Flu epidemic?

NYCRN16 · Dec 11, 2003

I stayed home from work last night with the flu, everyone is getting it. Sorry, cannot be on my feet for 12 1/2 hours with these muscle aches. The wait has been ridiculous in my ED, and although most of the time the people just need a kick in the ass out the door, I cringe when the nursing home patients get it, because they are almost always admitted. Peds has been swamped like you wouldnt believe, I feel bad for the nurses that work in there!

kate930 · Dec 11, 2003

I don't understand why people think that the common flu is serious enough to warrant a trip to the ER.

which was preceeded by:

Now I am hearing all sorts of information about things such as they expect the flu to kill at least 65,000 people

Let's not forget how we keep hearing of "X number of children have died from the flu in _________"

I wonder if it would have made a difference if any of those children's parents had taken them to the ER. I'm sure that there are many parents sitting in the ER's waiting room thinking they're not taking any chances with their own children.

Get a grip people and see your own doctor.

While that sounds like a great idea, we have yet to be able to get in to see a doctor at our military clinic for ANYTHING with less than a week's wait (I have yet to see the same doctor, nor have we ever met our PCM... I guess technically we have our "own" doctor...just not sure who it is) .

I'm sure a parent whose child is sick would not think it's in their child's best interested in waiting a week just so they could see their "own" doctor.

athomas91 · Dec 11, 2003

let's keep in mind that many of the children who have died WERE in the hospital - so i do not think that we need to keep this in mind........

the majority of the pt's we are seeing DO NOT need to be in the ED - they are ages 20-45 and NOT dying..... children, the elderly, and the immunocompromised are generally the only people who die from the flu.....at least 10 nurses including myself have had it - and guess what - we didn't seek tx at the ed......

eltrip · Dec 11, 2003

Alll of the hospitals in my city got together yesterday with our county health department as well as the local medical society & the Tennessee Dept. of health & held a press conference about the flu. They provided s/s of flu vs. cold & home care info for the flu & when to seek medical evaulation.

Folks here have been jamming the EDs & calling everywhere looking for flu shots. The 3 largest hospitals have been jam-packed this week with everyone who has flu symptoms. Makes things quite difficult when traumas come in. It's getting rather difficult to try to get through to doctor's offices as well. (Speaking from experience here, my daughter's been sick all week with something totally different from the flu)

It's not pretty, and it doesn't look like it's going to get any better very soon.

I can't have the flu shot...I'm just washing my hands every time I turn around!

kate930 · Dec 11, 2003

let's keep in mind that many of the children who have died WERE in the hospital - so i do not think that we need to keep this in mind........

What if these parents had sought out care before things got really bad??? Could these lives had been saved?

When medical personnel are saying that "65,000 are expected to be killed", then how can we blame patients (most of which have NO medical training) for thinking they should seek treatment right away???

at least 10 nurses including myself have had it - and guess what - we didn't seek tx at the ed......

Great. And I would assume since you are a SRNA, then you've had quite a bit of medical training to indicate when you should receive treatment in the ER, however, I wouldn't expect a patient to know the same.

kate930 · Dec 11, 2003

CDC flu info: http://www.cdc.gov/flu/weekly/fluactivity.htm

Flu and its complications are the sixth-leading cause of death nationally among children age 4 and younger, according to the CDC.

6th leading cause of death. Good enough reason to take your child to the ER if YOU feel your child is sick enough.

http://abcnews.go.com/wire/US/ap20031211_1927.html

Some experts predict this year's death toll easily could surpass the annual average of 36,000 flu deaths. Health officials are unsure why the outbreak has hit so early, why it has caused so many problems in the West, and why it seems to be so lethal in children.

That kind of reporting in the news frightens parents who think their child may be sick with the flu. Imagine being the average parent (with no medical training) sitting home and wondering what you should do for your child who is possibly sick with the flu... especially after hearing how this year's strain is "so lethal in children."

FranEMTnurse, CNA, LPN, EMT-I · Dec 12, 2003

I'm unfortunately, one of those immune compromised people, diagnosed with chronic asthmatic bronchitis, and am unable to have a flu shot because they make me sick, and no, I'm not allergic to eggs.

I was hospitalized 3 times last year with pneumonia, once accompanied with septicemia. And yes, I had the pneumonia vaccine. However, I have been able to avoid even getting a cold since November 2002, and I'm proud of that record. When I begin to get fatigued, I know it's time to go to bed and put myself on fluids, including chicken soup. I stay there until I begin to feel better, getting up only to go to the bathroom. I even get my bath in bed. Yes, I do have a healthcare worker, and she is such a wonderful blessing to me. I just love her.

So if I'm able to avoid getting the flu by taking care of myself, then others, with the exception of those who are in the midst of it treating those who have it, should be able to also. I do understand a parent's concern for his and her kids. My own daughter had my one year old grand daughter immunized two weeks ago.

Fran:nurse:

athomas91 · Dec 12, 2003

Kate -

65,000 people die every year from the flu - it is actually estimated that no more than ususal will die this year - the children that died did so w/in 3 days of onset of symptoms - very rapidly and were hospitalized prior to dying

if you read my post in it's entirety - you would see that children, the elderly and the immunocompromised ARE in jeopardy - and there is no question that they should seek care - and despite being an SRNA - i was unable to even get out of bed to care for myself - so alot of good that does....the only people i have a problem with are the ones ages 20-45 who are coming in - it is useless and a waste of our time and beds- they can buy otc meds and self treat - there is no miracle drug

UNLESS they seek tx immediately at the onset of sx - then their PMD (which most do not have) could give them tamiflu (or another similar med) to lessen their sx.

kate930 · Dec 12, 2003

65,000 people die every year from the flu - it is actually estimated that no more than ususal will die this year

Actually, according to the CDC http://www.cdc.gov/flu/keyfacts.htm

About Flu

"Influenza (commonly called "the flu") is a contagious respiratory illness caused by influenza viruses. Infection with influenza viruses can result in severe illness and life-threatening complications. An estimated 10% to 20% of U.S. residents get the flu each year: an average of 114,000 people are hospitalized for flu-related complications and 36,000 Americans die each year from complications of flu."

65,000 is an 80% increase from what the CDC reports typically die from the Flu.

UNLESS they seek tx immediately at the onset of sx - then their PMD (which most do not have) could give them tamiflu (or another similar med) to lessen their sx.

I guess since they don't have an PMD, that's why they are in the ER. And since they can have their symptoms lessened (thereby lessening the chance they'll have to miss work or whatever else is important to them), I would expect them to go to the ER.

Antiviral Medications: Four antiviral drugs (amantadine, rimantadine, zanamavir and oseltamivir) have been approved for treatment of the flu. All of these must be prescribed by a doctor. Antiviral treatment lasts for 5 days and must be started within the first 2 days of illness.

http://www.cdc.gov/flu/keyfacts.htm

Of course, I wouldn't expect a patient to know all of this, nor would I expect them to spend their time on the internet hunting down the facts when they're sick. However, I would expect that since MOST wouldn't know what to do when they're sick, and many would assume they can be treated with something... they would seek treatment to lessen their symptoms.

Treatment is available... but of course, you have to go to a doctor to get it. Often times, the ER doctor is the only choice available.

passing thru · Dec 12, 2003

To the poster who wrote they didn't know why /or what people were expecting from the ER............

The newspapers and t.v. have been advising people to go to their ER's within the 1st 24 hours of onset of symptoms, because the flu could be nipped in the bud ""if medications were begun immediately, but were useless to stop the progression of the disease if the patient waits longer than 24 hrs.""

Is this not true?

athomas91 · Dec 12, 2003

the er is not the place for tamiflu etc..... it is for EMERGENCIES....

again i reiterate - children ages 0 mos-24 mos, the elderly, and the immunocompromised are at risk - they are considered emergent cases - however to all the others - the emergency room isn't the place....

i do not know if you work in an ed.... i do - and in triage on wed dayshift alone i must have triaged 30 adults who had symptoms greater than a wk....NOT AN EMERGENCY

from MD Gerberding at http://www.cdc.gov/od/oc/media/transcripts/t031211.htm

"We don't have scientific evidence or epidemiologic evidence to suggest that this year's influenza outbreak is worse than it has been in in the past or that the strain is more virulent than strains that we've dealt with before. It's just simply too early in the course of the outbreak to say for sure how this will compare overall, but obviously the early start and the early widespread activity has given us a great deal of concern, and obviously, it's concerned a lot of people, and that's why there's been such an interest in getting the vaccination this year."

"In addition, it's important to remember that for healthy people, for the vast majority of us, influenza is an annoying illness, it's certainly not fun, but it's something that we will recover from with common sense self care. It's not necessary to go to the emergency room or to visit a physician simply because you have the flu. The treatment is good old-fashioned rest, fluids and the over-the-counter medications that we typically use to treat symptoms. "

hmmm... kinda sounds like what i said.....

as well at http//www.cdc.gov/flu/about/qa/fluseason.htm

for wk 48 - "proportions of death due to flu were 6.5% which is LOWER than the national baseline for this wk which is 7.5%"

and that "HISTORICALLY the A (H3N2) virus causes higher numbers of influenza related deaths"

so based on history this year may be worse (i stress MAY)

.

momoftriplets · Dec 13, 2003

I'm sorry, but it is amazing to me that most people do not have the common sense to take care of themselves. I just can't imagine someone not knowing at least a little bit about health. It is not that as ER nurses we don't want to take care of sick people, we do, BUT...this is our forum to vent about patients who can't seem to do the simple act of taking tylenol for a fever!!!! I do not want to get lectured about being "politically correct" about keeping in mind the people who do not have a doctor or any insurance. THIS IS NOT WHAT THIS FORUM IS ABOUT!! It is a shame that these patients are not utilizing an urgent care, because that would be the most appropriate place for them. In the past week, I have been called every name in the book when the patient is only prescribed tylenol and motrin and to go home and rest. They will state, "I could've just stayed home if I knew I wouldn't be getting anything for it."

I know the media has focused on this flu and have scared a lot of people, but...no nurse wants to hear other peers in the profession that we are being inconsiderate of our patients.

This past week at work, I just do my job, take care of my patients, I can only do one thing at a time (believe it or not). Everyone will be seen in my ER, you just might have to wait for 4-5 hours to be told, take motrin and rest. You just try discharging irrate people..

We will get through this flu season, head on into bronchitis and pneumonia season, and the dreaded slip-and fall-on-the-ice-crani season. So, everyone hang in there!!!