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Choosing Wisely ® : Things we do for no reason

Moss, BJ.

Significantly hypoxemic patients should receive supplemental oxygen. Instances, where the use of supplemental oxygen in normoxemic patients may be beneficial, are carbon monoxide poisoning, decompression injury, gas embolism, cluster headaches, sickle cell crisis, and pneumothorax. Hyperoxemia can be associated with adverse outcomes and increased mortality. Oxygen administration has direct and indirect financial costs, including those of supplies, care coordination, and monitoring.

Choosing Wisely®

American Academy of Pediatrics

Many pediatricians obtain ECGs in healthy patients with no personal or family history* of cardiac disease prior to initiating stimulant therapy for ADHD out of fear of triggering an adverse cardiovascular event or worsening a previously undiagnosed cardiovascular disease. However, the probability that such screening will lead to the diagnosis of cardiac disease is low. Furthermore, when ECG abnormalities are identified, they rarely warrant a change in planned ADHD therapy. As a result, ...

Choosing Wisely®

American Academy of Pediatrics

Syncope is a common complaint in pediatrics and is rarely caused by a cardiac issue in patients with a normal physical examination. If the episode is caused by the heart, it generally is an issue with the heart rhythm. Therefore, an echocardiogram rarely adds diagnostic value and it increases cost of care. In situations in which an echocardiogram may be warranted, (syncope that occurs in the circumstance of an abnormal ECG, exertional syncope, unexplained postexertional syncope, or syncope in ...

Choosing Wisely®

American Academy of Pediatrics

Chest pain is a common presenting symptom in pediatrics but is rarely life-threatening, and the vast majority of cases are not cardiac in origin. Therefore, the addition of an echocardiogram only adds diagnostic value in very limited circumstances and increases the cost of care. If the patient has a concerning personal (exertional chest pain with an abnormal ECG) or family history of sudden or unexplained death or cardiomyopathy or ECG abnormalities, consultation with a pediatric cardiologist ...

Choosing Wisely®

American Academy of Pediatrics

Routine screening ECGs for preparticipation sports clearance are not currently recommended by the American Heart Association (AHA). Instead, it is recommended that the AHA’s 14-point screening guidelines, or the American Academy of Pediatrics’ “Preparticipation Physical Evaluation” be used in conjunction with a targeted personal history, family history, and thorough physical examination. The goal is to identify warning signs or signs that raise suspicion of cardiovascular diseases that ...