Hospital ER giving incorrect discharge instructions -- need references and to whom should I send...

[Quirky]

I had to take my dd2 to the ER yesterday. She's almost 4 and is fully weaned, and my third child, so at least the bad advice printed on the discharge sheets didn't affect us, but I really want to write letters with references to refute the following wrong advice:

Under "General Information on a Fever":

1) Rest and drink plenty of fluids . . . Children less than one year old, for the first 12 to 24 hours, usually do best with:

A) diluted formula (mix one part "ready to drink" formula with one part water) or

B) Pedialyte. Pedialyte is a special salt solution for young children ("Gatorade for babies"). It can be found in the infant formula section of most grocery stores.

C) After 12 to 24 hours, breast milk or regular strength formula is usually best.

SO --

1) Does anyone have AAP, scientific paper references, etc. that I can use to write this letter? I.e. material that doctors and hospital administrators will actually pay attention to?

2) Which doctors and hospital administrators should receive a copy of this letter? I want to make sure it gets to the right people -- any BTDT experience?

BTW, this is all apparently boilerplate -- there's a (c) 2005 Wellsoft, Elsevier, Gold Standard notation at the bottom -- so I'm sure this is not the only hospital ER disseminating this nonsense!

[PatioGardener]

the WHO has a good one on breastfeeding for dehydration and there are several studies too. nak so will stop by later.

ps grrrrrrrrrrrrrrrrrrrrrrrrr! to bad advice!

Edited by PatioGardener - 9/6/11 at 3:22am

[katelove]

Good grief!

I would send it to the Director of Emergency Medicine, the ED Nurse Manager, the Director of Paediatrics and the paediatrics Nurse Manager. If you have enough energy you could send it to Elsevier as well.

[jessjgh1]

Seriously, double take there....  so that really implies not to breastfeed for the first 12-24 hours???

Wow.  

I'd start simple though--  I'd think that's a huge error that may easily be corrected- it's just so ridiculous- like they left a whole section out that explained to keep nursing.   I'm not sure you need all the back up etc..  Just say it caught your eye (and I'd had that I had to read it like 3-4 times to realize what it was really saying).  Maybe you'll get some one that agrees with you and ask to be followed up with if they say they will fix it.   And if they don't jump on it, then get together more info and take steps.

Maybe I'm naive to hope there was some sort of copy/paste compilation error... but it sure doesn't make any sense at all.

Hope everything is all okay now with your family.

Jessica

[BananaBreadGirl]

I agree with Jessica to just talk to them first and see if it is some kind of accidental omission. But if they don't agree to correct it, talk to a patient advocate and see who should get a copy of your info. Specify that you would like a response saying that they got the info, and what they are going to do.

[cameragirl]

Breast milk is considered a clear liquid, isn't it? It is often okayed up to four hours before surgery, and I can't imagine not breast feeding for 12-24 hours.