Monday, November 20, 2017

Q: What are the five core recommendations from "choosewisely"- Critical Care Societies Collaborative?

Answer: Choosing Wisely® is an initiative of the ABIM (american Board of Internal Medicine) Foundation. Website is

It works across the board with different societies and entities and to come up with recommendations with four basic objectives

  • Supported by evidence 
  • Not duplicative of other tests or procedures already received 
  • Free from harm 
  • Truly necessary

Following five are the basic recommendations  for critical care from Critical Care Societies Collaborative (here)

1.  Don’t continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort.

2. Don’t deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.

3. Don't use parenteral nutrition in adequately nourished critically ill patients within the first seven days of an ICU stay.

4. Don’t transfuse red blood cells in hemodynamically stable, non-bleeding ICU patients with a hemoglobin concentration greater than 7 g/dL. 

5.  Don’t order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions.

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