A reminder of the ongoing international campaign to to improve the care we deliver by engaging our patients in conversations about what care is really necessary and what may not be beneficial or even maybe harmful. CAEP has added to it’s list from last year and now presents 10 commonly used tests and treatments that should be questioned.
CAEPS’s first list, released in June 2015, identified the following five recommendations:
1. Don’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).
2. Don’t prescribe antibiotics in adults with bronchitis/asthma and children with bronchiolitis.
3. Don’t order lumbosacral (low back) spinal imaging in patients with non-traumatic low back pain who have no red flags/pathologic indicators.
4. Don’t order neck radiographs in patients who have a negative examination using the Canadian C-spine rules.
5. Don’t prescribe antibiotics after incision and drainage of uncomplicated skin abscesses unless extensive cellulitis exists.
This month, CAEP has added five additional recommendations:
6. Don’t order CT head scans in adult patients with simple syncope in the absence of high-risk predictors.
7. Don’t order CT pulmonary angiograms or VQ scans in patients with suspected pulmonary embolism until risk stratification with decision rule has been applied and when indicated, D-dimer biomarker results are obtained.
8. Don’t use antibiotics in adults and children with uncomplicated sore throats.
9. Don’t order ankle and/or foot X-rays in patients who have a negative examination using the Ottawa ankle rules.
10. Don’t use antibiotics in adults and children with uncomplicated acute otitis media.
