Tuesday, October 15, 2013

Review for the Flu Season Ahead

With the upcoming flu season just around the corner, triage nurses everywhere are preparing for the busy season ahead. Most people overcome the flu with little complications, but we must keep in mind those that are at higher risk and what we, as nurses, can do to recognize signs of complications and give the most appropriate advice to decrease the risk to the patient.
Those that are at highest risk include:
*Children under age 2
*Adults over age 65
*Persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), metabolic disorders (including diabetes mellitus) or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury)
* Persons with immunosuppression, including that caused by medications or by HIV infection
* Women who are pregnant or postpartum (within 2 weeks after delivery)
*Persons aged younger than 19 years who are receiving long-term aspirin therapy
*American Indians/Alaska Natives
* Persons who are morbidly obese (i.e., BMI is 40 or greater); and
* Residents of nursing homes and other chronic-care facilities.
Calls, where the patient falls into one of the above categories, and they are exhibiting flu like symptoms should be high priority, and would be candidates for anti-viral medications. For these medications to be most effective, they should be started less than 2 days of onset of flu symptoms. Patients should be encouraged to consult their physician’s office by the next day to discuss this treatment. However, if the office is closed, the nurse may often find themselves contacting the physician on the patient’s behalf to get treatment started immediately.
In addition to giving the usual advice for fevers, hydration, and minor upper respiratory symptoms, we should be educating callers on warning signs or red flags that could indicate more severe symptoms that they should seek immediate medical attention for. These symptoms would include very high fevers, fevers that are not responding to medications, increased weakness and lethargy, decreased levels of responsiveness or confusion, signs of dehydration, and labored breathing. I cannot stress education enough. If the caller and/or patient are armed with the necessary information they need, they are more likely to recognize early warning signs and seek further treatment more readily, thereby decreasing mortality and morbidity rates.