From the Guidelines
Discharge instructions for patients with Hand, Foot, and Mouth Disease (HFMD) should prioritize supportive care, infection control, and monitoring for complications to minimize morbidity, mortality, and improve quality of life. The primary focus should be on maintaining adequate hydration, managing pain and fever, and preventing the spread of the disease. Patients should drink plenty of fluids, such as water, milk, or popsicles, to stay hydrated and help soothe mouth sores 1. For pain management, over-the-counter medications like acetaminophen or ibuprofen can be used to reduce fever and discomfort, with dosages of 10-15 mg/kg/dose every 4-6 hours for acetaminophen and 10 mg/kg/dose every 6-8 hours with food for ibuprofen 1.
Key Discharge Instructions:
- Maintain good hygiene by washing hands frequently, especially after diaper changes and before handling food 1
- Avoid close contact with others until fever resolves and mouth sores heal, typically 7-10 days from symptom onset
- Children should not return to school or daycare until fever-free for 24 hours without medication and feeling well enough to participate in activities
- Seek immediate medical attention if signs of dehydration, persistent high fever, severe headache, stiff neck, or unusual behavior changes occur
Monitoring for Complications:
Patients with HFMD should be monitored for signs of dehydration, such as decreased urination, dry mouth, and excessive sleepiness, and seek medical attention if these symptoms occur 1. Additionally, parents should be aware of the risk of persistent high fever, severe headache, stiff neck, or unusual behavior changes, and seek immediate medical attention if these symptoms develop. By following these discharge instructions and monitoring for complications, patients with HFMD can receive proper supportive care and minimize the risk of morbidity, mortality, and improve quality of life.
From the Research
Discharge Instructions for HFMD
The following are key points to consider when discharging patients with Hand, Foot, and Mouth Disease (HFMD):
- HFMD is a self-limiting illness that typically resolves in 7 to 10 days without sequelae 2, 3, 4.
- Treatment is mainly symptomatic and supportive, focusing on hydration and pain relief as needed with acetaminophen or ibuprofen 2, 3.
- Patients should be advised to practice good personal hygiene, including handwashing and disinfecting potentially contaminated surfaces and fomites, to prevent the spread of the disease 2, 3, 5, 6.
- In severe or complicated cases, intravenous immunoglobulin may be considered for treatment 3.
- There are currently no specific antiviral agents approved for the treatment of HFMD, but several potential candidates are being researched 3.
- Vaccination of susceptible individuals in high-risk areas is an important preventative measure, although a globally representative multivalent HFMD vaccine is still in development 5, 6.
Post-Discharge Care
- Patients should be instructed to:
- Stay hydrated by drinking plenty of fluids
- Manage pain and fever with acetaminophen or ibuprofen as needed
- Practice good personal hygiene to prevent the spread of the disease
- Monitor for signs of complications, such as severe neurological or cardiopulmonary symptoms, and seek medical attention if necessary 2, 3, 4, 5, 6.