Influenza: Diagnosis and Management in the Emergency Department - $39.00
Publication Date: December 2018 (Volume 20, Number 12)
CME: This issue includes 4 AMA PRA Category 1 Credits™; 4 ACEP Category I credits; 4 AAFP Prescribed credits; and 4 AOA Category 2 A or 2B CME credits. Included as part of the 4 credits, this CME activity is eligible for 3 Pharmacotherapy CME credits, subject to your state and institutional approval.
AL Giwa MD, MBA, FACEP, FAAEM
Assistant Professor of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Chinwe Ogedegbe, MD, MPH, FACEP
Associate Professor of Emergency Medicine, Seton Hall School of Medicine, Nutley, NJ; Associate Professor of Emergency Medicine, Rutgers-New Jersey Medical School, Newark, NJ
Charles G. Murphy, MD
Department of Emergency Medicine, Metrowest Medical Center, Framingham, MA
Michael K. Abraham, MD
Clinical Assistant Professor, University of Maryland School of Medicine, Baltimore, MD
Daniel J. Egan, MD
Associate Professor, Vice Chair of Education, Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
Emergency clinicians must be aware of the current diagnostic and therapeutic recommendations for influenza and the available resources to guide management. This comprehensive review outlines the classification of influenza viruses, influenza pathophysiology, the identification of high-risk patients, and the importance of vaccination. Seasonal variations of influenza are discussed, as well as the rationale for limiting testing during periods of high prevalence. Differences between strains of influenza are discussed, as well as the challenges in achieving optimal vaccine effectiveness. Recommendations for use of the currently available oral, intranasal, and intravenous antiviral treatments are provided, as well as utilizing shared decision-making with patients regarding risks and benefits of treatment.
Excerpt From This Issue
A 20-month-old boy presents to the ED with a cough and fever for 3 days. He has no past medical history, and his routine vaccinations are up-to-date. His parents say he has been eating less than usual; however, his urine output is normal, and he has had no vomiting or diarrhea. Vital signs are: temperature, 39.6˚C (103.2°F); heart rate, 156 beats/min; respiratory rate, 32 breaths/ min; and oxygen saturation, 100% on room air. He is well-appearing, although his left tympanic membrane is erythematous and bulging, with apparent middle-ear purulence. You make the diagnosis of otitis media in the setting of a presumed viral upper respiratory infection. While preparing the discharge papers, you consider the many patients you’ve seen during the current flu epidemic and wonder whether treatment for influenza would be appropriate . . .
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