ASH-ASPHO 2019 Choosing Wisely campaign
| Recommendation . | Key references . |
|---|---|
| 1. Don’t perform routine preoperative hemostatic testing (PT, aPTT) in an otherwise healthy child with no previous personal or family history of bleeding. | 7,8,10,12 |
| 2. Don’t transfuse platelets in an asymptomatic (ie, nonbleeding) pediatric patient with hypoproliferative thrombocytopenia (eg, aplastic anemia, leukemia), with a platelet count >10 × 103/μL who is at least 1 year old unless signs and/or symptoms for bleeding develop or the patient is to undergo an invasive procedure. | 14-17 |
| 3. Don’t order thrombophilia testing on children with venous access (ie, peripheral or central)–associated thrombosis in the absence of a positive family history. | 23 , -27,30 |
| 4. Don’t transfuse packed red blood cells (pRBCs) for iron deficiency anemia in asymptomatic pediatric patients when there is no evidence of hemodynamic instability or active bleeding. | 37,42,43,46,47 |
| 5. Don’t routinely administer granulocyte colony-stimulating factor (G-CSF) for empiric treatment of pediatric patients with asymptomatic autoimmune neutropenia in the absence of recurrent or severe bacterial and/or fungal infections. | 48,49,51,52,54 |
| Recommendation . | Key references . |
|---|---|
| 1. Don’t perform routine preoperative hemostatic testing (PT, aPTT) in an otherwise healthy child with no previous personal or family history of bleeding. | 7,8,10,12 |
| 2. Don’t transfuse platelets in an asymptomatic (ie, nonbleeding) pediatric patient with hypoproliferative thrombocytopenia (eg, aplastic anemia, leukemia), with a platelet count >10 × 103/μL who is at least 1 year old unless signs and/or symptoms for bleeding develop or the patient is to undergo an invasive procedure. | 14-17 |
| 3. Don’t order thrombophilia testing on children with venous access (ie, peripheral or central)–associated thrombosis in the absence of a positive family history. | 23 , -27,30 |
| 4. Don’t transfuse packed red blood cells (pRBCs) for iron deficiency anemia in asymptomatic pediatric patients when there is no evidence of hemodynamic instability or active bleeding. | 37,42,43,46,47 |
| 5. Don’t routinely administer granulocyte colony-stimulating factor (G-CSF) for empiric treatment of pediatric patients with asymptomatic autoimmune neutropenia in the absence of recurrent or severe bacterial and/or fungal infections. | 48,49,51,52,54 |