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Choosing Wisely UK

Royal College of Obstetricians and Gynaecologists

In the absence of contraindications, a planned caesarean section by breech presentation should not be performed before an external cephalic version has been offered. Information should be given to the patient, questions should be answered and her individual circumstances and preferences should be discussed. Whenever possible, an external cephalic version should be offered for breech presentation before a planned caesarean section is agreed.

Choosing Wisely UK

Royal Pharmaceutical Society

Compared to most other areas of work with learners, there is a broad evidence base to guide professionals who support people whose behavior is considered challenging. However, there is the application of best practice, as shown by the number of people who have to be referred to centers outside their area of residence when local services cannot help them. The purpose of this section is to identify some of the practice areas that have not been covered in this document, or that need to be ...

Choosing Wisely ® : Things we do for no reason

Lind C. and Johnson D.

Acute gastroenteritis (AGE) remains a substantial cause of child- hood illness and is 1 of the top 10 reasons for pediatric hospitalization nationwide. In the United States, AGE is responsible for 10% of hospital admissions and approximately 300 deaths annually.1 The American Academy of Pediatrics (AAP) and other organizations have emphasized supportive care in the management of AGE. Routine diagnostic testing has been discouraged in national guidelines except in cases of severe dehydration or ...

Choosing Wisely ® : Things we do for no reason

Madeira C. et al.

Syncope is a common cause of emergency department (ED) visits and hospitalizations. Echocardiogram is frequently used as a diagnostic tool in the evaluation of syncope, performed in 39%-91% of patients. The diagnostic yield of echocardiogram for detecting clinically important abnormalities in patients with a normal history, physical examination, and electrocardiogram (ECG), however, is extremely low. In contrast, echocardiograms performed on patients with syn- cope with a positive cardiac ...

Smarter medicine

La Sociedad Profesional Suiza de Geriatría

Helping an affected patient to feed by hand is at least as good a method as tube feeding in terms of prognosis for survival, aspiration pneumonia, functionality, and patient comfort. Nutrient intake should be based primarily on food. Tube feeding is associated with a risk of depression, increased use of physical and chemical restraints, and worsening of pressure ulcers.