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It is not recommended give an adult patient a blood transfusion without informing them about the risks and benefits
Choosing Wisely UK
Royal College of Pathologists (2018)
A blood transfusion is the transfer of blood or one of its components from a healthy person (donor) to a sick person (recipient). It is done to increase the blood's ability to carry oxygen, restore the body's blood volume, and correct clotting problems. Evidence from a NICE clinical practice guideline suggests that patients have a limited understanding of many aspects of transfusion, but want to be part of an informed decision-making process. Evidence also indicates that patients are reassured ...
ver más ... 2018It is not recommended unnecessary duplicate genetic testing for inherited variants in adults
Choosing Wisely UK
Royal College of Pathologists (2018)
Genetic testing can help identify a disease risk or inherited condition. However, sometimes a genetic test is not the best way to identify a disease risk or inherited condition. A routine blood test or procedure might be just as good. A research article showed that approximately 0.8% of all genetic test requests received for germline mutations were unnecessary duplicate samples from patients who had already been successfully tested.
ver más ... 2018Avoidance of antibiotics for group B streptococcus until the onset of labor is recommended for all pregnant women.
Choosing Wisely UK
Royal College of Obstetricians and Gynaecologists
GBS is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. Prevention of late-onset group B streptococcal (GBS) disease and treatment of established GBS is not considered beyond initial antibiotic therapy.
ver más ... 2018Urine toxicity test is not recommended for patients with overdose as it does not usually change the treatment.
Choosing Wisely UK
Royal College of Emergency Medicine
Urine toxicology tests are usually performed on patients suspected of having taken a drug overdose. The results of these tests very rarely change treatment. There are also a number of newer recreational drugs that are not detected by these tests.
ver más ... 2018A computed tomography scan is recommended for patients with subarachnoid hemorrhage within the first 6 hours of headache onset.
Choosing Wisely UK
Royal College of Emergency Medicine
Standard investigations for patients suspected of having suffered a sub-arachnoid haemorrhage involve a CT scan and then, if the CT is normal, a lumbar puncture. Lumbar punctures are painful procedures, usually require hospital admission and some people develop worse headaches afterwards. CT Scanners have become better at detecting blood in the brain. A normal scan performed with 6 hours of onset of a severe headache means that the risk of having a sub-arachnoid haemorrhage is extremely low.
ver más ... 2018