Don’t transfuse red blood cells for arbitrary Hb levels, without symptoms of active coronary artery disease, heart failure, stroke.
In chronic anemia states, a sparing transfusion policy is recommended, even in hospitalized patients. In general, a decision to transfuse should be considered starting from Hb levels of 6 g/dl in young patients with acute anemia, 7 in the great majority of patients, 8...Don’t repeat chemistry testing in the face of clinical and laboratory stability
In the general wards, the patients are often submitted to ripetitive draws of blood in the short terms, for redundant chemistry testing. Altered laboratory results often require controls, even though the original request was futile, and this amplifies the phenomenon....
Don’t diagnose asthma without having performed lung function tests (including bronchodilating test and/or bronchial challenge).
Asthma-like symptoms (dyspnoea, chest tightness, cough, wheezing) are not enough to put a correct diagnosis of asthma.The international guidelines stress the need to perform lung function assessment in order to identify the presence of airway hyperreactivity or...
Don’t recommend percutaneous feeding tubes in advanced dementia; prefer oral assisted feeding instead.
In advanced dementia, the use of percutaneous feeding tubes does not increase survival, does not lower the risk of aspiration pneumonias, does not improve the healing of existing pressure ulcers (instead, it increases their risk); it augments phsycological stress, the...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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