The American College of Emergency Physicians (ACEP) is working to eliminate unnecessary CT scans in its second Choosing Wisely list of tests and procedures that should be used judiciously.
The aim of the American Board of Internal Medicine Foundation Choosing Wisely initiative is to lower healthcare costs and promote conversations among physicians and patients about the appropriate use of tests and treatments in which benefits can outweigh harms.
This newest list of evidence-based recommendations was released here at the ACEP 2014 Scientific Assembly.
The ACEP board of directors approved five recommendations for patients seen in the emergency department.
|Choosing Wisely in the Emergency Department|
|Avoid ordering head CT in asymptomatic adults with syncope, insignificant trauma, and normal results of a neurologic evaluation|
|Avoid ordering CT pulmonary angiography in patients with a low probability of embolism who either meet the Pulmonary Embolism Rule-out Criteria or have a negative D-dimer test|
|Avoid ordering lumbar spine imaging for adults with atraumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition|
|Avoid prescribing antibiotics for patients with uncomplicated acute sinusitis|
|Avoid ordering CT of the abdomen and pelvis in young, otherwise healthy patients with known histories of ureterolithiasis who present with symptoms consistent with uncomplicated kidney stones|