Inpatient Pathway for the Evaluation/Treatment of the Child with Appendicitis

Perforated with Drainable Collection

IR Consult for drain placement, PICC line
Diet/IVF NPO for PICC placement
Advance diet as tolerated
Activity Out of bed as tolerated
Pain Control Morphine or Nalbuphine
PO Oxycodone
Antibiotics Ceftriaxone + Metronidazole 14 day course
If post-op abscess, continue IV antibiotics
for additional 14 days
Drains Daily assess need for drain
Once output < 5-10 ml/day, discuss re-imaging
or drain removal with IR
Home Health Care Consult Consult for home IV antibiotics
Discharge Drain removed
Schedule surgical follow-up at 2-4 weeks
Failure to Improve Off Pathway