Influenza POCT (Adult)

The 2019-20 Flu season has arrived, and we need to be thinking about who to test and who to treat. Full guide HERE But don’t forget MERS!!

Q1. Do you suspect Flu?

  • Fever
  • Coryza
  • Arthralgia and/or Myalgia
  • Malaise
  • GI symptoms – with or without signs of respiratory/other involvement e.g. CN

Yes! – Respiratory precautions

  • Isolated in a side room
  • Surgical face mask worn on entry to room + gloves and apron
  • FFP3 mask or hood worn for aerosol generating procedures
  • Bare below the elbow / good quality hand hygiene
  • Proceed to Q2

 

Q2. Do they require admission?

  • No – Are they high risk and require Tamiflu? – Prescribe oseltamivir (Tamiflu) 75mg BD for 5 days if in an “at risk” group
    • >65 years old
    • obese
    • pregnant
    • chronic underlying condition
  • Yes – Isolate and test. Testing can be POCT or Lab, POCT will be our standard choice , but remember we only have one machine on each site and it takes 20min so samples may be stacked.
    • Flu Negative – Usual care
      • Haem/Oncology patient – Continue precautions and send nasal PCR
    • Flu Positive
      • Arrange for patient to go to a side room AND maintain respiratory precautions
      • Prescribe antivirals as per PHE guidelines (pdf)
      • Assess for secondary bacterial infection: if present, prescribe as per CHFT antibiotic policy
      • Ensure +ve flu status is included in nursing and medical handover

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