ED Pathway for the Evaluation/Treatment of the Child with Flu
Current Flu Activity
Low (as of 5/13)
Influenza-Like Illness (ILI)
Fever > 100.4°F AND Cough
AND/OR Sore Throat
During Influenza Season
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ILI Precautions
  • Mask in triage for patient and caregiver
  • ILI signage on door
  • Mask for care providers
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Patient requires admission
ALL patients requiring admission
are considered high risk
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Test and Treat Recommended
RRP
1st dose oseltamivir in ED
Isolation – droplet & contact
Further treatment pending RRP results
Patient stable for discharge
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  • Children < 2 years old
  • Chronic conditions:
    pulmonary, cardiac, renal, hepatic, hematologic, metabolic, or neurologic
  • Immunosuppressed
  • < 19 year old on long-term ASA
  • American Indians/Alaska Natives
  • Morbidly obese (BMI > 40)
  • Residents of Chronic Care facilities
  • Pregnant or postpartum women
LOW RISK
  • ≥ 2 years old
  • No co-morbidities
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High Influenza Activity
Low Influenza Activity
USE CLINICAL JUDGMENT FOR ANTI-VIRAL TREATMENT IN HIGH RISK OUTPATIENTS BASED ON:
  • Age
  • Likelihood of influenza
  • Time since onset of symptoms
  • Disease severity progression
  • Underlying medical conditions
  • Presence of high risk household contacts
Posted : January 2013
Authors : M. Jones, MD; K. Feemster, MD; R. Scarfone, MD; K. Cohn, MD, J. Molnar, CRNP;
K. Castelo, CRNP; M. Torpey, RN; R. Hodinka, PhD; T. Metjian, Pharm D; L. Kestenbaum, MD;