: August 2018.

Paediatric Burn Assessment

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Victorial Adult Burns Service at the Alfred

Burns management guidelines for pediatric burn assessment.

Paediatric Burn Guidelines

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Women's and Children's Hospital

Pediatric burn guidelines reference chart.

CSF interpretation

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The Royal Children's Hospital Melbourne

Guideline to help with the interpretation of CSF results for the purpose of diagnosing or excluding meningitis.

Lumbar puncture

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The Royal Children's Hospital Melbourne

Guideline for performing lumbar puncture.

Meningitis - encephalitis

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The Royal Children's Hospital Melbourne

Guideline for the assessment and management of meningitis-encephalitis.

Bottom Line: Recommendations: Special considerations in pediatrics (2013)

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Surviving Sepsis Campaign

Special consideration in pediatrics from the Surviving Sepsis Campaign. Published: 2013.

Sepsis Triage Poster

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TREKK Sepsis PedsPac

This screening tool is to facilitate early identification of suspected pediatric sepsis in the ED. Includes key indicators of sepsis and high-risk medical conditions. This screening tool is intended for use on patients greater than 28 days of age. Published online: June 2017, Version 1.0.

Sepsis References and Development Team

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TREKK Sepsis PedsPac

This document outlines the references used and team involved in the development of the sepsis PedsPac. Published online: April 2017.

Video: Sepsis PedsPac - Original Simulation with Expert Commentary

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TREKK Sepsis PedsPac

Video of simulated sepsis management in the ED, including commentary by Drs. Gina Neto and Anna-Theresa Lobos, Canadian physicians and sepsis experts. Commentary highlights salient management considerations. This video can be used to augment sepsis training or for an individual refresher on sepsis management. The content of this video is intended for use on patients > 28 days of age. June 2017: Version 1.0.

Video: Sepsis PedsPac - Transport

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TREKK Sepsis PedsPac

Video of simulated sepsis patient transfer, including commentary by Drs. Gina Neto and Anna-Theresa Lobos, Canadian physicians and sepsis experts. Commentary highlights key considerations when providing information to a pediatric referral centre. This video can be used to augment sepsis training or for an individual refresher on sepsis management. The content of this video is intended for use on patients >28 days of age. Posted June 2017, Version 1.0.

Video: Sepsis PedsPac - Triage and Transfer

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TREKK Sepsis PedsPac

Video demonstration of the Sepsis Triage Screener being used in the ED. This video can be used to augment sepsis nursing education or for individual refresher on pediatric sepsis considerations specific to triage. The content of this video is intended for use on patients>28 days of age. Posted June 2017, Version 1.0.

Video: Sepsis PedsPac - Team Debriefing

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TREKK Sepsis PedsPac

Video debrief of the simulated sepsis case, with discussion on how the Sepsis PedsPac was incorporated in to patient management. The content of this video is intended for use on patients >28 days of age. Posted June 2017, Version 1.0.

UNDER REVIEW: Bottom Line Recommendations: Asthma

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Johnson D and TREKK Network

Bottom line recommendations for the treatment and management of asthma. Updated January 2020, Version 1.5.

Bottom Line: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5)

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Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenboge...

The Child SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The Child SCAT5 is to be used for evaluating Children aged 5 to 12 years. For athletes aged 13 years and older, please use the SCAT5.

Bottom Line: The Sport Concussion Assessment Tool 5th Edition (SCAT5)

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Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, Makdiss...

The SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The SCAT5 is to be used for evaluating athletes aged 13 years and older. For children aged 12 years or younger, please use the Child SCAT5.

Recommendations de Base: Traumatisme Crnien Svre

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Beno S & TREKK Network

Bottom line recommendations for the treatment and management of severe head trauma - French. Published online: September 2015.

Bottom Line: Acute Procedural Pain: Paediatric Recommendations and Implementation Toolkits

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The Canadian Association of Paediatric Health Centres, Knowledge Exchange Net...

Objective: This overview is intended to summarize the systematic reviews of interventions studied to decrease paediatric pain that are currently available in the Cochrane Library. Given their unique physiology, research relevant to the management of newborns in the first month of life is not reviewed here. Four reviews relevant to the management of childrens pain are currently available

Care Pathway: Intussusception Care Pathway

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SickKids

The purpose of this pathway is to assist the health care team with clinical decisions regarding the management of a patient with intussusception.

Summary: Urinary tract infections in children

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Goilav B

This summary presents key diagnostic risk factors for urinary tract infections (UTIs) in children. The summary also covers diagnostic investigations and treatment algorithms for uncomplicated and complicated UTIs.

Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)

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Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L

The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.

Pediatric Burn Referrals

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UBC Division of Plastic Surgery

UBC Division of Plastic Surgery: Pediatric burn referrals.

Management of Bacterial Meningitis in Children and Young People

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Meningitis Research Foundation

Flowchart of management of bacterial meningitis in children and young people, incorporating NICE Bacterial Meningitis and Meningococcal Septicaemia Guideline CG102.

Aseptic Meningitis

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Melia M, Johns Hopkins ABX Guide

Guideline discussing aseptic meningitis pathogens, clinical presentation, diagnosis, treatment, and pathogen specific therapies.

Ask Suicide Screening Questions Toolkit

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National Mental Health Institute

The ASQ toolkit is organized by the medical setting in which it will be used: emergency department, inpatient medical/surgical unit, and outpatient primary care and specialty clinics.

Bottom Line: An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond. Pediatr Emerg Care 2016;32(1):36-42.

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Ali S, McGrath T, Drendel AL

Objective: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in the ED and beyond.

Flow diagram for the management of children with suspected and confirmed acute otitis media

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Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and ...

Flow chart of criteria for management of children with suspected and confirmed acute otitis media based on symptoms of children over 6 months of age.

Executive Summary: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

This executive summary is an overview of the common clinical challenges pediatric caregivers face when a child or adolescent presents with a psychiatric chief complaint or emergency.

Executive Summary: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

This executive summary is an overview of the common clinical challenges pediatric caregivers face when a mental health condition may be an unclear or complicating factor in a non-mental health ED presentation.

Clinical Pathway: Urinary tract infection in under 16s overview

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National Institute for Health and Care Excellence

This clinical pathway contains diagnosis and treatment information for persons under 16 with suspected urinary tract infection.

Early Recognition of Meningitis and Septicaemia

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Royal College of Nursing, Meningitis Research Foundation

Guidance for front line nurses on the early recognition of meningitis and sepsis (what to look for).

Bottom Line Recommendations: Severe Head Injury

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Beno S & TREKK Network

Bottom line recommendations for the treatment and management of severe head trauma. Published online: July 2015.

Bottom Line Recommenation: Optimal pain relief for pediatric MSK injury.

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Korownyk C, Young J, Michael Allan G

Evidence suggests that ibuprofen provides better single-agent relief than acetaminophen or codeine, and is at least equivalent to both acetaminophen with codeine and morphine for acute injury pain, with fewer adverse events.

Bottom Line: Intussusception

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Princess Margaret Hospital for Children

This general summary aids in the diagnosis and management of intussusception.

Emergency Medicine Cases Podcast: Emergency management of pediatric seizures - Guidance and podcast

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Helman A

With the help of two of Canada's Pediatric Emergency Medicine seizure experts handpicked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we'll give you all the tools you need to approach the child who presents to the ED with a seizure with the utmost confidence.

Bottom Line: Managing febrile seizures infographic

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Stahl-Timmins W

This infographic provides general information on managing febrile seizures.

Bottom Line: Flowchart of evaluation and management of functional constipation in children

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Koppen IJ, Lammers LA, Benninga MA, Tabbers MM

Flowchart of evaluation and management of functional constipation in children.

Bottom Line: Assessment in the emergency department for patients with head injury

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National Institute for Health and Care Excellence (NICE), National Clincial G...

A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive and designed to be used online.

Bottom Line: Approach to cyanotic congenital heart disease in the newborn

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Cheung C

This document summarizes causes, symptoms, and management of cyanosis in newborns.

Dosing Chart: Analgesic starting dosages for children

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World Health Organization

Analgesic starting doses for children.

Chart: WHO pain wall chart for waiting rooms

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World Health Organization

Is your child in pain? The doctor can help. As for pain treatment!

Bottom Line: Pain Ease(R): Topical anesthetic skin refrigerant (for children 4 years and older)

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BC Children's Hospital

Purpose: Pain Ease spray is a vapocoolant (skin refrigerant) intended for topical application to skin and minor open wounds. It controls pain associated with injections (venipunctures, IV start) and minor surgical procedures (eg. irrigating laceration/abrasions).

Bottom Line: Psychological Interventions

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BC Children's Hospital

Even with sedation, the success of a procedure is equally reliant upon careful consideration of psychosocial aspects as it is reliant on physical aspects. A sense of mastery and control experienced by parents and children is crucial to their confidence in managing any future procedures. Reducing both pain and anxiety will facilitate effective coping.

Bottom Line: Sucrose as a procedural analgesic for infants up to 12 monts of age

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BC Children's Hospital

Purpose: Oral sucrose and other sweet tasting solutions have been used for management of pain in infants for centuries. Studies done since the early 1990's have demonstrated that the administration of sucrose and non-nutritive sucking are effective non-pharmacological interventions for relief of procedural pain in neonates and infants and may help reduce pain in infants up to 12 months of age. Sucrose and non-nutritive sucking are thought to elevate pain thresholds via endogenous opioid pathways.

Videos in clinical medicine. Diagnosing otitis media--otoscopy and cerumen removal

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Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL

Video instructing how to diagnose otitis media with otoscopy and cerum removal.

Bottom Line: NICE Guidance: Child maltreatment: when to suspect maltreatment in under 16s

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National Institute for Health and Care Excellence

This guideline covers the signs of possible child maltreatment in children and young people aged under 18 years. It aims to raise awareness and help health professionals who are not child protection specialists to identify the features of physical, sexual and emotional abuse, neglect and fabricated or induced illness.

Bottom Line: Acute Concussion Evaluation (ACE): Physician/Clinician Office Version

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Goia G, Collins M

The ACE is intended to provide an evidence-based clinical protocol to conduct an initial evaluation and diagnosis of patients (both children and adults) with known or suspected mild traumatic brain injury.

Bottom Line: Autism Information for Paramedics and Emergency Room Staff

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Gammicchia C, Johnson C, Autism Society

Information for paramedics and emergency room staff on providing services to a person on the autism spectrum.

VIDEO: COVID-19 (updated)

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In this video Dr. Anthony Crocco (Sketchy EBM) outlines the symptoms of COVID-19, how to protect yourself and your family, what to do to be well and when to worry. This video is not a substitute for medical care. Please consult Public Health or your health professional for medical advice.

 

Measurement Tool: Faces Pain Scale - Revised for children 4 years of age and older

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International Association for the Study of Pain

Scores are from the left to the right (for the child): 0, 2, 4, 6, 8, 10 (0 for no pain at all and 10 for very, very much in pain).

VIDEO: Caring for a child with functional constipation

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Translating Evidence in Child Health to Enhance Outcomes (ECHO)

Canadian Anaphylaxis Action Plan for Kids

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VIDEO: Anaphylaxis in Kids

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Recommandations de Base: Interventions médicales générant des aérosols (IMGA)

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Dr. Kate Maki

Aerosole-generating medical procedures (AGMPs) are procedures that can generate aerosols when an infected person's airway is manipulated. 

Recommandations de Base: Douleur procédurale

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French Bottom line recommendations for the treatment and management of procedural pain. Published online: March 2017, v.2.0 May 2021

Recommandations de Base: Fractures chez l'enfant

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Boutis, K & TREKK Network

Recommandations de base pour le diagnostic et le traitement des fractures chez les enfants. Original (version 1.0) publié en ligne en décembre 2016. Mise à jour (version 2.0) publiée en ligne février 2018Mise à jour (version 3.0) publiée en ligne mai 2021.

 

Recommandations de Base: Anaphylaxie

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Alqurashi W and TREKK Network

Bottom line recommendations for the treatment and management of pediatric anaphylaxis - en francais. Published online: October 2018.

Fiche Dinformation: COVID-19 pdiatrique (nouveau coronavirus)

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TREKK Network

Fact sheet for the treatment and management of pediatric COVID-19 (novel coronavirus) - French

Recommandations de Base: Prise en charge de la douleur

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Ali, S, Drendel A and TREKK Network

Recommandations de base pour la prise en charge de la douleur aigüe chez l’enfant. Publiée en ligne juillet 2018, v2.0 mai 2021.

 

Recommandations de Base: Brûlures thermiques

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Crombie T & Malic C and TREKK Network

Bottom line recommendations for the treatment and management of pediatric thermal burns - en français. version 1.0. Published online: February 2021.

Recommandations de Base: La Bronchiolite

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Plint, A & TREKK Network

Bottom line recommendations for the treatment and management of bronchiolitis - en francais.  Published online: January 14, 2021, Version 3.0.

Feuille D’ordonnances Pré-Rédigées pour Choc Septique Severe

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PedsPac de TREKK sur le Choc Septique

This order set is for management of severe sepsis in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than 28 days of age. Published online: Feb 2020, v 1.2.

Status Epilepticus References and Development Team

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TREKK Status Epilepticus PedsPac

This document outlines the references used and team involved in the development of the status epilepticus PedsPac. Published online: December 2020

Algorithme pour le status epilepticus pediatrique

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PedsPac de TREKK sur le Status Epilepticus

This point of care algorithm is to guide initial management of pediatric status epilepticus in the Emergency Department. Published online: June 2020, Version 3.0.

Carte de Poche de Status Epilepticus

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PedsPac de TREKK sur le Status Epilepticus

This pocket card contains tips to manage pediatric patients with suspected status epilepticus. Reverse side of pocket card includes pediatric considerations for febrile and non-febrile patients. Published online: June 2020, Version 2.0.

Feuille D’ordonnances Pré-Rédigées pour Status Epilepticus

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PedsPac de TREKK sur le Status Epilepticus

This order set is for management of status epilepticus in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 2.0

Feuille D’ordonnances Pré-Rédigées pour L’Anaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

This French order set is for management of pediatric anaphylaxis in the ED and is adaptable to your hospitals form policy. Published online: March 2020, Version 1.2.

Feuille D’ordonnances Pré-Rédigées pour d'Acidose Diabetique

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TREKK Diabetic Ketoacidosis PedsPac

This order set is for management of pediatric diabetic ketoacidosis in the ED. This document is adaptable to your hospitals form policy. Published online: Mars 2020, Version 1.3 - French.

Carte de Poche d'Acidose Diabetique

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TREKK Diabetic Ketoacidosis PedsPac

A pocket guide to red flags for pediatric diabetic ketoacidosis - French

Algorithme Pediatrique pour d'Acidose Diabetique

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TREKK Diabetic Ketoacidosis PedsPac

An algorithm for recognizing and managing pediatric diabetic ketoacidosis - French

Feuille D’ordonnances Pré-Rédigées pour Nouveau-Ne en Etat Critique

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PedsPac de TREKK sur Nouveau-Ne en Etat Critique

This order set is for management of the critically ill neonate in the ED and is adaptable to your hospitals form policy. This document is intended for infants 0-28 days.  At birth, refer to NRP guidelines. Not intended for preterm infants.  Published online: January 2021, version 1.2.

Feuille D’ordonnances Pré-Rédigées pour d'Asthme

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PedsPac de TREKK sur d'Asthme

This order set is for management of pediatric severe asthma in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients > 12 months of age. Published online: Feb 2020, Version 1.1.

Algorithme pour Nouveau-Ne en Etat Critique

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PedsPac de TREKK sur Nouveau-Ne en Etat Critique

This point of care algorithm is to guide initial management of critically ill neonates in the Emergency Department. This algorithm is intended for use on patients less than or equal to 28 days of age (corrected age). Published online: February 2021, Version 1.3.

Recommandations de Base: Infection Urinaire

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Le Saux N, Neto, G TREKK Network

Bottom Line Recommendations for diagnosis and treatment of urinary tract infections - French. Version 1.1.

Liste de vérification pour le polytraumatisme pédiatrique

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PedsPac de TREKK sur le polytraumatisme

This checklist is for management of pediatric multisystem in the ED pre-arrival and post-departure. Published online: June 2020, Version 1.0.

Feuille d’ordonnances pré-rédigées pour le polytraumatisme pediatrique

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PedsPac de TREKK sur le polytraumatisme

This order set is for management of pediatric multisystem trauma in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 1.0.

Recommendations de Base: Laryngite Aigu

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Johnson, DW. & TREKK Network

Bottom line recommendations for the treatment and management of croup- French.

Recommendations de Base: Gastro-entrite

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Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis. Posted Feb 2020- version 3.1

Recommandations de Base: Fievre - Nouveau-nés et nourrissons

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Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants (French). Published online: June 2019, Version 2.0.

Recommandations de Base: Constipation

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Eltorki, M., Landry, P.and TREKK Network

Bottom line recommendations for the treatment and management of pediatric constipation - French, version 1.1. Published online: August 2019.

Recommandations de Base: Déficience intellectuelle et troubles du développement

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Hanlon-Dearman, A, Stevenson, M and TREKK Network

Bottom line recommendations for caring for children with developmental and intellectual disabilities in the ED. Published online: Feb 2020, v 1.1

Recommandations de Base: Otite moyenne aigu

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Le Saux N, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of AOM-French. Posted May 2020, Version 2.1

Recommandations de Base: Acidose Diabetique

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Reid S, and TREKK Network

Bottom line recommendations for the treatment and management of diabetic ketoacidosis (DKA) - French

Recommendations de Base: Traumatisme Cranien Severe

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Beno S and the TREKK Network

Updated bottom line recommendations for the treatment and management of severe head trauma - French. Version 2.1 published online: October 2018.

Recommendations de Base: Invagination

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Timmons Z, Bulloch B and TREKK Network

Recommandations de base pour le diagnostic et le traitement de l'invagination. Original (version 1.0) publié en ligne en fevrier 2016. Mise à jour (version 2.0) publiée en ligne juillet 2018.

Recommandations de Base: La Sédation Procédurale

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Evered L, Bhatt M & TREKK Network

Bottom line recommendations for the procedural sedation - French. Published online: March 2018.

Algorithme Pediatrique pour Choc Septique Severe

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PedsPac de TREKK sur le Choc Septique

This point of care algorithm is to guide initial management of pediatric sepsis in the Emergency Department. This algorithm is intended for use on patients greater than 28 days of age. Published online: April 2019, v 2.2.

Carte de Poche de Choc Septique

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PedsPac de TREKK sur le Choc Septique

This pocket card contains tips to recognize early shock, indications of poor perfusion, and management considerations for patients with suspected sepsis. Reverse side of pocket card includes pediatric definition of hypotension. This pocket card is intended for use on patients greater than 28 days of age. Published online: April 2019, Version 1.1.

Recommandations de Base: Suspicion de maltraitance physique d’un enfant

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Boutis, K, Ornstein A, Coombs C & TREKK Network

Bottom line recommendations for the treatment and management of suspected physical child maltreatment - FRENCH. Published online: October 2018.

Recommandations de Base: Choc septique

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Thompson G, Jabbour M and TREKK Network

Bottom line recommendations for the treatment and management pediatric sepsis - en francais. Published online: October 2018.

Anaphylaxis References and Development Team

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TREKK Anaphylaxis PedsPac

This document outlines the references used and team involved in the development of the anaphylaxis PedsPac. Published online: October 2018.

Carte de Poche pour LAnaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

This pocket card contains tips to manage pediatric patients with anaphylaxis. Published online: April 2019, Version 1.2.

Algorithme pour LAnaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

This point of care algorithm is to guide initial management of pediatric anaphylaxis in the Emergency Department. Published online: April 2019, Version 1.1.

Carte de Poche d'Asthme

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PedsPac de TREKK sur d'Asthme

This pocket card contains tips to manage pediatric patients with severe asthma. This pocket card is intended for use on patients > 12 months of age. Published online: April 2019, Version 1.0.

Algorithme Pediatrique pour d'Asthme

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PedsPac de TREKK sur d'Asthme

This point of care algorithm is to guide initial management of pediatric severe asthma in the Emergency Department. This algorithm is intended for use on patients greater than or equal to 12 months of age. Published online: March 2020, Version 1.1.

Carte de signes vitaux pour Choc Septique Severe

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PedsPac de TREKK sur le Choc Septique

This pocket card outlines pediatric heart rate and pediatric respiratory rate guidelines and was reviewed in October 2018. Posted online April 2019, version 2.0.

Recommandations de Base: Commotion crbrale (TCC lger)

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Zemek R and TREKK Network

Bottom line recommendations for the treatment and management of concussion - en francais. Updated: August 2018.

Scanner de Triage Choc Septique

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PedsPac de TREKK sur le Choc Septique

This screening tool is to facilitate early identification of suspected pediatric sepsis in the ED. Includes key indicators of sepsis and high-risk medical conditions. This screening tool is intended for use on patients greater than 28 days of age. Published online: June 2017, Version 1.0.

Sepsis References and Development Team

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TREKK Sepsis PedsPac

This document outlines the references used and team involved in the development of the sepsis PedsPac. Published online: April 2017.

UNDER REVIEW: Recommandations de Base: Asthme

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Johnson D and TREKK Network

Recommandations de base pour l'évaluation et la prise en charge de l'asthme.

VIDEO: Le plan d’action Canadien pour l’anaphylaxie chez les enfants

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VIDEO: Sepsis in Kids

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VIDEO: DKA in Kids

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MyHEARTSMAP - Mental Health Self-Assessment Tool and information

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MyHEARTSMAP is a digital tool that will help families, children and youth self-assess their mental health needs. Once the self-assessment is completed, the tool will recommend appropriate resources. This tool has been found to be highly reliable and can provide options for seeking care other than the emergency department or can provide doctors with valuable information in the ED.

View MyHEARTSMAP 

 
 

Recommandations de Base: Interventions médicales générant des aérosols (IMGA)

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Dr. Kate Maki

Aerosole-generating medical procedures (AGMPs) are procedures that can generate aerosols when an infected person's airway is manipulated. 

Bottom Line: Autism and the Hospital Emergency Room: A Practical Guide for Health Professionals to Meet the Needs of Individuals with Autism Spectrum Disorders

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Center for Autism & Related Disabilities (CARD)

A practical guide for health professionals to meet the needs of individuals with Autism Spectrum Disorder.

Bottom Line Recommendations: Fractures

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Boutis K & TREKK Network

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and treatment of fractures in children. Original (version 1.0) published online: November 2015. Updated (version 2.0) published online: February 2018. Updated (version 3.0) published online: May 2021.

Recommandations de Base: Douleur procédurale

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French Bottom line recommendations for the treatment and management of procedural pain. Published online: March 2017, v.2.0 May 2021

Recommandations de Base: Fractures chez l'enfant

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Boutis, K & TREKK Network

Recommandations de base pour le diagnostic et le traitement des fractures chez les enfants. Original (version 1.0) publié en ligne en décembre 2016. Mise à jour (version 2.0) publiée en ligne février 2018Mise à jour (version 3.0) publiée en ligne mai 2021.

 

Bottom Line Recommendations: Anaphylaxis

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Alqurashi W and TREKK Network

Bottom line recommendations for the treatment and management of pediatric anaphylaxis - version 1.2. Published online: December 2018.

Recommandations de Base: Anaphylaxie

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Alqurashi W and TREKK Network

Bottom line recommendations for the treatment and management of pediatric anaphylaxis - en francais. Published online: October 2018.

Bottom Line Recommendations: Constipation

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Eltorki, M., Landy, P.and TREKK Network

Bottom line recommendations for the treatment and management of pediatric constipation - version 2.0. Published online: November 2021.

Fact Sheet: Pediatric COVID-19

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TREKK Network

Fact sheet for the treatment and management of pediatric COVID-19 (novel coronavirus)

The 2019 Novel Coronavirus (COVID-19)

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Information on COVID-19 from Caring for Kids for parents and families. 

COVID-19 information and resources for paediatricians

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COVID-19 and Canadas Kids

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Canadian Association of Emergency Physicians - COVID-19 Information, Resources and Advocacy Centre

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Emergency Medicine Cases: Practical COVID-19 resources for front line healthcare professionals

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Fiche Dinformation: COVID-19 pdiatrique (nouveau coronavirus)

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TREKK Network

Fact sheet for the treatment and management of pediatric COVID-19 (novel coronavirus) - French

Bottom Line Recommendations: Procedural Pain

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Ali, S, Drendel A & TREKK Network

Bottom line recommendations for the treatment and management of procedural pain. Published online: November 2016, update May 2021

Bottom Line Recommendations: Pediatric Thermal Burns

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Crombie T & Malic C and TREKK Network

Bottom line recommendations for the treatment and management of pediatric thermal burns - version 1.0. Published online: February 2021.

Aerosol Generating Medical Procedure (AGMP)

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Dr. Kate Maki

Aerosol-generating medical procedures (AGMPs) are procedures that can generate aerosols when an infected person’s airway is manipulated.

VIDEO: Croup in Kids

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VIDEO: Gastroenteritis in Kids

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Shannon D Scott, RN, PhD; Lisa Hartling, PhD; Pediatric Parent Advisory Group...

Gastroenteritis, or the stomach flu, is an infection of the intestines caused by a virus or bacteria that can cause diarrhea and vomiting. It is common in infants and children and can lead to dehydration. This video was developed by ECHO, ARCHE, and TREKK.

Bottom Line Recommendations: Pain Treatment

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Ali, S, Drendel A and TREKK Network

Bottom line recommendations for pediatric pain treatment. Published online: May 2018, updated May 2021.

Recommandations de Base: Prise en charge de la douleur

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Ali, S, Drendel A and TREKK Network

Recommandations de base pour la prise en charge de la douleur aigüe chez l’enfant. Publiée en ligne juillet 2018, v2.0 mai 2021.

 

Opioids- Information for Parents

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Opioids- Information for Youth

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Opioids- Information for Clinicians

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Recommandations de Base: Brûlures thermiques

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Crombie T & Malic C and TREKK Network

Bottom line recommendations for the treatment and management of pediatric thermal burns - en français. version 1.0. Published online: February 2021.

Bottom Line Recommendations: Suicidal Risk Screening and Assessment

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Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurenc...

Bottom Line Recommendations for screening and assessment of suicide risk. September 2021, Version 1.0

Bottom Line Recommendations: Cannabis Intoxication

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Dr. Kaitlin Hogue, Dr. Neil Desai and TREKK Network

Bottom line recommendations for cannabis intoxication. Published online: December 2021

Formulations and Methods of Delivery: Cannabis

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Dr. Kaitlin Hogue, Dr. Neil Desai, Danica Irwin and TREKK Network

Formulations and methods of delivery table for cannabis. Uploaded 2021-12-06

High-flow nasal cannula oxygen therapy in children

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Nagler J, Torrey SB, Wiley JF

This topic will focus on the use of high-flow nasal cannula (HFNC) in pediatric patients, including discussion of equipment, proposed mechanisms of action, comparison with other oxygen delivery devices, indications and contraindications, approach to initiation, assessment of effectiveness, and potential complications.

Bottom Line Recommendations: Gastroenteritis

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Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis

Bottom Line Recommendations: Croup

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Johnson, DW. & TREKK Network

Bottom line recommendations for the treatment and management of croup.

Bottom Line Recommendations: Bronchiolitis

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Plint, A & TREKK Network

Bottom line recommendations for the treatment and management of bronchiolitis. Posted online: January 14, 2021, Version 3.0.

Bottom Line: Management of Acute Symptoms Algorithm

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Ontario Neurotrauma Foundation

This document is intended to guide health care professionals in diagnosing and managing pediatric concussion. See Page 48 of this document for the Management of Acute Symptoms Algorithm (Tool 2.1).

Recommandations de Base: La Bronchiolite

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Plint, A & TREKK Network

Bottom line recommendations for the treatment and management of bronchiolitis - en francais.  Published online: January 14, 2021, Version 3.0.

Sepsis Order Set

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TREKK Sepsis PedsPac

This order set is for management of severe sepsis in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than 28 days of age. Published online: Feb 2020, Version 1.2.

Feuille D’ordonnances Pré-Rédigées pour Choc Septique Severe

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PedsPac de TREKK sur le Choc Septique

This order set is for management of severe sepsis in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than 28 days of age. Published online: Feb 2020, v 1.2.

Status Epilepticus Algorithm

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TREKK Status Epilepticus PedsPac

This point of care algorithm is to guide initial management of pediatric status epilepticus in the Emergency Department. Published online: June 2020, Version 3.0.

Status Epilepticus Pocket Card

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TREKK Status Epilepticus PedsPac

This pocket card contains tips to manage pediatric patients with suspected status epilepticus. Reverse side of pocket card includes pediatric considerations for febrile and non-febrile patients. Published online: June 2020, Version 2.0.

Status Epilepticus Order Set

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TREKK Status Epilepticus PedsPac

This order set is for management of pediatric status epilepticus in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 2.0.

Status Epilepticus References and Development Team

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TREKK Status Epilepticus PedsPac

This document outlines the references used and team involved in the development of the status epilepticus PedsPac. Published online: December 2020

Algorithme pour le status epilepticus pediatrique

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PedsPac de TREKK sur le Status Epilepticus

This point of care algorithm is to guide initial management of pediatric status epilepticus in the Emergency Department. Published online: June 2020, Version 3.0.

Carte de Poche de Status Epilepticus

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PedsPac de TREKK sur le Status Epilepticus

This pocket card contains tips to manage pediatric patients with suspected status epilepticus. Reverse side of pocket card includes pediatric considerations for febrile and non-febrile patients. Published online: June 2020, Version 2.0.

Feuille D’ordonnances Pré-Rédigées pour Status Epilepticus

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PedsPac de TREKK sur le Status Epilepticus

This order set is for management of status epilepticus in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 2.0

Feuille D’ordonnances Pré-Rédigées pour L’Anaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

This French order set is for management of pediatric anaphylaxis in the ED and is adaptable to your hospitals form policy. Published online: March 2020, Version 1.2.

Anaphylaxis Order Set

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TREKK Anaphylaxis PedsPac

This order set is for management of pediatric anaphylaxis in the ED. This document is adaptable to your hospitals form policy. Published online: March 2020, Version 1.2.

Diabetic Keotacidosis Algorithm

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TREKK Diabetic Ketoacidosis PedsPac

An algorithm for recognizing and managing pediatric diabetic ketoacidosis

Diabetic Ketoacidosis Pocket Card

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TREKK Diabetic Ketoacidosis PedsPac

A pocket guide to red flags for pediatric diabetic ketoacidosis

Diabetic Ketoacidosis Order Set

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TREKK Diabetic Ketoacidosis PedsPac

This order set is for management of pediatric diabetic ketoacidosis in the ED. This document is adaptable to your hospitals form policy. Published online: March 2020, Version 1.3.

Asthma Order Set

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TREKK Asthma PedsPac

This order set is for management of pediatric severe asthma in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than or equal to 12 months of age. Published online: February 2020, Version 1.1.

Critically Ill Neonate Order Set

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TREKK Critically Ill Neonate PedsPac

This order set is for management of the critically ill neonate in the ED and is adaptable to your hospitals form policy. This algorithm is intended for infants 0-28 days.  At birth, please refer to NRP guidelines. Not intended for preterm infants. Published: January 2021, version 1.2.

UNDER REVIEW: Critically Ill Neonate Algorithm

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TREKK Critically Ill Neonate PedsPac

This point of care algorithm is to guide initial management of critically ill neonates in the Emergency Department. This algorithm is intended for infants 0-28 days.  At birth, please refer to NRP guidelines. Not intended for preterm infants. Published online: January 2021, Version 1.2.

Feuille D’ordonnances Pré-Rédigées pour d'Acidose Diabetique

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TREKK Diabetic Ketoacidosis PedsPac

This order set is for management of pediatric diabetic ketoacidosis in the ED. This document is adaptable to your hospitals form policy. Published online: Mars 2020, Version 1.3 - French.

Carte de Poche d'Acidose Diabetique

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TREKK Diabetic Ketoacidosis PedsPac

A pocket guide to red flags for pediatric diabetic ketoacidosis - French

Algorithme Pediatrique pour d'Acidose Diabetique

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TREKK Diabetic Ketoacidosis PedsPac

An algorithm for recognizing and managing pediatric diabetic ketoacidosis - French

Feuille D’ordonnances Pré-Rédigées pour Nouveau-Ne en Etat Critique

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PedsPac de TREKK sur Nouveau-Ne en Etat Critique

This order set is for management of the critically ill neonate in the ED and is adaptable to your hospitals form policy. This document is intended for infants 0-28 days.  At birth, refer to NRP guidelines. Not intended for preterm infants.  Published online: January 2021, version 1.2.

Feuille D’ordonnances Pré-Rédigées pour d'Asthme

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PedsPac de TREKK sur d'Asthme

This order set is for management of pediatric severe asthma in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients > 12 months of age. Published online: Feb 2020, Version 1.1.

Algorithme pour Nouveau-Ne en Etat Critique

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PedsPac de TREKK sur Nouveau-Ne en Etat Critique

This point of care algorithm is to guide initial management of critically ill neonates in the Emergency Department. This algorithm is intended for use on patients less than or equal to 28 days of age (corrected age). Published online: February 2021, Version 1.3.

Bottom Line Recommendations: Urinary Tract Infection

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Le Saux N, Neto G, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of urinary tract infection. Version 1.1

Recommandations de Base: Infection Urinaire

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Le Saux N, Neto, G TREKK Network

Bottom Line Recommendations for diagnosis and treatment of urinary tract infections - French. Version 1.1.

World Health Organization: Parenting in the time of COVID-19

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World Health Organization

To help parents interact constructively with their children during this time of confinement, the World Health Organization created these six one-page tips for parents cover planning one-on-one time, staying positive, creating a daily routine, avoiding bad behaviour, managing stress, and talking about COVID-19. 

 

 

Clinical management of patients with moderate to severe COVID-19 - Interim guidance

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Government of Canada

Multisystem Trauma Algorithm

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TREKK Multisystem Trauma PedsPac

This point of care algorithm is to guide initial management of pediatric multisystem trauma in the Emergency Department. Published online: June 2020, Version 1.0.

Multisystem Trauma Order Set

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TREKK Multisystem Trauma PedsPac

This order set is for management of pediatric multisystem trauma in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 1.0.

Multisystem Trauma Checklist

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TREKK Multisystem Trauma PedsPac

This checklist is for management of pediatric multisystem in the ED pre-arrival and post-departure. Published online: June 2020, Version 1.0.

Liste de vérification pour le polytraumatisme pédiatrique

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PedsPac de TREKK sur le polytraumatisme

This checklist is for management of pediatric multisystem in the ED pre-arrival and post-departure. Published online: June 2020, Version 1.0.

Feuille d’ordonnances pré-rédigées pour le polytraumatisme pediatrique

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PedsPac de TREKK sur le polytraumatisme

This order set is for management of pediatric multisystem trauma in the ED and is adaptable to your hospitals form policy. Published online: June 2020, Version 1.0.

Bottom Line Recommendations: Multisystem Trauma

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Beno S, TREKK Network

The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of multisystem trauma in children in the emergency department. Published online: January 14, 2021, Version 3.0.

Recommendations de Base: Polytrauma

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Beno S, TREKK Network

Le but du present document est de fournir aux professionnels de la sant les faits et recommandations cles pour le diagnostic et le traitement du polytrauma chez les enfants dans un service durgence. Published online: January 14, 2021, Version 3.0.

Bottom Line: Application of topical local anesthetic for potentially painful skin-breaking procedures

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Alberta Health Services

Objectives: To provide direction to health care professionals on the timely and safe application of topical local anesthetics prior to a painful skin-breaking procedure for in-patients and outpatients.

eMagazine No Mercy for the Coronas

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Looking for resources to understand the scientific realities of the COVID-19 virus and pandemic? Check out this children's science magazine, No Mercy for the Coronas, an engaging and accessible illustrated resource for kids (and parents!) to better understand viruses like COVID-19.
 
This e-magazine was created by La Liberté and POP Comm, and developed with the participation of scientists and researchers at Children’s Hospital Research Institute of Manitoba (CHRIM), University of Manitoba and St. Boniface Hospital Albrechtsen Research Centre’s Youth BIOlab Jeunesse.

No Mercy for the Coronas! is for all those who wish to offer children a scientifically reliable resource during this global health crisis affecting all ages and all aspects of society. You can read or download this free magazine in English or French.

Recommendations de Base: Laryngite Aigu

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Johnson, DW. & TREKK Network

Bottom line recommendations for the treatment and management of croup- French.

Recommendations de Base: Gastro-entrite

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Freedman S, & TREKK Network

Bottom line recommendations for the treatment and management of pediatric gastroenteritis. Posted Feb 2020- version 3.1

Bottom Line Recommendations: Fever in Young infants

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Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants. Published online: June 2019, Version 2.0.

Diabetic Ketoacidosis References and Development Team

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TREKK Diabetic Ketoacidosis PedsPac

This document outlines the references used and team involved in the development of the diabetic ketoacidosis PedsPac. Published online: January 2019.

Bottom Line Recommendations: Caring for Children with Developmental and Intellectual Disabilities in the ED

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Hanlon-Dearman, A, Stevenson, M and TREKK Network

Bottom line recommendations for caring for children with developmental and intellectual disabilities in the ED. Published online: Feb 2020, v 1.1

Recommandations de Base: Fievre - Nouveau-nés et nourrissons

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Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants (French). Published online: June 2019, Version 2.0.

Recommandations de Base: Constipation

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Eltorki, M., Landry, P.and TREKK Network

Bottom line recommendations for the treatment and management of pediatric constipation - French, version 1.1. Published online: August 2019.

Recommandations de Base: Déficience intellectuelle et troubles du développement

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Hanlon-Dearman, A, Stevenson, M and TREKK Network

Bottom line recommendations for caring for children with developmental and intellectual disabilities in the ED. Published online: Feb 2020, v 1.1

Bottom Line Recommendations: Acute Otitis Media

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Le Saux N, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of AOM. Posted online May 2020, Version 2.1

Recommandations de Base: Otite moyenne aigu

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Le Saux N, TREKK Network

Bottom Line Recommendations for diagnosis and treatment of AOM-French. Posted May 2020, Version 2.1

Burns Centre Consultation Guidelines

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CritiCall Ontario

Guidelines for burns centre consultations.

Suicide Prevention, Risk Assessment & Management, AMH

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Alberta Health Services

Suicide Prevention, Risk Assessment & Management (SPRAM) is a web-based, interactive e-Learning series designed to respond to the foundational learning needs of health practitioners working in Addiction and Mental Health (AMH).

Bottom Line Recommendations: Diabetic Ketoacidosis

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Reid S, and TREKK Network

Bottom line recommendations for the treatment and management of diabetic ketoacidosis (DKA).

Recommandations de Base: Acidose Diabetique

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Reid S, and TREKK Network

Bottom line recommendations for the treatment and management of diabetic ketoacidosis (DKA) - French

UNDER REVIEW: Bottom Line Recommendations: Procedural Sedation

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Evered L, Bhatt M & TREKK Network

Bottom line recommendations for pediatric procedural sedation. Published online: March 2018.

UNDER REVIEW: Bottom Line Recommendations: Severe Head Injury

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Beno S and the TREKK Network

Updated bottom line recommendations for the treatment and management of severe head trauma. Published online: October 2017.

Recommendations de Base: Traumatisme Cranien Severe

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Beno S and the TREKK Network

Updated bottom line recommendations for the treatment and management of severe head trauma - French. Version 2.1 published online: October 2018.

Bottom Line Recommendations: Intussusception

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Timmons Z, Bulloch B & TREKK Network

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and management of intussusception in children. Original (Version 1.0) published online in 2016. Update (Version 2.0) published online in June 2018.

Recommendations de Base: Invagination

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Timmons Z, Bulloch B and TREKK Network

Recommandations de base pour le diagnostic et le traitement de l'invagination. Original (version 1.0) publié en ligne en fevrier 2016. Mise à jour (version 2.0) publiée en ligne juillet 2018.

Acute Otitis Media- Emergency Management in Children - Flowchart

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Children's Health Queensland Hospital and Health Service

Flowchart of emergency management in children for acute otitis media.

Recommandations de Base: La Sédation Procédurale

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Evered L, Bhatt M & TREKK Network

Bottom line recommendations for the procedural sedation - French. Published online: March 2018.

Sepsis Algorithm

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TREKK Sepsis PedsPac

This point of care algorithm is to guide initial management of pediatric sepsis in the Emergency Department. This algorithm is intended for use on patients greater than 28 days of age. Published online: December 2018, Version 2.2.

Sepsis Pocket Card

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TREKK Sepsis PedsPac

This pocket card contains tips to recognize early shock, indications of poor perfusion, and management considerations for patients with suspected sepsis. Reverse side of pocket card includes pediatric definition of hypotension. This pocket card is intended for use on patients greater than 28 days of age. Published online: December 2018, Version 1.1.

UNDER REVIEW: Bottom Line Recommendations: Suspected Physical Child Maltreatment

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Boutis, K, Ornstein A, Coombs C & TREKK Network

Bottom line recommendations for the treatment and management of suspected physical child maltreatment. Published online: August 2018.

Bottom Line Recommendations: Sepsis

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Thompson G, Jabbour M and TREKK Network

Bottom line recommendations for the treatment and management pediatric sepsis. Published online: September 2018.

Algorithme Pediatrique pour Choc Septique Severe

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PedsPac de TREKK sur le Choc Septique

This point of care algorithm is to guide initial management of pediatric sepsis in the Emergency Department. This algorithm is intended for use on patients greater than 28 days of age. Published online: April 2019, v 2.2.

Carte de Poche de Choc Septique

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PedsPac de TREKK sur le Choc Septique

This pocket card contains tips to recognize early shock, indications of poor perfusion, and management considerations for patients with suspected sepsis. Reverse side of pocket card includes pediatric definition of hypotension. This pocket card is intended for use on patients greater than 28 days of age. Published online: April 2019, Version 1.1.

Recommandations de Base: Suspicion de maltraitance physique d’un enfant

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Boutis, K, Ornstein A, Coombs C & TREKK Network

Bottom line recommendations for the treatment and management of suspected physical child maltreatment - FRENCH. Published online: October 2018.

Recommandations de Base: Choc septique

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Thompson G, Jabbour M and TREKK Network

Bottom line recommendations for the treatment and management pediatric sepsis - en francais. Published online: October 2018.

Anaphylaxis References and Development Team

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TREKK Anaphylaxis PedsPac

This document outlines the references used and team involved in the development of the anaphylaxis PedsPac. Published online: October 2018.

Asthma Algorithm

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TREKK Asthma PedsPac

This point of care algorithm is to guide initial management of pediatric severe asthma in the Emergency Department. This algorithm is intended for use on patients greater than or equal to 12 months of age. Published online: March 2020, Version 1.2.

Asthma Pocket Card

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TREKK Asthma PedsPac

This pocket card contains tips to manage pediatric patients with severe asthma. This pocket card is intended for use on patients greater or equal to 12 months of age. Published online: March 2020, Version 1.3.

Anaphylaxis Algorithm

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TREKK Anaphylaxis PedsPac

This point of care algorithm is to guide initial management of pediatric anaphylaxis in the Emergency Department. Published online: December 2018, Version 1.1.

Anaphylaxis Pocket Card

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TREKK Anaphylaxis PedsPac

This pocket card contains tips to manage pediatric patients with anaphylaxis. Updated online: April 2019, Version 1.2.

Sepsis Vital Signs Pocket Card

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TREKK Sepsis PedsPac

This pocket card outlines pediatric heart rate and pediatric respiratory rate guidelines and was reviewed in October 2018. Posted online December 2018, version 2.0.

Carte de Poche pour LAnaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

This pocket card contains tips to manage pediatric patients with anaphylaxis. Published online: April 2019, Version 1.2.

Algorithme pour LAnaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

This point of care algorithm is to guide initial management of pediatric anaphylaxis in the Emergency Department. Published online: April 2019, Version 1.1.

Asthma References and Development Team

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TREKK Asthma PedsPac

This document outlines the references used and team involved in the development of the asthma PedsPac. Published online: December 2018, Version 1.0.

Carte de Poche d'Asthme

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PedsPac de TREKK sur d'Asthme

This pocket card contains tips to manage pediatric patients with severe asthma. This pocket card is intended for use on patients > 12 months of age. Published online: April 2019, Version 1.0.

Algorithme Pediatrique pour d'Asthme

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PedsPac de TREKK sur d'Asthme

This point of care algorithm is to guide initial management of pediatric severe asthma in the Emergency Department. This algorithm is intended for use on patients greater than or equal to 12 months of age. Published online: March 2020, Version 1.1.

Carte de signes vitaux pour Choc Septique Severe

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PedsPac de TREKK sur le Choc Septique

This pocket card outlines pediatric heart rate and pediatric respiratory rate guidelines and was reviewed in October 2018. Posted online April 2019, version 2.0.

Bottom Line Recommendations: Concussion

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Zemek R & TREKK Network

Bottom line recommendations for the treatment and management of concussion. Updated: August 2018.

Recommandations de Base: Commotion crbrale (TCC lger)

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Zemek R and TREKK Network

Bottom line recommendations for the treatment and management of concussion - en francais. Updated: August 2018.

Paediatric Burn Assessment

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Victorial Adult Burns Service at the Alfred

Burns management guidelines for pediatric burn assessment.

Paediatric Burn Guidelines

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Women's and Children's Hospital

Pediatric burn guidelines reference chart.

CSF interpretation

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The Royal Children's Hospital Melbourne

Guideline to help with the interpretation of CSF results for the purpose of diagnosing or excluding meningitis.

Lumbar puncture

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The Royal Children's Hospital Melbourne

Guideline for performing lumbar puncture.

Meningitis - encephalitis

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The Royal Children's Hospital Melbourne

Guideline for the assessment and management of meningitis-encephalitis.

Bottom Line: Recommendations: Special considerations in pediatrics (2013)

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Surviving Sepsis Campaign

Special consideration in pediatrics from the Surviving Sepsis Campaign. Published: 2013.

Sepsis Triage Poster

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TREKK Sepsis PedsPac

This screening tool is to facilitate early identification of suspected pediatric sepsis in the ED. Includes key indicators of sepsis and high-risk medical conditions. This screening tool is intended for use on patients greater than 28 days of age. Published online: June 2017, Version 1.0.

Scanner de Triage Choc Septique

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PedsPac de TREKK sur le Choc Septique

This screening tool is to facilitate early identification of suspected pediatric sepsis in the ED. Includes key indicators of sepsis and high-risk medical conditions. This screening tool is intended for use on patients greater than 28 days of age. Published online: June 2017, Version 1.0.

Sepsis References and Development Team

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TREKK Sepsis PedsPac

This document outlines the references used and team involved in the development of the sepsis PedsPac. Published online: April 2017.

Video: Sepsis PedsPac - Original Simulation with Expert Commentary

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TREKK Sepsis PedsPac

Video of simulated sepsis management in the ED, including commentary by Drs. Gina Neto and Anna-Theresa Lobos, Canadian physicians and sepsis experts. Commentary highlights salient management considerations. This video can be used to augment sepsis training or for an individual refresher on sepsis management. The content of this video is intended for use on patients > 28 days of age. June 2017: Version 1.0.

Video: Sepsis PedsPac - Transport

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TREKK Sepsis PedsPac

Video of simulated sepsis patient transfer, including commentary by Drs. Gina Neto and Anna-Theresa Lobos, Canadian physicians and sepsis experts. Commentary highlights key considerations when providing information to a pediatric referral centre. This video can be used to augment sepsis training or for an individual refresher on sepsis management. The content of this video is intended for use on patients >28 days of age. Posted June 2017, Version 1.0.

Video: Sepsis PedsPac - Triage and Transfer

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TREKK Sepsis PedsPac

Video demonstration of the Sepsis Triage Screener being used in the ED. This video can be used to augment sepsis nursing education or for individual refresher on pediatric sepsis considerations specific to triage. The content of this video is intended for use on patients>28 days of age. Posted June 2017, Version 1.0.

Video: Sepsis PedsPac - Team Debriefing

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TREKK Sepsis PedsPac

Video debrief of the simulated sepsis case, with discussion on how the Sepsis PedsPac was incorporated in to patient management. The content of this video is intended for use on patients >28 days of age. Posted June 2017, Version 1.0.

UNDER REVIEW: Bottom Line Recommendations: Asthma

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Johnson D and TREKK Network

Bottom line recommendations for the treatment and management of asthma. Updated January 2020, Version 1.5.

UNDER REVIEW: Recommandations de Base: Asthme

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Johnson D and TREKK Network

Recommandations de base pour l'évaluation et la prise en charge de l'asthme.

Bottom Line: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5)

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Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenboge...

The Child SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The Child SCAT5 is to be used for evaluating Children aged 5 to 12 years. For athletes aged 13 years and older, please use the SCAT5.

Bottom Line: The Sport Concussion Assessment Tool 5th Edition (SCAT5)

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Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, Makdiss...

The SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The SCAT5 is to be used for evaluating athletes aged 13 years and older. For children aged 12 years or younger, please use the Child SCAT5.

Recommendations de Base: Traumatisme Crnien Svre

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Beno S & TREKK Network

Bottom line recommendations for the treatment and management of severe head trauma - French. Published online: September 2015.

Bottom Line: Acute Procedural Pain: Paediatric Recommendations and Implementation Toolkits

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The Canadian Association of Paediatric Health Centres, Knowledge Exchange Net...

Objective: This overview is intended to summarize the systematic reviews of interventions studied to decrease paediatric pain that are currently available in the Cochrane Library. Given their unique physiology, research relevant to the management of newborns in the first month of life is not reviewed here. Four reviews relevant to the management of childrens pain are currently available

Care Pathway: Intussusception Care Pathway

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SickKids

The purpose of this pathway is to assist the health care team with clinical decisions regarding the management of a patient with intussusception.

Summary: Urinary tract infections in children

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Goilav B

This summary presents key diagnostic risk factors for urinary tract infections (UTIs) in children. The summary also covers diagnostic investigations and treatment algorithms for uncomplicated and complicated UTIs.

Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)

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Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L

The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.

Pediatric Burn Referrals

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UBC Division of Plastic Surgery

UBC Division of Plastic Surgery: Pediatric burn referrals.

Management of Bacterial Meningitis in Children and Young People

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Meningitis Research Foundation

Flowchart of management of bacterial meningitis in children and young people, incorporating NICE Bacterial Meningitis and Meningococcal Septicaemia Guideline CG102.

Aseptic Meningitis

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Melia M, Johns Hopkins ABX Guide

Guideline discussing aseptic meningitis pathogens, clinical presentation, diagnosis, treatment, and pathogen specific therapies.

Ask Suicide Screening Questions Toolkit

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National Mental Health Institute

The ASQ toolkit is organized by the medical setting in which it will be used: emergency department, inpatient medical/surgical unit, and outpatient primary care and specialty clinics.

Bottom Line: An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond. Pediatr Emerg Care 2016;32(1):36-42.

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Ali S, McGrath T, Drendel AL

Objective: This review article aims to provide a summary of several strategies, which are supported by definitive and systematically reviewed evidence, that can be implemented alone or in combination to reduce procedural pain and anxiety for children in the ED and beyond.

Flow diagram for the management of children with suspected and confirmed acute otitis media

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Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and ...

Flow chart of criteria for management of children with suspected and confirmed acute otitis media based on symptoms of children over 6 months of age.

Executive Summary: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

This executive summary is an overview of the common clinical challenges pediatric caregivers face when a child or adolescent presents with a psychiatric chief complaint or emergency.

Executive Summary: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

This executive summary is an overview of the common clinical challenges pediatric caregivers face when a mental health condition may be an unclear or complicating factor in a non-mental health ED presentation.

Clinical Pathway: Urinary tract infection in under 16s overview

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National Institute for Health and Care Excellence

This clinical pathway contains diagnosis and treatment information for persons under 16 with suspected urinary tract infection.

Early Recognition of Meningitis and Septicaemia

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Royal College of Nursing, Meningitis Research Foundation

Guidance for front line nurses on the early recognition of meningitis and sepsis (what to look for).

Bottom Line Recommendations: Severe Head Injury

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Beno S & TREKK Network

Bottom line recommendations for the treatment and management of severe head trauma. Published online: July 2015.

Bottom Line Recommenation: Optimal pain relief for pediatric MSK injury.

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Korownyk C, Young J, Michael Allan G

Evidence suggests that ibuprofen provides better single-agent relief than acetaminophen or codeine, and is at least equivalent to both acetaminophen with codeine and morphine for acute injury pain, with fewer adverse events.

Bottom Line: Intussusception

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Princess Margaret Hospital for Children

This general summary aids in the diagnosis and management of intussusception.

Emergency Medicine Cases Podcast: Emergency management of pediatric seizures - Guidance and podcast

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Helman A

With the help of two of Canada's Pediatric Emergency Medicine seizure experts handpicked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we'll give you all the tools you need to approach the child who presents to the ED with a seizure with the utmost confidence.

Bottom Line: Managing febrile seizures infographic

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Stahl-Timmins W

This infographic provides general information on managing febrile seizures.

Bottom Line: Flowchart of evaluation and management of functional constipation in children

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Koppen IJ, Lammers LA, Benninga MA, Tabbers MM

Flowchart of evaluation and management of functional constipation in children.

Bottom Line: Assessment in the emergency department for patients with head injury

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National Institute for Health and Care Excellence (NICE), National Clincial G...

A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive and designed to be used online.

Bottom Line: Approach to cyanotic congenital heart disease in the newborn

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Cheung C

This document summarizes causes, symptoms, and management of cyanosis in newborns.

Dosing Chart: Analgesic starting dosages for children

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World Health Organization

Analgesic starting doses for children.

Chart: WHO pain wall chart for waiting rooms

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World Health Organization

Is your child in pain? The doctor can help. As for pain treatment!

Bottom Line: Pain Ease(R): Topical anesthetic skin refrigerant (for children 4 years and older)

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BC Children's Hospital

Purpose: Pain Ease spray is a vapocoolant (skin refrigerant) intended for topical application to skin and minor open wounds. It controls pain associated with injections (venipunctures, IV start) and minor surgical procedures (eg. irrigating laceration/abrasions).

Bottom Line: Psychological Interventions

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BC Children's Hospital

Even with sedation, the success of a procedure is equally reliant upon careful consideration of psychosocial aspects as it is reliant on physical aspects. A sense of mastery and control experienced by parents and children is crucial to their confidence in managing any future procedures. Reducing both pain and anxiety will facilitate effective coping.

Bottom Line: Sucrose as a procedural analgesic for infants up to 12 monts of age

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BC Children's Hospital

Purpose: Oral sucrose and other sweet tasting solutions have been used for management of pain in infants for centuries. Studies done since the early 1990's have demonstrated that the administration of sucrose and non-nutritive sucking are effective non-pharmacological interventions for relief of procedural pain in neonates and infants and may help reduce pain in infants up to 12 months of age. Sucrose and non-nutritive sucking are thought to elevate pain thresholds via endogenous opioid pathways.

Videos in clinical medicine. Diagnosing otitis media--otoscopy and cerumen removal

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Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL

Video instructing how to diagnose otitis media with otoscopy and cerum removal.

Bottom Line: NICE Guidance: Child maltreatment: when to suspect maltreatment in under 16s

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National Institute for Health and Care Excellence

This guideline covers the signs of possible child maltreatment in children and young people aged under 18 years. It aims to raise awareness and help health professionals who are not child protection specialists to identify the features of physical, sexual and emotional abuse, neglect and fabricated or induced illness.

Bottom Line: Acute Concussion Evaluation (ACE): Physician/Clinician Office Version

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Goia G, Collins M

The ACE is intended to provide an evidence-based clinical protocol to conduct an initial evaluation and diagnosis of patients (both children and adults) with known or suspected mild traumatic brain injury.

Bottom Line: Autism Information for Paramedics and Emergency Room Staff

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Gammicchia C, Johnson C, Autism Society

Information for paramedics and emergency room staff on providing services to a person on the autism spectrum.

VIDEO: COVID-19 (updated)

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In this video Dr. Anthony Crocco (Sketchy EBM) outlines the symptoms of COVID-19, how to protect yourself and your family, what to do to be well and when to worry. This video is not a substitute for medical care. Please consult Public Health or your health professional for medical advice.

 

Measurement Tool: Faces Pain Scale - Revised for children 4 years of age and older

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International Association for the Study of Pain

Scores are from the left to the right (for the child): 0, 2, 4, 6, 8, 10 (0 for no pain at all and 10 for very, very much in pain).

VIDEO: Caring for a child with functional constipation

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Translating Evidence in Child Health to Enhance Outcomes (ECHO)

VIDEO: Le plan d’action Canadien pour l’anaphylaxie chez les enfants

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Canadian Anaphylaxis Action Plan for Kids

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VIDEO: Anaphylaxis in Kids

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cheminement clinique Anglais (1) Français Tout (1)

Use of high-flow nasal cannula oxygen therapy in infants and children

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L Chauvin-Kimoff, A DeCaen,Canadian Paediatric Society

Heated, humidified high-flow nasal cannula (HHHFNC) therapy provides warmed, humidified oxygen to infants and children in respiratory distress at flow rates that deliver higher oxygen concentrations and some positive airway pressure compared with standard low-flow therapy. Increased use and experience is informing practice and establishing the benefits of HHHFNC use in a variety of clinical conditions. The focus of this practice point is to describe best practices for HHHFNC in (non-neonatal) paediatric patients with moderate-to-severe respiratory distress and to offer a safe, practical approach to oxygen delivery and support.

Use of high-flow nasal cannula oxygen therapy in infants and children

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L Chauvin-Kimoff, A DeCaen,Canadian Paediatric Society

Heated, humidified high-flow nasal cannula (HHHFNC) therapy provides warmed, humidified oxygen to infants and children in respiratory distress at flow rates that deliver higher oxygen concentrations and some positive airway pressure compared with standard low-flow therapy. Increased use and experience is informing practice and establishing the benefits of HHHFNC use in a variety of clinical conditions. The focus of this practice point is to describe best practices for HHHFNC in (non-neonatal) paediatric patients with moderate-to-severe respiratory distress and to offer a safe, practical approach to oxygen delivery and support.

directive clinique Anglais (163) Français (2) Tout (165)

Clinical Practice Guideline: Guidelines for the management of suspected and confirmed bacterial meningitis in Canadian children older than one month of age (2014)

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Le Saux NCPS

Objective: This position statement outlines the rationale for current recommended empirical therapy using a third-generation cephalosporin and vancomycin for suspected bacterial meningitis. It also provides new recommendations for the use of adjuvant corticosteroids in this setting. Once antibiotic susceptibilities of the pathogen are known, antimicrobials should be reviewed and modified accordingly. Recommendations for treatment duration as well as audiology testing are included. The present statement replaces a previous Canadian Paediatric Society position statement on bacterial meningitis published in 2007 and revised in 2008. Published: 2014.

Clinical Practice Guideline: Paediatric Emergency Department Asthma Clinical Pathway (2014)

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Expert Content Working Group of the Ontario Lung Association,

The P-EDACP is for patients aged 1 to 17 years presenting with wheeze and/or cough who have a history of asthma and/or prior history of wheezing. Additional tools include medication guidelines and pre-printed physicians orders (PPO) for each of the four severity levels, a patient education checklist, and discharge instructions with integrated prescription.

Clinical Practice Guideline: Updated American College of Critical Care Medicine--pediatric advanced life support guidelines for management of pediatric and neonatal septic shock: relevance to the emergency care clinician (2010)

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Kissoon NO, R. A.; Carcillo, J. A.

Objective: Shock is a major preventable cause of morbidity and mortality in children referred to emergency care. The recently updated American College of Critical Care Medicine guidelines for the management of newborns and children with septic shock emphasize the role of emergency care in improving survival and functional outcomes. Implementation of these guidelines of stepwise use of fluids, antibiotics, and, if necessary, inotropes within the first hour of admission to the emergency department can reduce mortality and neurological morbidity risks 2-fold. Published: 2010.

Guideline: COVID in children with diabetes

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International Society for Pediatric and Adolescent Diabetes (ISPAD)

The International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2018 for management of diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state provide comprehensive guidance for management of DKA in young people. Intravenous infusion of insulin for treating DKA may necessitate intensive care unit admission in hospitals in some parts of the world. During the Coronavirus Disease 2019 (COVID-19) pandemic, ICU services may need to be prioritised for care of affected individuals

Guideline: Telemedicine and Virtual Concussion Care

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Ontario Neurotrauma Foundation

Preliminary research has demonstrated that telemedicine can be used to provide timely access to safe and cost-effective medical care of carefully selected concussion patients living in underserved regions. Research from the teleneurology, telepsychiatry and teleneuropsychology literature suggests that patients with prolonged concussion symptoms including those with headaches, mental health disorders, and cognitive impairment may also benefit from accessing care via telemedicine.

Clinical Practice Guideline: The management of pediatric severe traumatic brain injury: Italian Guidelines.

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Bussolin L, Falconi M, Leo MC, Parri N, DE Masi S, Rosati A, et al

The aim of the work was to update the "Guidelines for the Management of Severe Traumatic Brain Injury" published in 2012, to reflect the new available evidence, and develop the Italian national guideline for the management of severe pediatric head injuries to reduce variation in practice and ensure optimal care to patients.

Clinical Practice Guideline: Australian and New Zealand guideline for mild to moderate head injuries in children

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Babl FE, Tavender E, Dalziel S. On behalf of the Guideline Working Group for ...

Children frequently present with head injuries to acute care settings. Led by PREDICT (Paediatric Research in Emergency Departments International Collaborative), a multidisciplinary working group developed the first Australian and New Zealand guideline for mild to moderate head injuries in children. Addressing 33 key clinical questions, it contains 71 recommendations, and an imaging/observation algorithm. The Guideline provides evidence-based, locally applicable, practical clinical guidance for the care of children with mild to moderate head injuries presenting to acute care settings.

Clinical Practice Guideline: Management of the infant at increased risk for sepsis (2007)

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Canadian Paediatric Society

Canadian Pediatric Society position statement on management of infants at risk for sepsis. Published: 2007.

Living Guideline For Diagnosing And Managing Pediatric Concussion

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Ontario Neurotrauma Foundation

In 2019, the Ontario Neurotrauma Foundation worked with
concussion experts and researchers to create a living clinical
practice guideline for pediatric concussion.

Concussions and Head Injuries in Children: Care Instructions

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Resources on Concussion in a Virtual Environment (Recover)

RECOVER (Resources on Concussion in a Virtual Environment) was a study being conducted by researchers at Alberta Health Services, the University of Calgary and the University of Alberta. To improve outcomes for children with concussion who are seen in emergency departments, the study developed tools to help physicians and nurses provide better care and to help families to learn more about, assess, and monitor concussion.

Guideline: Considerations for Telemedicine and Virtual Care Algorithm

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Ontario Neurotrauma Foundation

Algorithm for telemedicine and virtual care

Liver trauma: WSES 2020 guidelines

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Coccolini, F., Coimbra, R., Ordonez, C. et al.

Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.

Guidelines: Constipation

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Royal Children's Hospital Melbourne

These clinical practice guidelines cover the description, etiology, diagnosis and management of constipation in children.

Consensus statement: Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts consensus statement.

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Shen K, Yang Y, Wang T, et al.

This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children.

Info page: What Does the Coronavirus Disease 2019 (COVID-19) Mean for Families?

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Thompson LA, Rasmussen SA

Objective: To prepare families for COVID-19 in the US.

Info page: Coronavirus Disease 2019 (COVID-2019) Information for Pediatric Healthcare Providers.

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US Centers for Disease Control and Prevention.

To inform pediatric healthcare providers of information available on children with COVID-19.

Guideline:Nasal High Flow Therapy

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Children's Health Queensland Hospital and Health Service

The aim of this guideline is to ensure safe and effective use of Nasal High Flow (NHF) therapy for children with acute respiratory illness through: Appropriate placement in inpatient areas with trained staff. Support for decision making in relation to initiation, continuation and weaning of therapy and escalation of concerns.

Clinical Guideline: Australasian bronchiolitis guideline

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PREDICT Network: OBrien S, Borland ML, Cotterell E, Armstrong D, Babl Franz, ...

Objective: to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population.

Clinical Practice Guideline: Paediatric fracture guidelines

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Victorian Paediatric Orthopaedic Network

Summary of paediatric fracture types, emergency department management, and information for fracture clinics.

Clinical Practice Guideline: Peripheral neurovascular checklist

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SicKids Division of Orthopaedic Surgery

Peripheral Neurovascular Checklist.

Clinical Practice Guideline: Head injury: assessment and early management

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National Institute for Health and Care Excellence (NICE), National Clincial G...

This guideline covers the assessment and early management of head injury in children, young people and adults. It promotes effective clinical assessment so that people receive the right care for the severity of their head injury, including referral directly to specialist care if needed.

Clinical Practice Guideline: Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies.

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ochanek PM, Tasker RC, Bell MJ, Adelson PD, Carney N, Vavilala MS, et al

To produce a treatment algorithm for the ICU management of infants, children, and adolescents with severe traumatic brain injury.

Pediatric Trauma Society Clinical Practice Guidelines

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Pediatric Trauma Society

These guidelines have been supplied by a hospital as an example of a clinical practice guideline to provide clinicians at that institution with an analytical framework for the evaluation and treatment of a particular diagnosis or condition.

Advanced Trauma Life Support Update 2019: Management and Applications for Adults and Special Populations

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Galvagno SM Jr, Nahmias JT, Young DA.

As the principal operating room resuscitationists, anesthesiologists must be familiar with the principles of Advanced Trauma Life Support, 10th edition. This edition recommends a highly structured approach to trauma patients and endorses several advances in trauma resuscitation. There are less stringent guidelines for crystalloid administration, references to video-assisted laryngoscopy, suggested use of viscoelastic methods to guide transfusion decisions, and other changes reflecting recent advances. This article discusses trauma team approach to resuscitation, greater focus on special populations, de-emphasis of spinal immobilization in favor of restriction of spinal motion, and other updates and technical advances.

Pediatric Cervical Spine Clearance: A Consensus Statement and Algorithm from the Pediatric Cervical Spine Clearance Working Group

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Herman MJ, Brown KO, Sponseller PD, et al.

The Pediatric Cervical Spine Clearance Working Group (PCSCWG), a subgroup of the Pediatric Cervical Spine Study Group, recognized the need for a consensus on comprehensive standardized guidelines for pediatric cervical spine clearance based on the best available evidence. We established a multidisciplinary group of practitioners with expertise in cervical spine clearance for injured children and applied the Delphi method and the nominal group technique to create consensus statements regarding pediatric cervical spine clearance in young patients who have experienced blunt trauma. The consensus statements were used to develop an algorithm to guide institutional protocols for cervical spine clearance.

The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition

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Spahn DR, Bouillon B, Cerny V, et al.

Severe traumatic injury continues to present challenges to healthcare systems around the world, and post-traumatic bleeding remains a leading cause of potentially preventable death among injured patients. Now in its fifth edition, this document aims to provide guidance on the management of major bleeding and coagulopathy following traumatic injury and encourages adaptation of the guiding principles described here to individual institutional circumstances and resources. The group applied a structured, evidence-based consensus approach to address scientific queries that served as the basis for each recommendation and supporting rationale. Expert opinion and current clinical practice were also considered, particularly in areas in which randomised clinical trials have not or cannot be performed. Existing recommendations were re-examined and revised based on scientific evidence that has emerged since the previous edition and observed shifts in clinical practice. New recommendations were formulated to reflect current clinical concerns and areas in which new research data have been generated.

Clinical Practice Guideline: Managing pain and distress in children undergoing brief diagnostic and therapeutic procedures.

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Trottier ED,Dor-Bergeron MJ,Chauvin-Kimoff L,Baerg K,Ali S.

Purpose: This statement focuses on infants (excluding care provided in the NICU), children, and youth who are undergoing common, minor but painful medical procedures

POSNA Study Guide: Upper Extremity Topics

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Pediatric Orthopaedic Society of North America

The POSNA Study Guide provides an overview of practice points related to fractures and other pediatric orthopaedic injuries of the upper extremity.

Clinical Practice Guideline: Paediatric fracture guidelines - Hip and proximal femur

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Victorian Paediatric Orthopaedic Network

Summary and classification of hip and proximal femur fractures.

Clincial Practice Guideline: Paediatric fracture guidelines - Femoral shaft (diaphysis)

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Victorian Paediatric Orthopaedic Network

Summary of femoral shaft fractures, ED management, and follow-up.

Clincial Practice Guideline: Paediatric fracture guidelines - Tibial shaft (diaphysis)

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Victorian Paediatric Orthopaedic Network

Summary of tibial shaft fracture, ED management, and follow-up.

Clinical Practice Guideline: Paediatric fracture guidelines - Ankle (distal tibial and fibula physeal)

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Victorian Paediatric Orthopaedic Network

Summary of distal tibia and-or fibula physeal fractures, ED management, and follow-up.

Clinical Practice Guideline: Time to revisit the definition and clinical criteria for anaphylaxis?

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Turner PJ, Worm M, Ansotegui IJ, et al.

The objective of this was to overview and discuss current definitions of anaphylaxis.

Clinical Practice Guideline: CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria.

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Fein MN, Fischer DA, OKeefe AW, Sussman GL

The objective of this was to overview the effects of new and old h1 antihistamines.

Clincal Practice Guildeline: Addressing Pediatric Cannabis Exposure

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American College of Medical Toxicology

The purpose of this was to outline recommendations for clincians treating pediatric patients with actue cannabis intoxication.

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