As a healthcare provider, you spend hours helping people feel better each week. You might come in contact with the flu, colds and other common viruses. How can you protect yourself?

For starters, don’t think that you’re immune to illnesses. You might work hard to boost your immunities, such as taking vitamins, exercising and eating healthy. Because of your efforts, you might dodge a bullet and go years without getting sick with the flu. This, however, can change from year to year.

The same way you recommend that your patients get a flu vaccine, take your own advice. Get your vaccine at the start of flu season to prevent an early-season infection. Additionally, always wear exam gloves when examining patients. Go a step further and encourage sick staff members to stay home. This can reduce illness among your staff and keep your office running smoothly.

The flu is easily preventable, as long as the appropriate measures are taken.

Bookmark It

Hide Sites

BACKGROUND: The Coaguchek S is the next-generation coagulation monitor for measuring the international normalized ratio (INR) that replaces the Coaguchek device. Studies are lacking comparing the Coaguchek S with local laboratory INR assessment to ensure its accuracy and precision for monitoring patients on anticoagulation.

OBJECTIVE: To evaluate accuracy, precision, and technical ease-of-use of the Coaguchek S compared with laboratory measurements.

METHODS: Accuracy was evaluated in 101 patients by parallel assessment of INRs (Coaguchek S and laboratory); precision was evaluated in 31 patients using duplicate INRs from Coaguchek S and laboratory and from liquid quality controls. Accuracy was determined using orthogonal regression, Bland-Altman plot, and clinical applicability (INRs discrepant in categorization of INR goal and resulting in different therapeutic decisions). Precision was examined by comparing mean difference +/- SD between repeated INRs from Coaguchek S and laboratory, coefficient of variation (CV), and coefficient of repeatability (CR). The influence of low and elevated INRs on accuracy and precision was also examined. To assess ease-of-use of the monitor, the number of technical errors was recorded.

RESULTS: The Coaguchek S significantly correlated to laboratory measurement (r = 0.93); 16.7% of INRs resulted in discrepant categorization and 24.5% would have required a different therapeutic plan. The CV and CR compared well between Coaguchek S and laboratory (6% vs. 4.9%; 0.455 vs. 0.346, respectively). When subgroups of INR values <4.0 and <3.0 were evaluated, the precision improved with both methods. Precision, based on liquid quality controls, was good (CV 4.6% = low-level; 3.3% = high-level). The Coaguchek S was found to have an error rate of 1.8%.

CONCLUSIONS: The Coaguchek S is an accurate and precise alternative to laboratory assessment of the INR at values <4.0; it is an efficient device with a low likelihood of errors during testing.

Content courtesy of the U.S. National Library of Medicine

Bookmark It

Hide Sites

In Part I, we presented you with some of the numbers about both the seasonal flu and the H1N1 flu. Here in Part II we will take a look at the final set of statistics. Please remember getting a yearly flu vaccine can greatly reduce your chances of getting the flu. All flu statistics are courtesy of WebMD.

• The typical incubation period for the flu is one to four days. Adults can be contagious from the day before symptoms begin through five to ten days after the illness starts.

• Two antiviral drugs are approved by the FDA for use in treating or preventing the flu in the 2012-2013 flu season: Tamiflu (oseltamivir) and Relenza (zanamivir ).

• During 2009-2010, a new and very different flu virus (called H1N1, or swine flu) spread worldwide, causing the first flu pandemic, (a global outbreak of disease caused by a new flu virus) in more than forty years.

• A regular case of the flu typically resolves after three to seven days for the majority of people, although cough and fatigue can persist for more than two weeks.

• It is estimated that the H1N1 pandemic resulted in more than twelve thousand flu-related deaths in the U.S. In contrast to seasonal flu, nearly ninety percent of the deaths occurred among people younger than sixty five.

Bookmark It

Hide Sites

It’s a common question, “What is the health impact of the flu shot?”

The flu vaccine is highly effective and recommended at the beginning of flu season. But despite the fact that the vaccine prevents countless cases of the flu each year, many people question its safety.

They’ve probably heard stories of people dealing with side effects, such as flulike symptoms. Additionally, they may have heard of people suffering allergic reactions. Understand, however, that there are risks with any type of vaccination – not just the flu. Doctors and pharmacists are aware of these risks, and to protect patients, they ask a series of questions before administering the shot.

The flu vaccine isn’t right for everyone. A doctor will not administer the shot if you have a fever, or if you’ve dealt with a past reaction to the vaccine. Furthermore, a doctor will not administer a shot if you’re allergic to eggs.

Be upfront about your medical history and you doctor can decide the best course. If you’re a good candidate for the vaccine, the shot reduces your risk of the flu by up to 90%.

Bookmark It

Hide Sites

WARNING: NEVER give aspirin (acetylsalicylic acid) to children or teenagers who have the flu; this can cause a rare but serious illness called Reye’s syndrome.

• Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.

• Teenagers with the flu can take medicines without aspirin, such as acetaminophen and ibuprofen to relieve symptoms.

• Children younger than 4 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.

• The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.

• Fevers and aches can be treated with acetaminophen or Ibuprofen or non-steroidal anti-inflammatory drugs (NSAIDS). Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.

• Over-the-counter cold and flu medications used according to the package instructions may help lessen some symptoms such as cough and congestion. Importantly, these medications will not lessen how infectious a person is.

• Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications – don’t double dose!

Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu. Check with your health care provider or pharmacist if you are taking other over-the-counter or prescription medications not related to the flu.

Remember, the best way to guard against the flu is to get a yearly flu vaccine.

Bookmark It

Hide Sites

If you are the caregiver to the sick person you play a very important role in their health and their recovery. However, you are at a higher risk of contracting the flu because of your frequent close contact with the sick person. With that in mind, we have some ideas to help mitigate your risk in contracting the flu.

Protecting the caregiver

• Avoid being face-to-face with the sick person

• Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.

• To prevent catching the flu and spreading it to others outside of the home, the caregiver should wear a mask when they leave the home to keep from spreading flu to others in case they are in the early stages of infection.

• The caregiver should also talk to their health care provider about taking antiviral medication to prevent contracting the flu.

• Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur.

• Make sure to always get your yearly flu vaccine. By doing so you are giving yourself the very best protection you can to guard against catching the flu yourself.

Bookmark It

Hide Sites

Exam gloves are used by coroners, doctors, nurses, paramedics and other individuals in the health industry. Also known as medical gloves, exam gloves are disposable gloves that protect patients and caregivers from the transference of diseases and germs. These gloves are made from different materials for different purposes. Most commonly, exam gloves are made of latex. This is a lightweight plastic that is perfect for protecting a person during routine exams. A heavier rubber called neoprene is used for surgical gloves because it is more resistant during the procedure. Finally, nitrile gloves are used by surgeons, coroners and funeral directors alike for its extreme thickness and durability during procedures.

Exam gloves were first developed in 1890 by William Stewart Halsted. He was a student at Johns Hopkins University and was studying germ theory. The first type of sterilization included using carbolic acid. However, this was an abrasive chemical that was harsh on sensitive skin. Halsted convinced the popular Goodyear Tire Company to create a glove that could be dipped in this acid for sterilization. It was not until 1964 that the first disposable medical gloves made from latex were produced. While latex is still the most common and preferred choice for exam gloves, an increase in latex allergies has led to the production of other glove types with include neoprene and nitrile.

Content adapted from ArticlesBase.

Bookmark It

Hide Sites

While we all know it is best to protect ourselves and our loved ones by getting a yearly flu vaccine, sometimes the flu still sneaks into our lives. When this happens you need to know how to take care of the sick person and to stop the flu from spreading to others. Here are some ideas and tips:

Caring for the sick person

• Keep the sick person away from other people as much as possible.

• The sick person should not have visitors other than caregivers.

• Have the sick person to cover their mouth when they cough, regularly clean their hands with soap and water, especially after coughing or sneezing.

• The person with the flu should not leave the house if they have a fever or during the time that they are most contagious unless it is necessary for medical care. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to seven days after they get sick. Children, (especially younger children), might potentially be contagious for longer periods.

• If the person with the flu HAS to leave the home for medical care, they should cover their nose and mouth when coughing or sneezing and wear a loose-fitting surgical mask if available.

• With respect to a surgical mask, have the sick person wear it if for some reason they have to be in a common area of the house near other people.

• If at possible, the sick person should use a separate bathroom which should be cleaned daily with household disinfectant to prevent the spread of the virus to others in the home.

In our next blog we’ll have ideas for protecting others in the home who have not yet contracted the flu.

Bookmark It

Hide Sites

In our previous post, we offered ideas on how to care for a person with the flu. In this second post we have tips for how to protect other people in the home who have not yet contracted the flu.

Protecting other people in the home

• If any of the people in the home have chronic health conditions, ask your healthcare provider if they should be taking antiviral medications as a preventative measure.

• If possible, have only one adult in the home take care of the sick person.

• Pregnant women should not be caring for the sick person. Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy.

• All persons in the household should clean their hands with soap and water or an alcohol-based hand rub frequently, including after every contact with the sick person, or the sick person’s room or any bathroom.

• Use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household. For example, have different colored towels for each person.

• Try to maintaining good ventilation in shared household areas (e.g., keeping windows open in restrooms, kitchen, bathroom, etc.).

• Before flu season starts, make sure all of the members of your house receive a flu vaccine. While not one hundred percent effective (because of various flu strains), it goes a long way to keeping your family healthy.

In our next blog we’ll have ideas for protecting yourself if you are the caregiver.

Bookmark It

Hide Sites

There are a number of flu test kits which can help in the diagnosis of influenza. But, tests do not need to be done on all patients. For individual patients, tests are most useful when they are likely to give a doctor results that will help with diagnosis and treatment decisions. During a respiratory illness outbreak in a closed setting (e.g. hospitals, nursing home, cruise ship, boarding school, summer camp) however, testing for influenza can be very helpful in determining if influenza is the cause of the outbreak.

Preferred respiratory samples for influenza testing include nasopharyngeal or nasal swab, and nasal wash or aspirate, depending on which type of test is used. Samples should be collected within the first 4 days of illness. Rapid influenza tests provide results within 15 minutes or less; viral culture provides results in 3-10 days. Most of the rapid tests that can be done in a physician’s office are approximately 50-70% sensitive for detecting influenza and approximately greater than 90% specific. Therefore, false negative results are more common than false positive results, especially during peak influenza activity.

Diagnostic flu test kits available for influenza can include viral culture, serology, rapid antigen testing, polymerase chain reaction (PCR), and immunofluorescence assays. Sensitivity and specificity of any test for influenza might vary by the laboratory that performs the test, the type of test used, and the type of specimen tested. Among respiratory specimens for viral isolation or rapid detection, nasopharyngeal specimens are typically more effective than throat swab specimens. As with any diagnostic test, results should be evaluated in the context of other clinical and epidemiologic information available to health-care providers.

Content adapted from the CDC.

Bookmark It

Hide Sites