Plan For SPA And The Flu

In the office, we will:

1. Have hand gel, tissues and masks available in the waiting room.
2. Enforce the sick/well areas by requesting patients to abide by the signs.

On the phone, we will:

1. Provide reassurance to callers that H1N1 is really no more severe than regular flu.
2. Document symptoms in the chart, but patients do NOT need to be seen unless parents are worried. Use normal triage judgment here and discuss principles of routine care. Generally children should stay home from school/daycare until no fever x 24 hours AND the main symptoms have remitted.
3. Emphasize importance of handwashing, keeping hands away from face, liberal use of antiseptic gel, covering coughs with elbow, staying away from sick people, etc.
4. Symptoms suggesting need to be seen:
• Very young (<6mo) with significant or worrisome symptoms
• Especially ill-appearing Fever over 104
• Significant symptoms beyond the usual achiness, headache, fever, anorexia, nausea, moderate cough, sore throat, etc.
• Chronic medical problems, including asthma, diabetes, etc.
5. Offer office visits to very ill children sick for fewer than 48 hours. At the time of the visit we can discuss performing a rapid flu test even if they do not have the serious symptoms described above.
6. Avoid over-prescribing anti-viral medications in the office. Healthy children do not need to take the anti-flu medications unless there are underlying medical problems but parents can be provided Relenza or Tamiflu if the influenza A test is positive and they request it. This would be a decision made at the time of the visit by the care provider.
7. Avoid prescribing antivirals on the phone BUT exceptions might be made if a family member has documented influenza, a child is especially ill and has been so for <48 hours. This would be up to the individual MD.
8. Reassure patients that when we get H1N1 vaccine we will try to make it as easy as possible to get their kids immunized. Encourage seasonal flu vaccine at our flu clinics and at the time of regular office visits.