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Choosing Wisely®

Pediatric Hospital Medicine – SHM, AAP, APA

The risk of poor neurologic outcomes, such as cerebral palsy due to kernicterus, is extremely low for term and late preterm newborns with modestly elevated bilirubin levels. Confirmed cases of kernicterus have average bilirubin levels near 40 mg/dL, and are typically associated with hemolysis. While phototherapy for bilirubin values above published thresholds may be useful to prevent severe hyperbilirubinemia and exchange transfusions, its use for bilirubin values below published thresholds is ...

Choosing Wisely®

Pediatric Hospital Medicine – SHM, AAP, APA

Using broad-spectrum antibiotic therapy does not improve rates of treatment failure, length of stay, or decrease costs when compared with narrowspectrum antibiotic therapy for children hospitalized with community-acquired pneumonia (CAP). The use of narrow-spectrum antibiotics for children hospitalized with CAP can limit the development of multi-drug resistant organisms, while achieving similar or better outcomes.

Choosing Wisely®

Society of Critical Care Medicine

Patients can develop significant muscle weakness and atrophy (including the diaphragm) during their ICU stay due to immobilization. However, multidisciplinary facilitated early mobilization has been shown to be safe in the ICU setting. Numerous, patient-centered, clinically meaningful outcomes are supported by early mobilization of critically ill patients.

Choosing Wisely®

Pediatric Hospital Medicine – SHM, AAP, APA

Unnecessary exposure of infants to antibiotics is associated with increased parental anxiety, length of stay, increased cost, gut microbiome dysbiosis, necrotizing enterocolitis and possibly allergic and autoimmune diseases. Antibiotic therapy often leads to transfers to higher levels of care and thus decreased maternal-infant bonding. The use of evidence-based sepsis calculators has demonstrated reductions in antibiotic use of 50% or more without a concomitant increase in the incidence of ...

Choosing Wisely®

Society of Critical Care Medicine

The condition of ICU patients is often uncertain and dynamic, which generates stress for ICU families and the care staff. Accordingly, eliciting and documenting desired care preferences helps ensure the provision of goal-concordant care. Patients, families and providers may participate as partners in shared decision-making to ensure that goals and values align with care that is offered and provided.