The Critical Care Societies Collaborative (CCSC) released a list of “Five Things Physicians and Patients Should Question” in critical care as part of the Choosing Wisely® campaign, led by the ABIM Foundation. The list identifies five targeted, evidence-based recommendations that can support physicians and patients in making wise choices about their care:
- Don’t order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions.
- Don’t transfuse red blood cells in hemodynamically stable, non-bleeding ICU patients with a hemoglobin concentration greater than 7 g/dL.
- Don’t use parenteral nutrition in adequately nourished critically ill patients within the first seven days of an ICU stay.
- Don’t deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.
- 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.
CCSC nominated 10 individuals to represent all four societies and several disciplines including internal medicine, surgery, anesthesiology, emergency medicine, and critical care nursing. The taskforce created a list of 58 items for consideration. They put the list through various evaluations, debates and grading systems to come up with a penultimate list of five that all four societies could endorse.