With the Choosing Wisely Canada campaign underway, Emergency Medicine recently published their list of “5 Things Physicians and Patients should question” in conjunction with the Canadian Association of Emergency Physicians. Here we’ll list the 5 “things” for you to quickly reference and for the full list, explanations, and references please go to Choosing Wisely Canada: Emergency Medicine. Given this is a Canadian endeavour each of the recommendations includes it’s Canadian Article and FOAMed references that you can go to if you want to learn more about each topic. Maybe we should have saved this post for July 1st!
1) Don’t order CT head scans in adults and children who have suffered minor head injuries (unless positive for a head injury clinical decision rule).
Canadian References:
2) The Canadian CT Head Rule for patients with minor head injury
Canadian FOAMed Reference:
The SGEM: Canadian CT Head Rule for patients with minor head injury
2) Don’t prescribe antibiotics in adults with bronchitis/asthma and children with bronchiolitis.
Canadian Reference:
1) Antibiotics for acute asthma
Canadian FOAM Reference:
Emergency Medicine Cases: 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.
Canadian FOAMed Reference:
Emergency Medicine Cases: Low Back Pain Emergencies
4) Don’t order neck radiographs in patients who have a negative examination using the Canadian C-spine rules.
1) Accuracy of the Canadian C-spine rule and NEXUS to screen for clinically important cervical spine injury in patients following blunt trauma: a systematic review
2) Implementation of the Canadian C-Spine Rule: prospective 12 centre cluster randomised trial
3) The Canadian C-Spine Rule versus the NEXUS Low-Risk Criteria in Patients with Trauma
Canadian FOAMed Reference:
Boring EM Tiny Tip: Canadian C-Spine Rule
