- Don’t order sinus computed tomography (CT) or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.
- Don’t prescribe antibiotics for URTIs
- Don’t order antibiotics for adenoviral conjunctivitis (pink eye).
- CT scans are not necessary in the immediate evaluation of minor head injuries; clinical observation/Pediatric Emergency Care Applied Research Network (PECARN) criteria should be used to determine whether imaging is indicated.
- Neuroimaging (CT, MRI) is not necessary in a child with simple febrile seizure.
- CT scans are not necessary in the routine evaluation of abdominal pain.
- In the evaluation of simple syncope and a normal neurological examination, don’t obtain brain-imaging studies (CT or MRI).
- Don’t do imaging for uncomplicated headache.
- Avoid imaging studies (MRI, CT, or X-rays) for acute low back pain without specific indications.
- Do not order CT of the cervical spine after trauma for patients who do not meet the National Emergency X-ray Utilization Study (NEXUS) low-risk criteria or the Canadian C-Spine Rule.
- Do not order CT to diagnose pulmonary embolism without first risk-stratifying for pulmonary embolism (pretest probability and D-dimer tests if low probability).
- Do not order magnetic resonance imaging of the lumbar spine for patients with lower back pain without high-risk features.
- Do not order CT of the head for patients with mild traumatic head injury who do not meet New Orleans Criteria or Canadian CT Head Rule.
- Do not order coagulation studies for patients without hemorrhage or suspected coagulopathy (eg, with anticoagulation therapy, clinical coagulopathy).
