Resultados de Búsqueda
Don’t perform stress cardiac imaging or advanced non-invasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present.
Choosing Wisely Canada
Canadian Cardiovascular Society - Canadian Medical Association - University of Toronto
Asymptomatic, low-risk patients account for up to 45 percent of unnecessary “screening”. Testing should be performed only when the following findings are present: diabetes in patients older than 40-years-old; peripheral arterial disease; or greater than 2 percent yearly risk for coronary heart disease events.
ver más ... 2014Don’t do an ankle X-ray series in adults for minor injuries.
Choosing Wisely Canada
Canadian Association of Radiologists - Canadian Medical Association - University of Toronto
X-rays are only indicated if there is pain in the malleolar zone, bone tenderness at the posterior edge or tip of either malleolus, or inability to bear weight for four steps immediately after the trauma and in the emergency department.
ver más ... 2014Don’t do computed tomography (CT) for the evaluation of suspected appendicitis in children until after ultrasound has been considered as an option.
Choosing Wisely Canada
Canadian Association of Radiologists - Canadian Medical Association - University of Toronto
Although CT is accurate in the evaluation of suspected appendicitis in the pediatric population, ultrasound is nearly as good in experienced hands. Since ultrasound will reduce radiation exposure, ultrasound is the preferred initial imaging examination in children. If the results of the ultrasound exam are equivocal, it may be followed by CT. This approach is cost-effective, reduces potential radiation risks and has excellent accuracy, with reported sensitivity and specificity of 94 percent.
ver más ... 2014Don’t do imaging for uncomplicated headache unless red flags are present.
Choosing Wisely Canada
Canadian Association of Radiologists - Canadian Medical Association - University of Toronto
Red flags include recent onset, rapidly increasing frequency and severity of headache; headache causing the patient to wake from sleep; associated dizziness, lack of coordination, tingling or numbness, new neurologic deficit; and new onset of a headache in a patient with a history of cancer or immunodeficiency.
ver más ... 2014Don’t do imaging for minor head trauma unless red flags are present.
Choosing Wisely Canada
Canadian Association of Radiologists - Canadian Medical Association - University of Toronto
Red flags include Glasgow Coma Scale (GCS) less than 13; GCS less than 15 at 2 hours post-injury; a patient aged 65 years or older; obvious open skull fracture; suspected open or depressed skull fracture; any sign of basilar skull fracture (e.g., hemotympanum, raccoon eyes, Battle’s Sign, CSF otorhinorrhea); retrograde amnesia to the event lasting 30 minutes or longer after the event; “dangerous” mechanism (e.g., pedestrian struck by motor vehicle, occupant ejected from motor vehicle, or ...
ver más ... 2014