Language Barrier is Key Reason for Unnecessary Emergency Visits for Children's Fever

Main Category: Caregivers / Homecare
Article Date: 23 Jun 2004 - 10:00 PDT

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A recent study, published in Pediatric Emergency Care, found that non-English speaking parents in Canada were unnecessarily bringing their feverish children to Emergency Rooms without first administering the recommended dose of acetaminophen*. To help physicians address the issue, McNeil Consumer Healthcare, Canada, the maker of TYLENOL®, has launched Canada's first dosage chart for non-English speaking Canadians in the Chinese and East Indian communities.

"According to Statistics Canada, 25 percent of recent immigrants to Canada come from Hong Kong, the People's Republic of China and India**," says Lan Lai-Minh, director of Communications and Linguistic Services at McNeil Consumer Healthcare, Canada. "When we heard of this study we created a Chinese and Hindi dosage chart. Our intent is to help non-English speaking parents from these particular groups have a tool in their mother tongues to help them give their children the recommended dose of fever reducing medicine and avoid unnecessary trips to the Emergency Room."

The study conducted by The Hospital for Sick Children in Toronto found that 41 percent of caregivers gave an underdose of acetaminophen when treating their children for fever. Families in which English was not the primary language significantly gave a lower than recommended dose of acetaminophen as compared with households in which English was the primary language.

"A majority of family visits for fever to the Emergency Department can be prevented if parents dose their children appropriately with acetaminophen or ibuprofen," says Dr. Ran Goldman, staff physician for the Division of Emergency Medicine at the Hospital for Sick Children, associate professor at the University of Toronto and one of the study's principal investigators. "Giving non-English speaking parents dosage tools in their own language is indeed a step in the right direction."

The Chinese and Hindi dosage charts can be found at www.helpinghand.tylenol.ca/dosage/. They provide information on proper dosage for two types of fever reducers - acetaminophen (the active ingredient in Children's TYLENOL®) and ibuprofen (the active ingredient in Children's MOTRIN®).

"This is excellent news for the Chinese community," says Dr. King Sun Chan, a family physician with a large practice in the Toronto Chinatown area. "Eighty percent of my patients are immigrants from Hong Kong and mainland China who are still learning English, and they presently count on the pharmacist or my staff to translate the dosage instructions. Some of my patients follow the Asian news on the Internet so they can easily access this Web site."

"The dosage chart in Hindi is very clear and easy to understand. Because of the growing Indian population in Canada this will make my job easier," says Dr. Pal Sunerh, who has many East Indian patients. "Acetaminophen or ibuprofen, when taken properly, can relieve many symptoms quickly without necessitating medical visits."

About the Study

A sample of 248 caregivers of children aged 28 days to 17 years was prospectively interviewed. Inclusion criteria were chief complaint of fever and at least one dose of acetaminophen was given to the child in the 24 hours preceding their arrival at the pediatric Emergency Department at The Hospital for Sick Children in Toronto. Enrolment for this study occurred during a six month period from September 2000 to February 2001.

Questionnaires gathered information that included parental age, education, country of origin and language spoken at home, and the number of children in the household. Parents were asked how they had noticed the fever, what they had based the acetaminophen dosage on, whether they had read the medicine label before administering the drug, why they had decided to turn to the Emergency Department and whether they would have come if the fever had subsided with treatment.

About McNeil Consumer Healthcare, Canada

McNeil Consumer Healthcare, Canada, is a leading manufacturer of brand name over-the-counter pharmaceuticals, including TYLENOL® brand products and is located in Guelph, Ontario.

* Goldman, R., and Scolnik, D. Underdosing of Acetaminophen by Parents and Emergency Department Utilization. Pediatric Emergency Care 2004;20(2): 89-93.

** Statistics Canada Web site: http://www.statcan.ca/english/census96/nov4/table1.htm