Emergency Department » Influenza (Flu)

Hazard

Exposure of ED staff to infectious diseases, such as seasonal or pandemic influenza*.

Healthcare workers, particularly physicians and nurses, are at a higher risk of acquiring influenza than healthy adults working in non-healthcare settings (Kuster et al., 2011).

Influenza can be transmitted by both symptomatic and asymptomatic individuals through respiratory tract secretions, mucus, cough and sneeze aerosols, and contaminated hands and materials.

Recognized Controls and Work Practices

  • Encourage workers to get vaccinated and make vaccinations available to workers. The Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. health care workers get vaccinated annually against influenza.
  • Modify patient intake, triage, and other service areas to increase space between workers, coworkers, and patients and provide barriers against transmission when applicable (e.g., install sneeze guards or partitions).
  • If available, use airborne infection isolation rooms (AIIRs), for aerosol-generating procedures and limit the number of people present during the procedure.
  • Isolate and group flu patients when possible.
  • Limit patient transport. Conduct exams and procedures at the bedside, instead of transporting the patient to other areas of the facility. Place a surgical mask on the patient, if possible, when they are being transported out of the ED.
  • Use closed suctioning systems to suction a patient's airways and use high quality filters on the expiratory port of ventilators, when available.
  • Limit the staff entering patient isolation rooms to only those necessary for patient care.
  • Restrict visits for patients in isolation.
  • Use proper respiratory and cough etiquette and encourage hand washing by patients and visitors.
  • Wash hands with soap and water for at least 20 seconds before and after contact with patients, after using PPE, and after touching contaminated surfaces; use an alcohol-based hand rub if soap and water are not available.
    • When using soap and water, rub soapy hands together for at least 20 seconds, rinse hands with water, and dry completely.
    • If soap and water are not available, use of an alcohol-based hand rub is helpful as an interim measure until hand washing is possible. When using an alcohol-based hand rub, apply liquid to palm of hand, cover all surfaces of the hands with the liquid, and rub hands together until dry.
  • Monitor yourself for symptoms of the flu, such as fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue (tiredness).
  • Follow standard cleaning and disinfection methods.
  • Use a facemask when entering a flu patient's room. A facemask is not a respirator. It will not protect workers during aerosol-generating procedures, which may create very fine aerosol sprays. A facemask can only be used to protect workers from contact with the large droplets made by patients when they cough, sneeze, talk or breathe.
  • Use a respirator during aerosol-generating procedures; a fit tested N95 disposable respirator or better is needed.
  • Use gloves, gowns, and eye protection for any tasks that might cause contamination or create splashes.
  • Put on and take off protective equipment in the correct order to prevent contamination.

* While the recognized control and work practices that protect workers from exposure to seasonal and pandemic influenza are basically the same, consult the CDC's "Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease," in the event of an influenza pandemic to determine if any higher level precautions should be implemented (i.e., the use of respirators rather than surgical masks when HCWs are engaged in direct patient care).

Additional Information