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Posted (edited)

My squad transported a 16 year old with 104 fever last night.

The doc in the ER said potential Swine Flu.

How does that relate to the EMT's that transported? Also should anyone take any precautions around those EMT's now?

I know where are supposed to have protocols for issues like this, but they have not been updated in about 10 years.

Thanks

Edited by ghurty
Posted

I'd treat it the way you do any time you've transported a febrile patient. Take off your N-95 and gloves, wash your hands, clean the truck and put it back into service. If no PPE, then feel and appreciate the pucker feeling you're getting in the nether regions, learn from it and start looking up transmission rates and mortality rates for H1N1 and compare it to the other flu strains out there. Gain some perspective on the call.

Regarding a specific plan of action with regards to your own post exposure protocols, talk to your infection control officer, medical director and hospital staff to lay out a plan. See what testing or follow-up you need and consider taking some time off while it gets sorted out. I'm not sure if you can transmit asymptomatic, but it wouldn't surprise me (since you seem to be able to with everything else) and you need to limit your exposure to other crews and patients. Might be time for work quarantine if time off isn't an answer; that means N-95 all the time on you at work. (Ontario medics will remember this from SARS; I won't as I was only 18 and not a medic at the time)

Good luck!

- Matt

Posted

Perhaps the attached file will be of benefit. Regardless, don't panic. even the CDC admits the reaction to the H1N1virus outbreak was over the top. If you did get it and don't have any other complications you'll likely be fine. Simple use of coughing etiquette and washing will significantly limit transmission.

Posted

Where are you located and what made the doctor say "potential swine flu"?

Was fever the only symptom? What made that potential dx versus the dozens of other potential dx's for that age and with a fever, for example bacterial meningitis?

What more do you know?

Posted
Where are you located and what made the doctor say "potential swine flu"?

Was fever the only symptom? What made that potential dx versus the dozens of other potential dx's for that age and with a fever, for example bacterial meningitis?

What more do you know?

We are located in Monmouth county NJ. There has been reports thru-out the county of swine flu cases.

I was not the one transporting, but from what I understand, the patient had complained of coughing a lot as well. However the entire time of transport, the patient did not cough at all. The crew that transported, stated that they had put on a NRB to the patient immediately.

I do not know what caused the doc to say potential swine flu. Maybe the doc was just over reacting.

One of the officers is going to call the hospital tomorrow to see if the patient tested positive.

Are they still required to tell us?

I know that as of mid last year, the notification clause was repealed. Has it been put back in?

http://www.jems.com/news_and_articles/arti...w_repealed.html

Thanks

Posted

We are just talking about the flu? In essence, a bad cold. Last year, we would not bat an eyelash over a febrile patient, now "swine flu" has us loosing sleep.

Take care,

chbare.

Posted (edited)
I was not the one transporting, but from what I understand, the patient had complained of coughing a lot as well. However the entire time of transport, the patient did not cough at all. The crew that transported, stated that they had put on a NRB to the patient immediately.

Brilliant move! The patient can now spray droplets with the aid of a NRBM running at a high flow rate.

Did some in EMS not get the memo about devices such as masks using a higher flow rate and CPAP that are discouraged unless the patient can be isolated if infectious disease is suspected?

We are just talking about the flu? In essence, a bad cold. Last year, we would not bat an eyelash over a febrile patient, now "swine flu" has us loosing sleep.

Influenza A is taken serious in hospitals regardless of what animal it is named after and the patient is isolated in hospitals. We have cases pop up year round.

Edited by VentMedic
Posted
We are located in Monmouth county NJ. There has been reports thru-out the county of swine flu cases.

I was not the one transporting, but from what I understand, the patient had complained of coughing a lot as well. However the entire time of transport, the patient did not cough at all. The crew that transported, stated that they had put on a NRB to the patient immediately.

I do not know what caused the doc to say potential swine flu. Maybe the doc was just over reacting.

One of the officers is going to call the hospital tomorrow to see if the patient tested positive.

Are they still required to tell us?

I know that as of mid last year, the notification clause was repealed. Has it been put back in?

http://www.jems.com/news_and_articles/arti...w_repealed.html

Thanks

you said you were not the one transporting. Did you or didnt' you transport?

If you did not transport the patient then why are you worried?

i'm confused

Posted
Influenza A is taken serious in hospitals regardless of what animal it is named after and the patient is isolated in hospitals. We have cases pop up year round.

So much so that most are D/C'd home and told to ride it out. I had the one of the iso rooms on my last shift, and had 4 (out of many) who ruled in for type A. Tamiflu and taxi was the dispo and they were in and out of the ED in no time.

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