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Don’t prescribe antibiotics in adults with bronchitis/asthma and children with bronchiolitis.
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Respiratory distress from bronchospasm/wheezing is a common presentation in both children (i.e., bronchiolitis) and adults (i.e., bronchitis/asthma) seen in the emergency department. Most patients with symptoms do not have bacterial infections that require antibiotic treatment or influence outcomes (i.e., hospitalization). Inappropriate administration of antibiotics can expose patients to unnecessary risks (i.e., allergies, rash, diarrhea and other side-effects) and has the potential to ...
ver más ... 2018Don’t order CT head scans in adults and children who have suffered minor head injuries (unless positive for a validated head injury clinical decision rule).
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Head injuries in children and adults are common presentations to the emergency department. Minor head injury is characterized by: Glasgow Coma Scale (GCS) 13-15, associated with either witnessed loss of consciousness, definite amnesia, or witnessed disorientation. Most adults and children with minor head injuries do not suffer from serious brain injuries that require hospitalization or surgery. CT head scans performed on patients without signs of significant injuries can expose patients to ...
ver más ... 2018Don’t routinely drain non-painful fluid-filled breast cysts. Breast cysts are common.
Choosing Wisely®
The American Society of Breast Surgeons – Benign Breast Disease
They are harmless fluid filled sacs. If an ultrasound (sonogram) confirms that a breast mass is a simple cyst, it does not need to be drained unless it is bothersome to the patient or if there are concerns it could be something other than a cyst or has complex characteristics.
ver más ... 2018Don’t perform screening mammography in asymptomatic patients with normal exams who have less than 5-year life expectancy.
Choosing Wisely®
The American Society of Breast Surgeons – Benign Breast Disease
Mammography identifies breast cancers at early stages and has demonstrated benefits in reducing mortality and morbidity from a breast cancer diagnosis. There is minimal benefit of screening mammography in women with life expectancies of <5 years. Additionally, there is a risk of false positives and potential procedures that do not provide patients improved outcomes.
ver más ... 2018Don’t routinely operate for a breast abscess without an initial attempt to percutaneously aspirate or drain it.
Choosing Wisely®
The American Society of Breast Surgeons – Benign Breast Disease
An abscess is an infection of the breast tissue, forming pockets of pus that can be painful. Many times these can be treated by placing a large needle in the pocket and draining the fluid instead of performing an operation where an incision is made and the fluid removed. The needle removal of the fluid forms less scar and sometimes avoids an operation.
ver más ... 2018