Pancreatitis Clinical Pathway — Emergency Department and Inpatient

Subspecialty Consults

General Surgery/IR	Necrotic Pancreatitis Destruction of ducts Pancreatic mass on imaging Suspected peritonitis
Acute Pain Service or Integrative Health	Failure of standard pain medication plan Opioid use beyond 48 hrs History of chronic pain prior to admission
Metabolism	If known or suspected metabolic disorder, contact Metabolism provider for initial guidance around glucose, fluid and acidosis management, and further diagnostic studies.
Child Life	Consult for coping with new diagnosis, NG or NJ tube placement, or persistent pain.
Behavioral Health	Consult early in admission for acute or recurrent/chronic pancreatitis if medical and integrative health strategies are insufficient in order to evaluate for and address: Psychological symptoms that might be impacting care (e.g., mood symptoms interfering with treatment). Physical symptoms that may be a result of mood/stress. Acute psychiatric needs (e.g., suicidality, mania, aggression). Significant psychiatric or mood symptoms that require medication management. Followed by outpatient mental health provider(s) and psychological symptoms are impeding care or treatment in the hospital setting. Obtain consent from child and family for BHIP consult before team comes to the room (consent not required if there is a safety concern).

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.