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Decreasing unscheduled return visits in a pediatric emergency department

The study aims to evaluate whether unscheduled return visits within one week for similar complaints are impacted by ensuring parents have access to the appropriate doses of acetaminophen and ibuprofen. Patients will be randomized to the intervention or control group after parental/caregiver permission is obtained for general participation in a research study. Patient care will look the same for all participants, but discharge process will differ slightly for each group. One week after discharge, the research team will contact the child’s caregiver to determine if an unscheduled return visit was made, and, if so, the reason why. We will ask about visits to EDs, urgent cares, and clinics/primary care providers, and about their satisfaction with the care they received in the ED. The primary outcome will be unscheduled revisits to the ED (binary endpoint). Secondary endpoints include total number of unscheduled return visits, return with hospital admission, and parental satisfaction with ED care.

Inclusion

  1. Children 6 to < 36 months of age being discharged home from DCMC ED who are evaluated for fever
  2. Caregiver fluent in English or Spanish

Exclusion

  1. Previous enrollment in this study
  2. Patient admitted to hospital
  3. Trauma patient
  4. Orthopedic complaint
  5. Other painful indication for acetaminophen or ibuprofen
  6. Acetaminophen or ibuprofen prescribed for anything other than fever
  7. Allergy or another contraindication to acetaminophen or ibuprofen
  8. Parent and patient unlikely to follow up in the region (i.e., lives out of state)

Timeline

This study plans to enroll through 11/2025.

Principal Investigator

Brad Yingst, PGY 5

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