title: A proposal for an evidenced-based emergency department discharge form for mild traumatic brain injury.
abstract: OBJECTIVE
  To examine and compare a sample of head injury care instruction forms available in hospital emergency departments (EDs) against evidence-based factors predictive of haemorrhage or traumatic lesions and to propose an easy-to-understand discharge instruction form for patients with concussion or mild traumatic brain injury (MTBI).
  
  
  METHODS
  Fifteen hospital discharge instruction forms were reviewed for inclusion of six factors known to be associated with the presence of haemorrhage after MTBI. ED instruction forms were also evaluated for readability.
  
  
  RESULTS
  The 15 hospital ED instruction forms varied in what patients' caretakers were instructed to observe. Some but not all important factors associated with haemorrhage were included. The mean Flesch-Kincaid reading grade level of the discharge instruction forms was 8.2 with a mean Reading Ease score of 59.9%.
  
  
  CONCLUSIONS
  EDs use discharge instruction forms listing signs and symptoms that are highly variable, confusing, not all evidence-based and often not easy to understand. This review proposes a discharge instruction form containing the six best evidence-based variables (according to the current literature) as being useful and understandable to patients and their families for home observation after MTBI.
authors.affiliation: Department of Family Medicine, University of New York, Buffalo, NY, USA. mikefung19@hotmail.com
authors.forename: Michael
authors.initials: M
authors.lastname: Fung
authors.forename: Barry
authors.initials: B
authors.lastname: Willer
authors.forename: Douglas
authors.initials: D
authors.lastname: Moreland
authors.forename: John J
authors.initials: JJ
authors.lastname: Leddy
mesh_terms: D001930:Brain Injuries / Q000628:therapy*; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D006801:Humans; D010174:Pamphlets; D010351:Patient Discharge / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards*; D012307:Risk Factors