Flu Guidelines Update, New CDC Recommendation for Providers in Patients with Flu-Like Symptoms: Guidelines Knowledge Check

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Physician Assistant, Urgent Care

flu guidelines regarding patients with flu-like symptoms CDC recommendations EVALI

Based on New CDC Flu Guidelines, What Should You Now Ask Patients with Flu-like Symptoms?

Clinical Guidelines Knowledge Check

A large number of patients will be presenting to healthcare facilities with flu-like respiratory symptoms, such as cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhea, fever, chills, and weight loss, during the winter season who may not meet criteria for hospital admission.  It may not be the flu.

What follows is a guide to red flags in flu like presentations, new considerations in flu diagnosis, what is now recommended to ask any patient (school age or older) presenting with flu-like symptoms - and what to do upon the answer.

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Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

The CDC's updated guidance, published in Morbidity and Mortality Weekly Reports (MMWR), comes as the 2019-2020 influenza season approaches, when many patients may show up in outpatient clinics or hospitals with symptoms of respiratory illness. Find out if you’re following the most current recommendation for health care providers as flu activity increases nationally.

Try this case invloving a patient presenting with flu-like symptoms...

A 26-year-old, previously healthy male presents to the urgent care track of an emergency department with a complaint of 24 hours of fever, chills, headaches, body aches, congestion, sore throat, cough, and myalgias.

His vitals are T 101.3 F; P 101 bpm; BP 131/84 mm Hg, RR 16, unlabored, but with sounds of bronchitis.

He is congested and his throat is erythematous with mild swelling, but no exudates.

What do the most recent CDC flu guidelines specifically emphasize with regards to management of the above patient?

Answer Options:

Ask all patients with flu-like symptoms about recent travel to the area in China (Wuhan) with the Corona virus pneumonia outbreak.

Ask all patient, who have flu-like symptoms about vaping or e-cigarette use within the last 3 months

Offer antiviral treatment not only to all high-risk groups, but also to all patients with a positive rapid influenza PCR test.

Due to the corona-virus pneumonia recently having spread from China to the United States, check room air pulse oximetry in all patients with flulike symptoms and obtain chest x-rays in patients with oxygen saturation ≤ 95%.

See the Answer:

flu guidelines in diagnosing patients with flu-like symptoms vs EVALI lung injury

About Guideline Knowledge Checks:

With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.

About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.


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