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<< Influenza: Challenges In Diagnosis And Management In The Emergency Department
Cost- and Time-Saving Strategies
1. Reserve formal diagnostic testing for patients who are more severely ill or during times of low disease prevalence.
Risk Management Caveat: The clinical presentation of influenza is nonspecific, and not every patient requires formal testing. Patients with more severe illness who require hospitalization should be tested to help guide treatment and management decisions. In times of high disease prevalence, many patients who are at high risk of complications and a more severe disease course can be treated empirically without formal diagnostic testing. Many patients who are otherwise healthy and at low risk for disease complications can be treated with supportive therapy. Testing is appropriate in times of low disease prevalence, since the signs and symptoms ofm influenza can closely mimic many other upper respiratory infections. For patients with an influenza-like illness in which influenza testing and antiviral treatment are not warranted, close follow-up with the patient’s primary care provider is important as is a discussion of reasons to return to the ED.
2. Be familiar with the available Internet-based public health resources that can inform the clinician about local influenza strain prevalence as well as strain-specific medication susceptibilities.
3. Prescribe antiviral medications only for patients who are more severely ill or at high risk for a more severe disease course.
Risk Management Caveat: The vast majority of previously healthy patients without underlying comorbid medical conditions can be treated with supportive therapy alone. Antiviral medication should be reserved for patients who are more severely ill or who are at higher risk for a more severe disease course. For patients in whom antiviral treatment is not warranted, followup with the patient’s primary care provider is important as well as a discussion of important reasons to return to the emergency room.
4. A careful review and clear understanding of published strategies for ED management during influenza epidemics will result in greater skill and proficiency in the rapid processing of a large number of patients.
5. Careful ED infection control is important for the protection of both patients and health care personnel and will reduce absenteeism among staff.
Risk Management Caveat: The clinical presentation of influenza is nonspecific, and not every patient requires formal testing. Patients with more severe illness who require hospitalization should be tested to help guide treatment and management decisions. In times of high disease prevalence, many patients who are at high risk of complications and a more severe disease course can be treated empirically without formal diagnostic testing. Many patients who are otherwise healthy and at low risk for disease complications can be treated with supportive therapy. Testing is appropriate in times of low disease prevalence, since the signs and symptoms ofm influenza can closely mimic many other upper respiratory infections. For patients with an influenza-like illness in which influenza testing and antiviral treatment are not warranted, close follow-up with the patient’s primary care provider is important as is a discussion of reasons to return to the ED.
2. Be familiar with the available Internet-based public health resources that can inform the clinician about local influenza strain prevalence as well as strain-specific medication susceptibilities.
3. Prescribe antiviral medications only for patients who are more severely ill or at high risk for a more severe disease course.
Risk Management Caveat: The vast majority of previously healthy patients without underlying comorbid medical conditions can be treated with supportive therapy alone. Antiviral medication should be reserved for patients who are more severely ill or who are at higher risk for a more severe disease course. For patients in whom antiviral treatment is not warranted, followup with the patient’s primary care provider is important as well as a discussion of important reasons to return to the emergency room.
4. A careful review and clear understanding of published strategies for ED management during influenza epidemics will result in greater skill and proficiency in the rapid processing of a large number of patients.
5. Careful ED infection control is important for the protection of both patients and health care personnel and will reduce absenteeism among staff.
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