Ver el código de «Choosing wisely ACEP»

==Background==
*Recommendations by ACEP for standard clinical practice in the ED in the United States
*First produced in 2013, updated 2014
==Recommendations==
===2013===
#Avoid computed tomography (CT) scans of the head in emergency department patients with [[Head trauma (main)|minor head injury]] who are at low risk based on validated decision rules. (See [[Head CT (Clinical Decision Rules)]]
#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.
#Don't delay engaging available [[Palliative medicine|palliative and hospice care services]] in the emergency department for patients likely to benefit.
#Avoid antibiotics and wound cultures in emergency department patients with [[Skin and Soft Tissue Infections|uncomplicated skin and soft tissue abscesses]] after successful [[Incision and Drainage|incision and drainage]] and with adequate medical follow-up.
#Avoid instituting intravenous (IV) fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate [[Dehydration|dehydration]] in children.
===2014===
#Avoid CT of the head in asymptomatic adult patients in the emergency department with [[Syncope|syncope]], insignificant trauma and a normal neurological evaluation.
#Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of [[Pulmonary embolism|pulmonary embolism]] and either a negative Pulmonary Embolism Rule-Out Criteria ([[PERC Rule|PERC]]) or a negative [[D-dimer]].
#Avoid lumbar spine imaging in the emergency department for adults with non-traumatic [[Back Pain|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|cauda equina syndrome]], or cancer with bony metastasis). (See [[Back pain (red flags)]])
#Avoid prescribing antibiotics in the emergency department for uncomplicated [[Sinusitis|sinusitis]].
#Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department (ED) patients (age <50) with known histories of [[Nephrolithiasis|kidney stones, or ureterolithiasis, presenting with symptoms consistent with uncomplicated renal colic]].

==References==
*[http://choosingwisely.org/societies/american-college-of-emergency-physicians/ Choosing wisely Campaign]

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