Thursday, November 4, 2010

Telephone triage for suspected influenza

Although the Centers for Disease Control and Prevention's weekly flu tracking report showed "low" influenza activity in the U.S. as of the publication date of AFP's November 1, 2010 issue, we know that it is only a matter of time before family physicians' offices are filled with patients either seeking the vaccine or presenting with symptoms of an acute infection. Accordingly, this issue contains several key resources for managing influenza, including a focused clinical review of testing and treatment; a Tip on the effectiveness and limitations of oseltamivir (Tamiflu) for reducing flu duration in children; and an updated influenza management guide from the University of California at San Francisco's Department of Family and Community Medicine. The guide suggests using "telephone triage" to reduce office visits that can potentially transmit influenza to other patients and staff:

Telephone triage can assess severity of symptoms and identify patients at risk of complications who would benefit from expedited access to antiviral medications, which can then be prescribed by telephone or fax. This approach provides timely access to treatment while reducing waiting room exposures. Conversely, if telephone triage identifies concerning symptoms that would require outpatient or emergency department evaluation, this can be arranged and expedited.

For additional information about best practices and a sample protocol for telephone triage, you can refer to a previous editorial by Jonathan L. Temte, MD, PhD. This editorial and other up-to-date resources, including the CDC's 2010-11 vaccination guidelines, are all included in AFP's Influenza Topic Collection. Finally, you can also click on the CDC's Flu.Gov widget, located on the lower right border of this blog, for updates and alerts throughout the influenza season.