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STUDENT HEALTH CENTER

Healthy You @ RSU » Archives
September 2009

Triage Protocol for Patients with Suspected Influenza

Answer the following questions.

Y N    
    1. A positive rapid influenza test documented in the community.
    2a. Documented fever of 100 degrees F or higher?
    2b.

Night sweats and/or shaking chills? If YES to either question (2a or 2b) please continue; if NO to BOTH questions skip to #7

    3. Cough or sore throat? If NO to BOTH go to #7; if Yes to either please continue;
    4. Has the illness been present for less than 48 yours? If YES, go to #8; if NO please continue;
    5. Are ANY of these symptoms present: fast breathing, difficulty breathing, bluish or gray skin color, rash, difficulty drinking fluids, low urination, severe or persistent vomiting, fever for more than 72 hours, not responding or difficulty arousing? If NO please continue, if YES to ANY symptoms, go to #10.
    6. Illness more than 48 hours; Has the patient been diagnosed with a chronic medical illness (e.g. diabetes, asthma, immunosuppression, kidney disease)? If YES, go to #10; If NO go to #13;
    7. Does the patient have a rash, neck pain, painful urination, difficulty breathing or abdominal pain? If NO to ALL questions, go to #11; If YES to ANY question go to #10.
    8. Illness less than 48 hours: Does the patient have ANY of the following: fast breathing, trouble breathing, bluish or gray skin color, rash, trouble drinking fluids, low urination, severe or persistent vomiting, difficulty arousing or responding? If NO, go to #9; If Yes go to #10;
    9. Illness less than 48 hours: Has the patient been diagnosed with a chronic medical condition (e.g. diabetes, asthma, immunosuppression, kidney disease)? If YES, go to #10; if NO go to #13.
    10. This patient should be evaluated by a provider as soon as possible.
    11. Unlikely to be influenza, may be another viral infection; patient symptoms should be addressed; Advise the patient to hydrate, rest, use acetaminophen or ibuprofen prn and follow-up if symptoms worsen or do not resolve in 3-4 days. Advise patient to document presence or absence of fever with a thermometer. Advise patient to call if documented fever is greater than 100 degree F and respiratory symptoms of cough or sore throat develop.
    12. This patient may have influenza; they are past the time frame for anti-virals to be effective; Advise the patient to monitor fever and other symptoms; Discuss with patient symptoms that require an evaluation, infectious disease precautions, over the counter medications for symptom relief;
    13. This patient may have influenza; pt not a candidate for anti-viral therapy based on no chronic medical diagnosis or current symptoms indicative of severe illness. Patient is in early phase of illness and is highly contagious; Advise patient to monitor fever and signs and symptoms worsening; Advise patient to take precautions to prevent spread of illness; Discuss: symptoms that would require an evaluation by a medical provider, infectious disease precautions, over the counter medications, potential prophylaxis of close contacts, and importance of close contacts monitoring themselves for illness.