Do not obtain comprehensive viral panel testing for patients who have suspected respiratory viral illnesses.

Do not obtain abdominal radiographs for suspected constipation.

Do not obtain radiographs in children with bronchiolitis, croup, asthma, or first-time wheezing.

Don’t prescribe tramadol for older adults without due consideration of the potential risks and harms related to serotonergic excess, seizures, falls and drug-drug interactions.

Don’t maintain a peripheral capillary oxygen saturation (SpO2) of higher than 96% when using supplemental oxygen, unless for carbon monoxide poisoning, cluster headaches, sickle cell crisis, or pneumothorax.

Do not order ankle or midfoot X-rays for patients older than 6 years old without positive criteria per the Ottawa ankle rules.

Do not obtain imaging of the cervical spine following trauma in an awake and alert patient without considering the use of clinical decision making (CDM) tools for cervical spine clearance.

Don’t place peripherally inserted central catheters and/or use prolonged IV antibiotics in otherwise healthy children with infections that can be transitioned to an appropriate oral agent.

Do not place central lines or peripherally inserted central lines (PICC) in pediatric patients with advanced (Stage 3-5) chronic kidney disease (CKD)/end-stage renal disease (ESRD) without consultation with pediatric nephrology due to goals to avoid adverse events, preserve long-term vascular access, and avoid unnecessary and costly procedures.

Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department (ED) patients (age <50) with known histories of kidney stones, or ureterolithiasis, presenting with symptoms consistent with uncomplicated renal colic.

Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis.

Avoid lumbar spine imaging in the emergency department for adults with non-traumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition (such as vertebral infection, cauda equina syndrome, or cancer with bony metastasis).

Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria (PERC) or a negative D-dimer.

Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma and a normal neurological evaluation.

Don’t transfuse O negative blood except to O negative patients and in emergencies for women of child bearing potential with unknown blood group.

Don’t routinely use blood products to reverse warfarin.

Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.

Avoid instituting intravenous (IV) fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration in children.

Avoid computed tomography (CT) scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.

Avoid wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up.

Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can void, or for patient or staff convenience.