Local Implementation of CDC Swine Flu Interim Guidelines for VA Hospital, Louisville, KY

Low Alert Level – April 30, 2009

Patient Signs InStep 1:

A sign identifies signs and symptoms of respiratory illness/protective actions (cover cough, mask use)Surgical mask and tissues provided to patientSign identifies designated area in waiting room

Patient continues to wear mask while waiting

Triage by NurseStep 2:Nurse wears surgical mask and eye protectionPatient continues to wear surgical maskNurse sends patient to closed ED bayPatient wears mask during transport

Step 3: Any employee in contact with patient wears surgical mask and eye protectionPatient can remove mask if in enclosed bayObtain epidemiologic history

Suspect Case

Signs and symptoms of respiratory illness plus

travel in past 7 days to area

with confirmed case (see below)

Non-Suspect

CaseNo travel in

past 7 days to States (in USA)

or Countries (other than USA) with confirmed

swine flu cases

Step 4: Airborne Isolation Follow Normal Airborne Precautions

Step 5:Diagnostic Testing

Ordered by Clinician

Nasopharyngeal swab or nasal wash for diagnosisDiagnostic tests will be performed per laboratory protocols. Options are rapid influenza A, PCR and viral culture. Specimen collector wears respiratory protection consistent with type of isolation, plus eye protection

Additional isolation precautions may be necessary depending on other potential etiologies of illness or other patient factors

Droplet Isolation Follow Normal Droplet Precautions

Cases have been confirmed in: USA (California, Nevada, Arizona, Texas, Kansas, Indiana, Michigan, Ohio, New York, Massachusetts), Mexico, Spain, New Zealand, Nova Scotia, British Columbia, Scotland, and Israel

Created by the University of Louisville Swine Flu Working Group