Barry
Sorry about delay - travelling from the UK back to North America
That's an incredible e-mail
So we have antivirals that probably don't work more than they harm
We don't have a vaccine - certainly not one in my clinic yet - and it has only some animal evidence as far as I know -
And we don't know what questions to ask and what exam to do to predict the serious cases.
Is this summary wrong?
Martin
On 18/09/09 10:37 AM, "Barry Diner" <[log in to unmask]> wrote:
Dear All
After reviewing over 3000 abstracts to develop pre hospital triage for
pandemic flu, there is nothing that specifically answers that question. The
results of our consensus conference which has yet to be published was mostly
taken from the pneumonia literature
Barry Diner, MD, MPH, FACEP
Attending Physician St Lukes Episcopal Hospital
Clinical Assistant Professor Emory University
Methodologist, ACEP Clinical Policy Committee
-----Original Message-----
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of Martin Dawes, Dr.
Sent: Friday, September 18, 2009 2:06 AM
To: [log in to unmask]
Subject: Re: measurement section in oscar
Dear all
We are trying to develop a template for our open source electronic record.(
http://www.oscarcanada.org/ )
The context is an urgent care clinic.
Are there any questions or exam that are rule in or rule out for flu?
I guess any further questions and exam is for prognosis?
Does anyone know of an evidence based summary that would help us develop
such a template - or maybe this has all been done and we can have an EB
prediction rule?
So far we have a non EB list which I feel is a bit long
Thanks
Martin
dyspnea Y/N
sore throat Y/N
travelled recently Y/N
exposure to someone with H1N1 Sx Y/N
RR
O2 sat
HX: Fever>38 x days
Headache: Y
Arthralgia: Y
Myalgia: Y
Cough: Y
Sputum: N
Nausea: N
Vomiting: N
Diarrhea: N
Smoker:
Asthma:
O/E H&N:
CHEST:
CVS:
ABD:NAD
DERM: no rash
DX:Influenza
PLAN:supportive
FU:
________________________________
From: [log in to unmask]
To: [log in to unmask]
Subject: measurement section in oscar
Date: Fri, 31 Jul 2009 14:03:01 +0000
Hi Dr. Roper,
I was looking at the measurement section and was thinking of the following:
Under the measurement box, can Respiratory be added on
with the following assessment points under this category for pt with any
resp symptoms or with cOPD/asthma health issue so it can all be summarized..
RR
dyspnea (yes/No)
cough (yes/No)
expectorations (yes/No)
chest pain (yes/No)
edema (options: 1+, 2+, 3+)
auscultation (indicate findings)
O2 sat
O2 use (yes/No)
Temp
Med use (yes/No) then specify if yes..what meds?
Skin color (option to write: pink, pale, cyanosis)
Signs of Anxiety (yes or No)
Smoking (yes or no)
exposure to someone with H1N1 Sx (yes or no)
travelled recently (Y or N)
In addition to this, i was thinking about the H1Ni pandemic situation which
will be pronounced this Fall2009
should we make a triage sheet for suspected H1N1 here in our clinic in
preparation?? and it can be used at QEHC walk in as well?
What do you think of this?
Your ideas would be greatly appreciated..or we could discuss this further...
Thank you for your time..Have a great weekend!
Anna
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