Influenza POCT (Adult)

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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