Hospitals across the continent have adopted procedures that fit recommendations from authoritative sources like the US Centers for Disease Control and the World Health Organization. While hospitals will modify their procedures for local conditions, in general, here’s what to expect.
First Step: Who Gets ‘Screened Out’?
If you have or had a fever of 100 degrees F (37.8 C) and symptoms of an upper respiratory infection—cough, sore throat, runny nose, nasal congestion—not due to something other than possible flu, then you enter the “Infection Control” phase. Otherwise, you are not tested for flu, and you are treated for whatever might be found. If you have symptoms of upper respiratory infection and no fever and nothing else (e.g., no shortness of breath or pain), you probably have a cold.
Infection Control
If you are considered a possible H1N1 case, you will be given a surgical mask, which you must wear. You will be put in a separate waiting area, if possible. Ideally, that will be a room with a closed door. You still must wear your mask. Staff seeing you will be gowned and wear masks and probably eye protection.
To Be Hospitalized or Not?
If you have enough respiratory distress or other problems, you will be considered for hospitalization. If not, you could be treated anyway for H1N1 or for some other condition, but you probably won’t be tested for H1N1. (You will never know for sure, but if you have flu in fall 2009, it is probably H1N1.)
Not Hospitalized?
If you are "high risk" and you have been ill for more than 48 hours, you will be treated for H1N1; if you are high risk and have been ill for less than 48 hours, you may be treated.
The following types of patients are considered high risk:
- those under five years old
- those over 65 years old
- those under 19 years and receiving aspirin and might be at risk for Reye syndrome after flu infection
- pregnant women
- those with chronic lung disease, including asthma
- those with heart, liver, blood, neurologic, neuromuscular or metabolic disorders
- those living in a nursing home or other chronic care facility
- those who are immunosuppressed
If you are not at high risk, and not hospitalized, you will likely not receive treatment for H1N1.
Hospitalized?
You will be under “Droplet and Contact Precautions.” That means there will be ways to control mist from coughing and sneezing, and no one will touch you without wearing a mask and gloves. You may feel like you have the plague, but those are only the standard precautions.
If you have a procedure done, the room should have negative pressure or HEPA filtration.
You will probably get antiviral medications.
These guidelines are based on CDC and WHO interim guidance in October, 2009. Hospitals will adapt their own procedures according to their local situation, but they will probably be similar to these.
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