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Tuesday, January 15, 2013

Is the Flu a Reason to Go to the Emergency Room?

The flu has made its grand entry this year, sending many normally healthy individuals into misery. So much misery that many are heading to local emergency rooms, doctor offices, or clinics for treatment.

But according to the Pennsylvania Medical Society (PAMED) and the Pennsylvania Chapter of the American College of Emergency Physicians (PaACEP), a trip to the ER or clinic may not always be necessary.

“For many flu victims, staying at home, drinking fluids, and taking acetaminophen is all that they need,” says Ralph J. Riviello, MD, MD, FACEP, president of PaACEP. “But there will be exceptions, and those people should seek immediate assistance.”

For example, Dr. Riviello says certain symptoms will trigger a reason to seek immediate care from a physician. Specifically, physicians will be concerned if you have any signs of pneumonia, low oxygen levels, or severe dehydration.

“An adult with difficulty breathing, chest or abdomen pain, dizziness, confusion, or severe vomiting needs to head to the emergency room,” says Dr. Riviello.

Children also need to be closely watched for those symptoms, but there may be other reasons to seek immediate attention. A child who develops bluish skin or is not waking up or interacting may signal a reason to visit the ER. If a fever with a rash develops, then seek immediate attention. If the flu symptoms appear to be improving, but then return with a fever and a cough worse than before, then seek treatment at an ER.

According to C. Richard Schott, MD, president of PAMED, using this as a basic guide, many people can save themselves from making a trip to their local hospital and in doing so also save money by treating themselves at home with rest, liquids, and over-the-counter painkillers.

“Patients may feel badly for up to a week, but will get better at home,” he said.

As a heads up, Dr. Schott says that doctor offices will often triage patients over the phone, so if you call your primary care physician for an appointment, they may ask questions about your condition before providing a recommendation for your next step. Tamiflu, given early, may help limit the severity and duration of the flu, and may help decrease secondary problems for those who are at higher risk for complications, such as patients with underlying lung disease.

Both PAMED and PaACEP recommend getting a flu shot. “It won’t guarantee a patient will not get the flu, but it does sharply decrease the odds, and it’s still not too late to get one,” Dr. Schott said.

“Having a high percentage of the patient population protected with flu shots can decrease transmission of the flu virus through the population. Unless you fall into a group in which it is not recommended, then get a shot since it’s your best defense,” Dr. Riviello adds.

In addition, Dr. Schott suggests regular hand washing as a precaution, and to avoid unnecessary contacts, such as crowds, and with those known to have the flu. “Those with flu symptoms should also avoid contact with others, and should not visit friends or relatives in hospitals or nursing facilities.”

Seek immediate care for you or a loved one if the following happens:

Adults

Difficulty breathing
Chest or abdomen pain
Dizziness
Confusion
Severe vomiting

Children

Difficulty breathing
Chest or abdomen pain
Dizziness
Confusion
Severe vomiting
Bluish skin
Not waking up or interacting
Fever with a rash
Symptoms appear to be improving, but then return with a fever and a cough worse than before

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