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Choosing Wisely Canada

Public Health Physicians of Canada

Rabies post-exposure prophylaxis (including rabies vaccine and immunoglobulin) should only be offered to individuals with known or highly probable contact with the saliva of a potentially infected animal. Risk assessment should be based on type of exposure, local rabies epidemiology, symptoms of the animal, ability to test or observe the animal for rabies, prior rabies immunization of the animal and exposed person, and if necessary, consultation with local public health officials. In general, ...

Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

With modern instrumentation, analytical precision is very high when the result is within the reportable range and no delta checks have failed. Providing that sample integrity and performance validity has been confirmed, repeating critical values rarely changes the result. However, turnaround time is significantly increased. This can delay clinical action, negatively impact patient care, and increase the likelihood of unnecessary investigations.

Choosing Wisely Canada

Public Health Physicians of Canada

Post-immunization titres to determine immunity following a complete vaccine series are often not necessary. For example, anti-HBs titres following completed hepatitis B virus vaccination series are unnecessary in the general population. Similarly, serologic testing for measles, mumps and rubella immunity following two doses of MMR is not necessary.

Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

Many analytes have known stability profiles or minimum retesting intervals. In most cases, values will not change during this time. These intervals may be longer than traditional or historical test repeat ordering frequency. Ordering tests more frequently is unlikely to provide clinically meaningful results, and may contribute to iatrogenic anemia. Iatrogenic anemia can worsen patient outcomes. Laboratorians can play an active role in drawing awareness to and/or acting to reduce these types of ...

Choosing Wisely Canada

Canadian Society for Medical Laboratory Science

Frequently called ‘just-in-case’, ‘rainbow draws’ or simply ‘extra tubes’, blood collected before tests are ordered is frequently unused and ultimately discarded. This represents a waste of laboratory resources and a challenge for specimen management. Excessive phlebotomy is a recognized contributor to iatrogenic anemia, which is linked to worsened patient outcomes.