The Canadian Pandemic Influenza Plan for the Health Sector

Chapter 2. Patient Management I
2.1 Initial Assessment Management
The algorithms shown in this chapter were designed to be used by healthcare staff and also by
volunteers with minimal triaging experience to identify influenza patients who present to the
health clinics, doctor’s offices, emergency rooms, temporary emergency services, or other
influenza triaging centres. Assuming that there will be a large number of cases and limited
resources during a pandemic, the assessment guidelines are intended to evaluate the needs
of each individual, and triage influenza patients efficiently in a crisis situation. Triage personnel
will decide when patients can be managed in an ambulatory setting, redirected home, sent to
an alternate care site, or admitted to an acute care hospital.
Two algorithms are included in this chapter, one for adults and adolescents (Section 2.1), and
a second for children (Section 2.2). There is no clear age limit for the use of these algorithms.
Depending on the age of the patient, place of consultation, and on the number of cases of
influenza in a given community, young children and adolescents may be seen by personnel
specialized in childcare or by the same staff and volunteers who assess the adult population.
Nevertheless, influenza can be more severe in youngsters, and different criteria should be
used to judge the seriousness of the illness in children (Section 2.2).
Healthy seniors living in the community can be evaluated as other adults (Section 2.1).
Nevertheless, elderly individuals are also at increased risk for complications of influenza and
those over 65 years of age should be monitored closely (see Chapter 1).
Management of patients/residents in long-term care facilities is discussed in Chapter 3.
Because of their age and/or underlying medical condition, most individuals living in long-term
care facilities are at increased risk for developing complications after influenza infection. In a
pandemic situation it is expected that long-term care residents will remain in the long term
care facility for treatment.
These algorithms were designed mainly for urban centres that have a variety of health
resources as well as alternative sources of assistance. See Chapter 6 for assessment
recommendations tailored to the health care resources found in rural and isolated
communities.
16 The Canadian Pandemic Influenza Plan for the Health Sector