AAPEH-5 With the exception of certain heavy metals (eg, lead), do not routinely use measurements of environmental chemicals in a person’s blood or urine to make clinical decisions. Posted May 17th, 2021 by Nick Mackara & filed under .
AAPEH4-Do not order “chelation challenge” urinary analyses for children with suspected lead poisoning. Posted May 17th, 2021 by Nick Mackara & filed under .
AAPEH3-Do not order mold sensitivity testing on patients without clear allergy or asthma symptoms (particularly those with chronic fatigue, arthralgia, cognitive impairments, and affective disorders). For those with allergy or asthma symptoms who have not responded to environmental interventions to reduce allergen exposures, mold sensitivity testing may be performed by an allergist or pulmonologist, but should not routinely be performed in the primary care setting. Posted May 17th, 2021 by Nick Mackara & filed under .
AAPEH2-Do not order hair analyses for “environmental toxins” in children with behavioral or developmental disorders, including autism. Posted May 17th, 2021 by Nick Mackara & filed under .
AAPEH1-Do not routinely test urine for metals and minerals in children with autistic behaviors. Toxicologic exposures have not been conclusively associated with the development of autistic behaviors in children. Testing for metals and minerals may be harmful if treatment is guided on the basis of these results. Posted May 17th, 2021 by Nick Mackara & filed under .
AAPSNS5-Do not routinely obtain a CT or MRI scan for developmentally normal, clinically asymptomatic infants with macrocephaly. Posted March 15th, 2021 by Nick Mackara & filed under .
AAPSNS3-Do not routinely perform imaging or routine elective procedures requiring sedation or general anesthesia for very young children with low-risk asymptomatic lesions. Posted March 14th, 2021 by Nick Mackara & filed under .
AAPD3-Do not routinely order laboratory tests for patients with alopecia areata in the absence of signs and/or symptoms of the diseases in question. Posted January 27th, 2021 by Nick Mackara & filed under .
AAPD4-Avoid the use of combination topical steroid antifungals for tinea corporis, Candida skin infections, and diaper dermatitis. Posted January 27th, 2021 by Nick Mackara & filed under .
AAPD2-Do not routinely order laboratory tests for associated autoimmune diseases in patients with vitiligo in the absence of signs and/or symptoms of the diseases in question. Posted January 27th, 2021 by Nick Mackara & filed under .
PHM5-Do not start IV antibiotic therapy on well-appearing newborn infants with isolated risk factors for sepsis such as maternal chorioamnionitis, prolonged rupture of membranes, or untreated group-B streptococcal colonization. Use clinical tools such as an evidence-based sepsis risk calculator to guide management. Posted January 11th, 2021 by Nick Mackara & filed under .
PHM4-Do not use broad-spectrum antibiotics such as ceftriaxone for children hospitalized with uncomplicated community-acquired pneumonia. Use narrow-spectrum antibiotics such as penicillin, ampicillin or amoxicillin. Posted January 11th, 2021 by Nick Mackara & filed under .
PHM3Do not initiate phototherapy in term or late preterm well-appearing infants with neonatal hyperbilirubinemia if their bilirubin is below levels at which the AAP guidelines recommend treatment Posted January 11th, 2021 by Nick Mackara & filed under .
PHM2-Do not continue hospitalization in well-appearing febrile infants once bacterial cultures (i.e. blood, cerebrospinal, and/or urine) have been confirmed negative for 24–36 hours, if adequate outpatient follow-up can be assured. Posted January 11th, 2021 by Nick Mackara & filed under .
PHM1-Do not prescribe IV antibiotics for predetermined durations for patients hospitalized with infections such as pyelonephritis, osteomyelitis and complicated pneumonia. Consider early transition to oral antibiotics. Posted January 11th, 2021 by Nick Mackara & filed under .
