Influenza in a multidisciplinary emergency department Proposed algorithm for action in cases of suspectedinfectious disease in an emergency department
Medical Review (Med. pregled), 2025, 61(6), 33-38.
P. Krasteva1, R. Argirova2
1 Emergency Department, Acibadem City Clinic UMHAT Tokuda – Sofia
2 Clinical Laboratory, Acibadem City Clinic UMHAT Tokuda – Sofia
Abstract. Multidisciplinary emergency departments (EDs) serve a diverse contingent of patients with urgent medical conditions from different age groups. Patients with fever are often examined, even though they do not meet the clinical requirements for an emergency. The aim of our study is to quickly differentiate patients with fever and influenza infection, which will prevent its spread among patients and staff in the emergency department and enable the timely initiation of specific treatment with neuraminidase inhibitors. This specific goal also leads to the need to create and implement in practice an algorithm for behavior in case of suspected infectious disease in the emergency department of a multi-profile hospital for active treatment (MHAT). Materials and Methods: For the period from 1 January to 31 Janu- ary 2025, 185 febrile patients were followed up out of a total of 1630 patients who sought medical care in the emergency department of Acibadem City Clinic UMHAT Tokuda. They were tested with specific rapid tests, as required by the Regional Health Inspectorate (RHI) of Sofia for 35 patients, the tests taken were also sent to a reference
laboratory for PCR-confirmation of the influenza virus infection. For each patient with laboratory-proven influenza with a rapid test in the RHI, a rapid notification was sent to the RHI of Sofia. The results obtained demonstrate the reliability and necessity of using rapid tests in emergency departments for triage of patients and diagnosis in cases of suspected infectious disease, in this case influenza. The conclusions drawn are that it is advisable to perform specific tests in the emergency department when influenza is suspected, and that the application of an algorithm when an infectious disease is suspected in the emergency department guarantees the separation of patient flow and prevents the spread of the infectious agent among patients and medical staff. This not only ensures the preservation of the functional integrity of the ED and its limited medical staff in the context of the epidemic spread of the influenza virus, but also increases the safety and satisfaction of patients and their companions.
Key words: influenza, emergency department, algorithm
Address for correspondence: Parvoleta Krasteva, MD, DSc, e-mail : etika_k@abv.bg