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Choosing Wisely®

JHM, Abdul-Moheeth

The Society of Hospital Medicine’s Choosing Wisely recommendations include avoiding repetitive routine laboratory testing. In the setting of the early stages of the COVID-19 pandemic, the benefits of avoiding routine repetitive testing may have been more pronounced considering the need to limit unnecessary healthcare professional exposure to infected individuals and to conserve resources, including personal protective equipment and laboratory resources. Non-critically-ill COVID-19 patients ...

Choosing Wisely ® : Things we do for no reason

JHM, Black

The American Society of Anesthesiologists (ASA) recommends calculating the risk of aspiration in patients who are going to undergo sedation so that, based on their level, they can undergo certain dietary restrictions or others. Low-risk patients are allowed to eat heavy fatty foods 8 hours before, light meals 6 hours, breast milk 4 hours, and carbohydrate drinks up to 2 hours before. This makes it possible to achieve normophysiology and increase patient satisfaction. Patients who have a high ...

Choosing Wisely®

JHM, Friedman

The clinical practice guideline specifies a set of steps to implement this project, such as creating lists of recommendations aligned with quality metrics and measuring and supporting practice change. Practicing pediatric medicine in a well-resourced hospital setting should not lead to overuse in practice. The harms of this approach to our patients and health systems, coupled with the pressures of the pandemic, are compelling reasons to be more responsible. We must see it as an opportunity to ...

Choosing Wisely ® : Things we do for no reason

MD, Golfeuz S.

Initial studies of samples in patients with acute diarrhea show poor sensitivity. To do this, a "wait and see" guideline should be carried out for patients at high risk for parasitic diseases and to carry out targeted tests to focus on the cases with the greatest probability of being sensitive to the microbiological study. Furthermore, in high-risk patients with no travel history, the first option is to perform other rapid tests (PCR, DFA or EIA). In the case of negative, we can obtain samples ...

Choosing Wisely ® : Things we do for no reason

JHM, Niforatos

Tumor lysis syndrome remains a metabolic emergency that requires rapid diagnosis and management to prevent morbidity and mortality. Rasburicase is often considered the standard-of-care treatment for hyperuricemia due to its ability to reduce circulating uric acid levels rapidly. Oncologists presume reducing uric acid levels prevents and treats TLS. As a preventive treatment, clinicians should identify patients high-risk of TLS and consider a single 3-mg dose of rasburicase and manage low- and ...