Video Discharge Instructions for Fever and ED Recidivism

To evaluate the effect of video discharge instructions on return visits to the ER or ED within 72 hours of the original visit for children with febrile illnesses.

This is a randomized prospective convenience study of children presenting to the ED. Children greater than 8 weeks and up to and including their 18th birthday are enrolled. Patients were randomly assigned to one of two study groups: video + written fever specific discharge instructions and only written fever specific discharge instructions. Parents assigned to the video group watched the DVD in the emergency department (ED) and take it home along with the written instructions. At 72 hours both groups received a phone call asking whether they returned to the ED and the usefulness of discharge instructions (DVD and/or written). Critically ill children and those with chronic medical conditions were excluded. The primary outcome is a return ED visit for fever confirmed in our electronic medical record and questionnaire response. The secondary outcome is reported parental usefulness of the discharge instructions.

Inclusion Criteria: Children ages 8 weeks to 18 years Presented to the ED with a chief complaint of fever. Fever was defined as a temperature greater than or equal to 100.4⁰F English or Spanish speaking Working telephone for follow-up call Venue to view DVD at home (TV, computer, etc) Exclusion Criteria: Children with a chronic medical illness Children with immune-compromising conditions Allergies to acetaminophen or ibuprofen Previously enrolled Admitted at the time of their index ED visit