Pediatrics
Last updated 6/21/24
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Routine Screens and Preventive Care
DOT PHRASES: .PEDSLABS (all CCHMC lab locations)
AAP Peds Preventive Health Guidelines Chart
Ohio Newborn Screen Info National Website: babysfirsttest.org
Abnormal newborn screen: ACT sheets form American College of Medical Genetics
Interpretation of Newborn Screen Hemoglobin Results
M-CHAT R Autism Screen (translations): 2, 5, 12 should be NO, all others YES [for abnormal answers, make sure you do the revised f/u questions before formally scoring them]
Vision Screening: a fantastic how-to guide (and practice examples) for navigating vision screening by Dr. Clara Mao
Gender Unicorn (additional languages)
Cerebral Palsy for the PCP (screening & management)Vaccines
DOT PHRASES: .VACCINEREFUSALINFO, .VACCINEPREVENTABLEILLNESSES
Catch Up Schedule
AAP Vaccine Refusal Form
Vaccine Ingredients list from the CDC, can also be found on vaccine package
Videos of Accounts of Preventable Illnesses
RSV for Babies -
Beyfortus (monoclonal antibody) was recently approved and recommended to prevent severe RSV disease in infants under 8 months old entering their first RSV season or infants aged 8-19 months old at increased risk of severe RSV disease entering their second RSV season.
- It comes in 2 doses: < 5 kg or > 5kg.Lead Process
1. Pre-chart and identify if a patient needs lead screening.
2. Determine if you will order CBC/lead from the lab or POC lead.
3. Update Care Coordination note to reflect need for POC lead.
4. Follow-up on results!
POC Lead is now in the preference list AND part of the Care Gaps SmartSetInfant Feeding
6/21/24: Stephanie Burke is a lactation consultant at CCHMC and she is going to be in Hoxworth on Thursdays to provide outpatient lactation services. The mother must have delivered at UCMC to qualify. Call 513-584-5239 and ask for lactation appointment.
DOT PHRASES: .LACTATION (for the above information, steal from Leslie), .BREASTFEEDING SUPPORT
UC Resources: Baby Cafe (FREE breastfeeding support at Hoxworth every Thursday from 2:00 - 3:30pm)
General Resources: WIC Breastfeeding Info, Breastfeeding Guide from the Office of Women's Health, part of HHS
Community Resources: BOOBS (Breastfeeding Outreach for Our Beautiful Sisters), Southwest Ohio Breastfeeding Coalition
Provider Education Resources: from AAP, global videos (also other women's health topics), lactation counselor training course
Formula Shortage: HHS website, AAP website, Dotphrase: .formulashortage
LactMed: database on medications and lactation
Higher calorie feeds: (see peds instructions dotphrases) Fortifying Breast Milk, Concentrating Standard Formula, Concentrating Neosure
WIC formChildhood Nutrition
Macros Recommended by Age (from Food and Nutrition Board, Institute of Medicine, National Academy of Sciences)
Milk Comparison***Early Intervention
Bold Beginnings: 1 stop shop online for early childhood resources in Ohio
Ohio: Help Me Grow Online Referral
Kentucky: call/fax the specific county agency: First Steps Point of Entry List
Indiana: find the right agency: First Steps INNutrition and Fitness
DOT PHRASES: .HEALTHWORKSVIDEOS, .5210
AAP Institute for Healthy Childhood weight
HealthWorks, refer for nutrition counseling & group exercise
Fun2BFit, YMCA exercise program for teens and kidsDentist Lists
.DENTALUPDATE2024
Special Needs .afzndentalsn (Nye, may need updating) -
Injury Safety Checklists for Kids, specific to ATVs, guns, daycare, bikes and other wheeled sports, water, teen driving, etc, from the Injury Free Coalition injuryfree.org
CCHMC Injury Prevention Resources
Safety Guides, etc. 513-636-7865Affordable Care Seats and Helmets
DOT PHRASES: .HELMETS, .CARSEATSANDBOOSTERS, .BABYPROOFING
Safety Resource Center in the CCHMC Family Resource Center (Main Hospital, Location A, 1st floor): M-F 9am – 7pm 513-636-7606
Safety Outreach Programs free safety equipment with home visit, free car seats with a class (some zip code and income limitations)
Comprehensive Children’s Injury Center 513-517-4663
AAP Car Seat Guidelines, Ohio Law: carseat until >4 y/o AND >40 lbs, booster until 8 y/o OR >4'9"
Ohio Buckles Buckeyes Program 800-755-GROW (4769): free car seats if income eligible for WICGun Safety
DOT PHRASES: .GUNSAFETY, .FIREARMSAFETYCOUNSELING (if you counsel any of your patients about firearm safety)
Make sure 1) firearm is unloaded 2) firearm is locked up 3) ammunition locked up in a separate place
Project Child Safe
Ohio sheriffs offices reportedly supply free gun locks to help make guns safer at home, can call to confirm.Online Safety/Social Media
DOT PHRASES: .SOCIALMEDIAGUIDANCE
Common Sense (has great guides and info)
Digital Citizenship Curriculum lessons by grade level
Best Apps List can be sorted by age
Setting up a Child's iPhone
Facebook's Guides(surprisingly good, advice may apply beyond facebook, i.e. think before you post guide, partner organization links at the end)
Social Media Apps Guide for parents to learn about them from Family Online Safety Institute (somewhat limited but useful)
Parental Controls Guide for Parents, Cyberbullying Guide for Parents, from Connect Safely silicon valley non-profit with useful guides including
Cyber Civil Rights Initiative support if intimate images are shared against person's will (i.e. revenge porn), including removal guides, and a 24/7 hotline: 844-878-CCRI (2274) -
Referring to CCHMC? Make sure you associate the order with the appropriate diagnosis (ie: Failed hearing screen) BEFORE signing - association changes made after signing are not transmitted within the referral. Reminder: "Well Child Check" is not an appropriate diagnosis code to link to referrals.
Asthma
Asthma Severity Criteria
Asthma Treatment Steps (GINA & NIH charts)
Inhaler Intensity Chart (GINA & NIH charts)
Inhalers: Wheezy Puff Inhaler Guide
Inhaler Videos from American Lung Association: Instruction Videos
Inhaler Chart, inhalers4u.org, Medicaid Preferred Inhalers (Tri-state)
Asthma Triggers Handout, EPA triggers booklet for kidsChildhood Cancer Survivors
Screening guidelines from Children's Oncology GroupAcne
Acne Treatment- American Academy of DermatologyAllergies
.epipen or .anaphylaxisinstructions for visual instructions on when to use the epi penMSK
orthokids.org Pediatric Orthopedic Society of North America (good disease specific info and sport specific info on injury prevention)Hypertension
AAP Guidelines 2017: Flynn, Et al.
Stages, Evaluation and management by stage, Medication Doses and Ages, Recommended Workup
-recheck manually in the RIGHT arm twice and average for a final BP
-measure in 2 arms and a leg
-for 13+ y/o: use adult cutoffs
For elevated BP, 90-95th percentile (120-130/70-80)
-follow up at 6 months, then 6 months later do workup
For stage 1 HTN, >95 percentile, but less than 12mmHg above that (130-140/80-90)
-follow up in 1-2 weeks, then 3 months later start treatment, do workup
For stage 2 HTN, >95th percentile +12 mmHg (>140/90)
-follow up in 1 week to start treatment and do workup -
Referring to CCHMC? Make sure you associate the order with the appropriate diagnosis (ie: Failed hearing screen) BEFORE signing - association changes made after signing are not transmitted within the referral. Reminder: "Well Child Check" is not an appropriate diagnosis code to link to referrals.
ADHD
Vanderbilt Forms
Preschool Treatment:Guidelines, Dosing
Evidence Based Treatment form Ohio Minds Matters, see page 2
CCHMC ADHD Parenting Classes Information and Schedule
ADHD Referral ResourcesAutism
AAP Clinical Report: Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
AAP Guidance: Considerations for Prescribing /Recommending Common Supports and Services for Children on the Autism Spectrum -
Some of the adult information may apply here as well
Guide for Parents about getting good careSuicide Prevention
Overall Pathway
1. ASQ: screening tool
2. If non-acute positive, do the Brief Suicide Safety Assessment (BSSA)
3. If going home, make a safety plan, Stanley Brown is one validated tool, more tips here
Crisis text number: Text HOME to 741741 to connect with a volunteer Crisis Counselor
Psychiatric Intake Response Center (PIRC) At CCHMC
(513) 636-4124General Mental Healthcare
SCARED-5: All of our adolescents are getting this Anxiety Screener with Well Child Checks. You can enter the results in Flowsheets! A score of 3 is positive. In these scenarios consider referring for anxiety-related services. PCAY is an awesome study where patients are randomized to therapy +/- medications. Information is on the wall in clinic! To refer, send an Epic Staff Message to Dr. Jeffrey Strawn - additional contact information is on the wall information. 🙂
Best Point for intensive outpatient counseling, psychiatry
MindPeace: School Based Counseling most efficient way to get a child counseling, good toolkits too
Grief counseling for children www.fernside.org
Apps for Mental Health from Common Sense
DocAssist, psychiatric medication charts for children adolescents, perinatal care
Evidence Based Interventions for Pediatric Mental Health from Ohio Minds Matters
The Resilience Project integrated services for people with developmental disabilities that have a mental health problem and trauma, referrals go through the board of developmental disabilitiesADHD
Vanderbilt Forms (ADHD)
CCHMC ADHD Parenting Classes Information and Schedule -
Just In Time Parenting: anticipatory guidance newsletter by email
1-2-3 Magic: easy to learn discipline strategy, 12p summary pdf
Sesame Workshop: family resources about tough topics, including race, trauma, grief, etc.
ACT program tip sheets (Spanish available): from the APA, program goal is violence prevention through parenting
Central Clinic Young Child Institute: Parenting classes with no referral required (513.751.3133, Ext. 7)
Beach Acres: one-to-one parenting coaching, useful for + ACE screen (513-231-6630)
Vroom: free app with tips for parents to help early brain development, also printable tip sheets
Serve and Return Handout: how to encourage early brain development in everyday situations -
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