One Minute Guides

One Minute Guide to: Type & Screen Testing

One Minute Guide to: Type & Screen Testing

Posted by  | Patient Care

Q: How often should I order a type and screen for my patients? The Bottom Line: A single type and screen upon admission is sufficient for most patients who are at low risk of bleeding, are not pregnant and have not had a prior positive antibody screen. Context: A type and screen (T&S) determines ABO(...)

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One Minute Guide to: Folate Testing in Anemia

One Minute Guide to: Folate Testing in Anemia

Posted by  | Patient Care

Q: Should you test folate levels in your anemic patients? The Bottom Line: Do NOT routinely test folate levels in your anemic patients. Context: Folate deficiency is a well-described cause of macrocytic anemia. The American diet has been fortified with folate from a variety of food sources since 1998. This has led to near-elimination of(...)

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One Minute Guide to: Appropriately Ordering Urine Cultures

One Minute Guide to: Appropriately Ordering Urine Cultures

Posted by  | Patient Care

Q: Should I routinely obtain a urine culture from my asymptomatic inpatients? What if the urinalysis indicates the presence of both bacteria and white blood cells? What if my patient has a chronic indwelling catheter? Context: Urinary tract infections (UTIs) are the most commonly encountered bacterial infections in the ambulatory, inpatient and long-term care settings.(...)

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One Minute Guide to: Telemetry Inpatient Cardiac Monitoring

One Minute Guide to: Telemetry Inpatient Cardiac Monitoring

Posted by  | Patient Care

Q: Should cardiac monitoring be routinely ordered for non-ICU in-patients with concern for clinical deterioration to provide early indication of worsening status? The Bottom Line: Cardiac monitoring is indicated for specific patient populations at high risk for life-threatening arrhythmias and should not be used in place of or as an adjunct to close clinical observation.(...)

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One Minute Guide to: Thrombophilia Testing

One Minute Guide to: Thrombophilia Testing

Posted by  | Patient Care

Q: Should I test my patient with a provoked deep vein thrombosis (DVT) for hereditary thrombophilia? Context: The Centers for Disease Control and Prevention estimates that between 300,000 and 600,000 Americans are affected by venous thromboembolism (VTE) yearly. Of these, roughly 60,000 – 100,000 Americans die of VTE yearly, with 25% of deaths occurring within(...)

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One Minute Guide to: Fractional Excretion Indices in Acute Kidney Injury

One Minute Guide to: Fractional Excretion Indices in Acute Kidney Injury

Posted by  | Patient Care

Q: Should we always use fractional excretion indices in the evaluation of acute kidney injury? The Bottom Line: Do not order urine electrolytes to calculate fractional excretion indices as part of the initial evaluation of acute kidney injury. These indices may be helpful in differentiating pre-renal azotemia from acute tubular necrosis in oliguric patients, but(...)

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One Minute Guide to: High Value Prescribing

One Minute Guide to: High Value Prescribing

Posted by  | Patient Care

Q: Should I bother to find generic alternatives to brand-name drugs for my patients? The Bottom Line: Prescribing generic alternatives to brand name drugs reduces costs for your patients and may result in improved adherence and clinical benefit. Context: The U.S. healthcare system generates more than 4 billion prescriptions annually (more than 13 prescriptions per(...)

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