Table 1.
CW recommendations (2017) selected for analysis
| CW number | Recommendation |
|---|---|
| ACEP #1a | Avoid CT scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules. |
| ACEP #2a | Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can void, or for patient or staff convenience. |
| ACEP #4a | 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. |
| ACEP #5a | Avoid instituting intravenous fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration in children. |
| ACEP #6a | Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma, and a normal neurological evaluation. |
| ACEP #7a | Avoid CT pulmonary angiography in emergency department patients with a low pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria or a negative D-dimer. |
| ACEP #8a | Avoid lumbar spine imaging in the emergency department for adults with nontraumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition (such as vertebral infection, cauda equina syndrome, or cancer with bony metastasis). |
| ACEP #9a | Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis. |
| ACEP #10a | Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department patients (<50 years of age) with known histories of kidney stones, or ureterolithiasis, presenting with symptoms consistent with uncomplicated renal colic. |
| ACR #1b | Don’t do CT for the evaluation of suspected appendicitis in children until after ultrasound has been considered as an option. |
ACEP: American College of Emergency Physicians; ACR: American College of Radiology; CT: computed tomography; CW: Choosing Wisely.