May 1, 2009

VUMC leadership creates guidelines regarding swine flu

The following actions should be implemented IMMEDIATELY:
ASK any patient presenting with fever and respiratory symptoms (cough, runny nose, congestion, or sore throat) the following:

1)    In the 7 days prior to when your symptoms began, have you traveled to any communities either within the United States or internationally where there are one or more confirmed cases of swine flu infection (for an up-to-date list, go to 

2)    Have you had contact with anyone who lives in or has recently traveled to any of these areas in the 7 days preceding illness onset?

If a “YES” response to EITHER question, do the following:
1)    Place a regular surgical mask on the patient
2)    Put the patient in a private room as soon as possible and keep the door closed
3)    Healthcare workers: Wear an N-95 mask; gowns/gloves; eye protection (“Enhanced Precautions”)
4)    Contact Infection Control and Prevention @ 835-1205 IMMEDIATELY
5)    Obtain a “flu test” using two swabs as per guidance noted at  Note on the requisition that there is a concern for swine influenza.

ANTIVIRAL PRESCRIPTIONS:  The CDC has provided guidance on use of antivirals, such as Tamiflu and Relenza (, and there is concern nationally of hoarding of the antivirals for personal use.  Vanderbilt actively discourages personal stockpiling of antivirals, as this could lead to shortages for infected patients.  We encourage all practitioners to follow CDC guidelines on prescription of these drugs. 

ILL EMPLOYEES:   Vanderbilt faculty or staff who have respiratory symptoms and either recent travel to an affected area or close contact with someone who has had a confirmed case of swine influenza should contact the Occupational Health Clinic at 936-0955 to determine if further evaluation is needed.

NEW VISITOR AND PATIENT SIGNAGE:   Signage instructing visitors with respiratory symptoms to not visit patients will be placed at entrances throughout the Medical Center.  Additional signs will be placed at the entrances to clinics and the EDs instructing those patients seeking care who have fever AND respiratory symptoms to wear a mask.

OUTPATIENT SWINE FLU TOOLS:    Clinics will receive very soon guidance documents on how to manage patients with suspected swine influenza, including information for phone triage to help guide clinicians.

PERSONAL PREPAREDNESS:  While we have not seen cases of swine influenza in Tennessee, these instances should remind us to make sure we are prepared, whether for natural disaster or influenza outbreak.  VMC Office of Emergency Management has some helpful tips for your own personal and family preparedness planning at

Please be advised that these issues are evolving and advice may change as new information arises.