Children Who Present to the ED With Minor Febrile Illnesses
Conditions
Keywords
children, fever, emergency department
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALIntervention
Sponsors
Connecticut Children's Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
8 Weeks to 18 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recidivism | 72 hours | Number of repeat visits to the ED within 72 hours of initial visit for fever |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Usefulness | 1 week | Rating of how useful the parents found the discharge instructions |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Intervention Video (DVD) discharge instructions | 140 |
| Control Written instructions only | 133 |
| Total | 273 |
Baseline characteristics
| Characteristic | Intervention | Control | Total |
|---|---|---|---|
| Age, Customized Age | 2.7 years STANDARD_DEVIATION 3 | 2.1 years STANDARD_DEVIATION 2.4 | 2.4 years STANDARD_DEVIATION 2.7 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 72 Participants | 73 Participants | 145 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 68 Participants | 60 Participants | 128 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 22 Participants | 19 Participants | 41 Participants |
| Race (NIH/OMB) More than one race | 15 Participants | 13 Participants | 28 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 72 Participants | 72 Participants | 144 Participants |
| Race (NIH/OMB) White | 31 Participants | 29 Participants | 60 Participants |
| Sex: Female, Male Female | 72 Participants | 74 Participants | 146 Participants |
| Sex: Female, Male Male | 68 Participants | 59 Participants | 127 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Recidivism
Number of repeat visits to the ED within 72 hours of initial visit for fever
Time frame: 72 hours
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention | Recidivism | 6 number of return visits within 72 ho |
| Control | Recidivism | 3 number of return visits within 72 ho |
Secondary
Usefulness
Rating of how useful the parents found the discharge instructions
Time frame: 1 week
Population: Parents were not considered enrolled but contributed to the assessment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention | Usefulness | 94 number of parents found useful |
| Control | Usefulness | 94 number of parents found useful |