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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, October 21, 2013

ACEP´s Choosing Wisely

"SEATTLE — Dedicated to reducing health care costs and improving patient care, the American College of Emergency Physicians (ACEP) today announced a list of five tests and procedures that may not be cost effective in some situations and should prompt discussion with patients in order to both educate them and gain their agreement regarding avoidance of such tests and procedures, when appropriate. These recommendations are part of ACEP’s participation in the ABIM Foundation’s Choosing Wisely® campaign and were made to more than 1,000 emergency physicians attending the Opening Session of the organization’s annual meeting in Seattle." 

The following are the five Choosing Wisely recommendations approved by ACEP’s Board of Directors: 

  1. Avoid computed tomography (CT) scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules. 
  2. Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can urinate on their own, or for patient or staff convenience. 
  3. Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit. 
  4. Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up. 
  5. Avoid instituting intravenous IV fluids before doing a trail of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration of children.