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AAP Grand Rounds 20:1-2 (2008) Reducing After-Hours Visits for Ear PainSource: McWilliams DB, Jacobson RM, Van Houten HK, et al. A program of anticipatory guidance for the prevention of emergency department visits for ear pain. Arch Pediatr Adolesc Med. 2008;162(2):151–156; doi:10.1001/archpediatrics. 2007.30
Investigators at the Mayo Clinic in Rochester, MN, evaluated an anticipatory guidance intervention to enable parents of toddlers to recognize and manage episodes of ear pain with fewer after-hours emergency visits. The program was instituted as a practice-wide change involving all children presenting for 15-month well child visits at one of the four Mayo Clinic practice sites. Patients were excluded if they had tympanostomy tubes or at the request of their physician. At the well child visit, a nurse provided an educational intervention consisting of 10 slides addressing recognition of ear pain, ways to relieve ear pain, and symptoms suggesting a need for urgent evaluation. A prescription was given for analgesic ear drops to be used in the event of ear pain.
Childrens records were analyzed for emergency department (ED) and other health care utilization for ear pain-related ICD-9 codes during the 12 months following the well child visit,
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