Rapid Response: Don’t take the flu home for the holidays
Austin-Travis County EMS reports influenza spike: EMS responding to 30 cases a day
What happened: As predictable as the holidays themselves, influenza has started its annual spread across the country. This year, Texas is one of the first states to report a surge and stress on the healthcare system. Austin-Travis County EMS officials are reporting a 100% increase in flu cases each week and their crews are currently seeing at least 30 cases per day.
Why it’s significant: If the flu is not in your area, it will be soon.
The Centers for Disease Control and Prevention closely monitors flu activity across the country and posts “Influenza-Like Illness” activity maps, updated each week. Currently, the southern states from Texas to South Carolina are showing extremely high activity levels.
The flu usually peaks in January or February and the CDC estimates that during the last flu season, there were approximately 42.9 million cases of illness, 647,000 hospitalizations and 61,200 deaths. It’s easy to groan when the pager squawks out yet another “sick person, possible flu” call, but these folks can be really ill and they need our help. But they can also easily spread that illness to us and our families.
Top takeaways on recommendations to reduce the transmission of influenza
Here are six ways providers can protect themselves and their families during flu season.
1. Seasonal influenza vaccination
The CDC and the Advisory Committee on Immunization Practices stand behind the safety and efficacy of the influenza vaccine and recommend that all people aged 6 months and older, including healthcare providers, be vaccinated. Many healthcare employers require vaccination. It is ideal to get it early in the fall so that the body can build antibodies, but a dose can still be effective if received later.
2. Personal protective equipment
The use of personal protective equipment by EMS providers is a must, but probably an area in which many of us could do a little better. The flu virus is generally spread by large droplets produced when a person coughs, sneezes or talks. Standard and droplet precautions should be implemented, including wearing a surgical mask and eye protection. If the patient is not having difficulty breathing, it is also recommended to have them were a surgical mask.
The virus may also be transported in aerosol (smaller droplet) form, so the CDC recommends that if healthcare providers are performing aerosol generating procedures, they wear N95 masks. In the EMS setting, this may include suctioning, airway management or giving a nebulizer treatment, especially if it causes the patient to cough.
3. Management of influenza
Prehospital care of a patient suspected to have influenza is limited to supportive interventions. Poor oxygenation and respiratory failure are often seen in the flu. Provide supplemental oxygen and use standard respiratory support as appropriate and per your protocols. These may include CPAP or BiPAP, assisted ventilations and advanced airway placement.
Patients with the flu are often dehydrated, so insertion of an IV and infusion of crystalloid fluids are usually appropriate.
4. Notify the receiving hospital
When calling in your pre-arrival report, be sure to relay your concerns of influenza. The receiving hospital may need to prepare an isolation room and set out their PPE supplies.
5. Hand hygiene
Hands should be washed, or alcohol-based hand sanitizers used frequently, including before and after patient contact, even if gloves were worn. If hands are visibly soiled, they should be washed with soap and water.
6. Post-transport decontamination
After the transport, your ambulance will need to be wiped down with an approved sanitizing cleaner. This should include the stretcher, monitoring equipment, BP cuff, stethoscope and any surface that may have been exposed. Large droplet precautions usually include a radius of 6 feet around the patient, so this includes most everything in the back of the ambulance.
After wiping everything down, consider using a UV sterilizing lamp, also known as ultraviolet germicidal irradiation, to further sanitize the back of the ambulance. Portable and handheld units are available in many emergency departments.
Stay safe out there and don’t take influenza home for the holidays.
Additional resources for influenza prevention, management
Learn more about universal precautions and other measures to prevent the spread of influenza and how to manage influenza patients with these resources from EMS1, the CDC and the World Health Organization:
- Flu cases increased by 100% for Texas county EMS
- Universal precautions are not just to protect us
- Plague in the modern day: Public health outbreaks at home and away
- How EMS can prevent, assess, treat influenza
- Increasing EMS provider influenza vaccination will decrease transmission
- Influenza infection control guidelines
- Infection control: 4 tips to embrace a clean squad culture
- EMTs, paramedics: Infection control is your job
- CDC: Prevention Strategies for Seasonal Influenza in Healthcare Settings
- CDC: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2018–19 Influenza Season
- CDC: Clinical Signs and Symptoms of Influenza
- CDC: Seasonal Influenza Vaccination Resources for Health Professionals