Emergency Department Clinical Pathway for Evaluation/Treatment of
Non-oncology Child ≥ 56 Days with a Central Venous Catheter (CVC) and Fever

  • Exclusions:
  • Oncology
  • Stem cell transplant
  • Engineered cell therapy
  • Pulmonary hypertension
  • Hyperinsulinism
  • Cystic fibrosis
  • Aplastic anemia
ED Team Assessment
  • Intestinal failure
  • Home parental nutrition
  • Complex care service
  • Sickle cell disease with apheresis port
  • Hemophilia with Broviac/PICC
Liver transplant
Metabolism with port
Hemophilia with port
1. Cefepime
2. Vancomycin
Add Vancomycin for the Following Indications
  • Ill appearance
  • Presence of hemodialysis catheter
  • History of MRSA
    • Review MDRO, prior blood cultures, and outpatient notes
  • Suspected MRSA infection
    • Skin or soft tissue infection
      • Including line exit site or tunnel infection
    • Deep tissue abscess
    • Lobar pneumonia
  • Suspected CNS infection
    • Meningitis/ventriculitis
  • Non-central line indwelling hardware
    • VP shunt, prosthetic valve
  • Consult appropriate subspecialty as clinically indicated
  • Disposition planning should occur with subspecialist and inpatient admission is determined on case-by-case basis