Health Professional

Overview  

Healthcare providers play a crucial role during seasonal flu, and even more so during an influenza pandemic. The following guidance, checklists and information will assist healthcare providers and service organizations in planning and responding to seasonal flu or a pandemic flu outbreak.

Seasonal Flu Guidance  

Clinicians and Other Health Care Providers

• Responding to Influenza: A Toolkit for Prenatal Care Providers (PDF - 3.1 MB)
• Guidance for the Prevention and Control of Influenza in the Peri- and Postpartum Settings
• Guidance for Clinicians on the Use of Rapid Influenza Diagnostic Tests for the 2010-2011 Influenza Season
• Interim Guidance on the Use of Influenza Antiviral Agents During the 2010-2011 Influenza Season
• Joint Pregnancy and Influenza Letter (PDF - 123 KB)
  Letter from the Centers for Disease Control and Prevention and healthcare organizations urging providers to vaccinate pregnant and postpartum women to prevent the flu.
• Recommendations of the Advisory Committee on Immunization Practices (ACIP)
• Podcast: Influenza 2010-2011: ACIP Vaccination Recommendations
• Seasonal Influenza Vaccine Safety: A Summary for Clinicians
• Seasonal Influenza Vaccination Resources
• Influenza Vaccination Coverage among Children Aged 6–23 Months — U.S., 2008–09 Influenza Season

Health Care Workers

• Influenza Vaccination Information for Health Care Workers

Health Care Facilities

• Infection Control in Health Care Facilities

Pandemic Planning Checklists  

• Home Health Care Services Checklist [PDF - 201KB] [En Español (PDF) (295KB)]
  This checklist identifies specific steps that home health care service providers can take now to prepare for a pandemic.
• Medical Offices and Clinics Pandemic Influenza Planning Checklist (PDF - 172.16 KB)
  Specific steps are outlined in this checklist that medical offices and clinics, including outpatient care clinics, can take prepare for a pandemic.
• Emergency Medical Services and Non-Emergent (Medical) Transport Organizations Pandemic Influenza Planning Checklist (PDF - 225.09 KB)
  EMS and medical transport organizations can use this checklist to help prepare for a pandemic.
• Hospital Pandemic Influenza Planning Checklist (PDF - 2.03 MB)
  Checklist for hospitals to help prepare for a pandemic.
• Long-Term Care and Other Residential Facilities Pandemic Influenza Planning Checklist (PDF - 148.45 KB)
  The checklist identifies key areas: a structure for planning and decision making, and a written plan with subplans.
• Health Insurer Pandemic Influenza Planning Checklist (PDF - 102.74 KB)
  Planning is organized according to business-related, employee-related, and communications-related activities
• CDC 2009 H1N1 Vaccination Campaign Planning Checklist
  The checklist outlines the main 2009 influenza A (H1N1) monovalent vaccine (2009 H1N1 vaccine) planning actions. Within each state, the checklist should be tailored to distinguish between state and local responsibilities.

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Pandemic Flu General Information  

• Providing Mass Medical Care with Scarce Resources: A Community Planning Guide (Agency for Healthcare Research and Quality)
  For State, local, community, and facility planners, this guide discusses ethical and legal issues, and considerations regarding prehospital care, hospital/acute care, palliative care, and alternative care sites. Chapter 8 is a 29-page case study for a flu pandemic.
• Altered Standards of Care in Mass Casualty Events (Agency for Healthcare Research and Quality)
  Report from an expert panel convened by the Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Public Health Emergency Preparedness to discuss planning for emergency heath and medical care standards to ensure that the health care provided in a public health emergency such as pandemic influenza results in saving as many lives as possible.
• Adapting Community Call Centers for Crisis Support: A Model for Home-Based Care and Monitoring (Agency for Healthcare Research and Quality)
  A model to enable community health call centers, such as poison control centers, nurse advice lines and other hotlines, to support home-management and shelter-in-place approaches in public health emergency events such as pandemic influenza.
• Emergency Preparedness Atlas: U.S. Nursing Home and Hospital Facilities (Agency for Healthcare Research and Quality)
  To support State and local planning for a public health emergency, the Atlas includes 1) maps illustrating the size range and distribution of nursing homes and hospitals relative to preparedness regions for six case-study States, and 2) 51 State-specific maps showing the location and size of nursing homes and hospitals serving the resident population.
• Health Emergency Assistance Line and Triage Hub (HEALTH) Model (Agency for Healthcare Research and Quality)
  Designed to minimize surges in patient demand on the health care delivery system during a public health emergency. Helps planners determine the requirements, specifications, and resources needed for developing an emergency contact center such as the HEALTH model. Includes a Contact Center Assessment Tool Set that will calculate the numbers of a constituent population that may try to reach a public health agency during a bioterrorism or emergency event.
• National Hospital Available Beds for Emergencies and Disasters (HAvBED) System: Final Report and Appendixes (Agency for Healthcare Research and Quality)
  A demonstration model exploring the feasibility of a national real-time hospital-bed tracking system to address a surge of patients during a public health emergency.
• Project XTREME: Cross-Training Respiratory Extenders for Medical Emergencies (Agency for Healthcare Research and Quality)
  An interactive cross-training program to teach non-respiratory therapy health care professionals to provide basic respiratory care and ventilator management in a public health emergency such as pandemic influenza. (DVD: Description and ordering information.)
• Readiness and Response to Public Health Emergencies: Help Needed Now From Professional Nursing Associations (Agency for Healthcare Research and Quality)
  Originally published in the Journal of Professional Nursing. Although nursing is not the only health profession experiencing a workforce shortage, nursing is vital to any large-scale demand for care. Agencies within the Department of Health and Human Services have been working to address readiness and response capabilities in health care professions including nursing, but private organizations and professional associations also have a role to play.
• Reopening Shuttered Hospitals to Expand Surge Capacity (Agency for Healthcare Research and Quality)
  Designed to help public health officials and hospital and health facility staff determine how best to choose and use a closed or partially closed hospital or health facility to expand surge capacity in advance of a public health emergency. (Includes Surge Toolkit and Facilities Checklist)
• Rocky Mountain Regional Care Model for Bioterrorist Events: Locate Alternative Care Sites During an Emergency (Includes Alternate Care Site Selection Tool) (Agency for Healthcare Research and Quality )
  To help State and local officials quickly locate alternative care sites if hospitals are overwhelmed by patients during a public health emergency such as pandemic influenza.

H5N1 (Bird) Flu Guidance  

• Interim Guidance for Cleaning Emergency Medical Service (EMS) Transport Vehicles during an Influenza Pandemic
  This document contains general guidelines for cleaning or maintaining EMS Transport Vehicles after transporting a suspected influenza patient during a pandemic.
• Home Health Care during an Influenza Pandemic: Issues and Resources (Agency for Healthcare Research and Quality)
  Report from an expert panel that reviewed work currently being done in home health care planning and preparedness and explored the key issues and challenges of providing home health care services during an influenza pandemic. Of special interest to home health care agencies, and State and local pandemic influenza planners.
• Interim Guidance on Environmental Management of Pandemic Influenza Virus
  CDC guidance on hygiene and use of disinfectants on environmental surfaces (countertops, laundry) in the home and in health-care facilities.

• Community Strategy for Pandemic Influenza Mitigation  (PDF - 10.3 MB) CDC guidelines on actions, designed primarily to reduce contact between people, that community government and health officials can take to try to limit the spread of infection should a pandemic flu develop.

• Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers (PDF - 405 KB) (Occupational Safety and Health Administration)
• Clinical Management of Human Infections with Avian Influenza A (H5N1) Virus (World Health Organization)
  This August 2007 document replaces the WHO interim guidelines on clinical management of humans infected by influenza A (H5N1), published in March 2004.
• Summary of the Second WHO Consultation on Clinical Aspects of Human Infection with Avian Influenza (H5N1) Virus (PDF - 45.7 KB) (World Health Organization)
  Read how clinicians, epidemiologists, and other public health specialists around the world are working together to share medical information concerning human cases of H5N1.
• WHO Guidelines for Investigation of Human Cases of Avian Influenza A(H5N1) (World Health Organization)
  The Guidelines provide a framework and approach for public health authorities and investigators at all levels, to plan for and conduct investigations of human cases of A(H5N1) (or other avian influenza viruses of pandemic potential). The document focuses on the key steps that should be undertaken in an investigation.
• Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic
  Provides background information on influenza transmission, pathogenesis, and control. Gives recommendations on kinds of mask and respirators, as well as their proper use.
• WHO Infection Control Recommendations for Avian Influenza in Health-Care Facilities (PDF - 116 KB) (World Health Organization)
  The WHO has provided infection control guidance for health care workers in health care facilities who evaluate or provide care for patients with suspected or confirmed avian influenza infection, including H5N1.

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H1N1 (Swine) Flu Guidance  

The following materials were developed and used for the 2009 H1N1 (Swine Flu) Pandemic.

Health Care Workers 

• H1N1 Compendium: A Resource for H1N1-Specific Response Guidance
• Questions and Answers about Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings
• Questions and Answers Regarding Respiratory Protection for Infection Control Measures for 2009 H1N1 Influenza among Healthcare Personnel

Clinicians 

• Clinical Aspects of Pandemic 2009 Influenza A (H1N1) Virus Infection
  (Writing Committee, WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza)
• Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices: Guidance from Stakeholders (PDF)
• 10 Actions Steps for Medical Offices and Outpatient Facilities
• Identifying and Caring For Patients
• Questions and Answers: 2009 H1N1 and Pneumococcal Disease in the News
• Hospitalized Patients with 2009 H1N1 Influenza in the United States- April-June 2009: Questions and Answers, NEJM
• Clinical Data Collection Forms and Templates
  
• Vaccines
  • Non-Safety-Related Voluntary Recall of Certain Lots of Sanofi Pasteur H1N1 Pediatric (0.25 mL, for 6-35 month olds) Vaccine in Pre-Filled Syringes Questions & Answers
  • H1N1 Vaccine - Dose Spacing for Children 6 Months through 9 Years of Age
  • Updated Guidance for the Use of CSL™ 2009 H1N1 Monovalent Vaccine
  • H1N1 Influenza A (H1N1) 2009 Monovalent Vaccine Dosage Chart
  • Healthcare Providers and Facilities - Decision Tree for 2009 H1N1 Vaccination
  • CDC 2009 H1N1 Vaccination Campaign Planning Checklist
  • Vaccine Distribution Q&A
  • Monovalent Influenza Vaccine Dosage, Administration and Storage
  • Letter to Providers Promoting PPSV for Adults
  • Prevention Of Pneumococcal Infections Secondary To Seasonal And 2009 H1N1 Influenza Viruses Infection
  • Interim guidance for use of 23-valent pneumococcal polysaccharide vaccine during novel influenza A (H1N1) outbreak
  • State/Jurisdiction Contact Information for Providers Interested in Providing H1N1 Vaccine (CDC)
    
  Antivirals
  • Quick Facts for Clinicians on Antiviral Treatments for 2009 H1N1
  • Key Issues for Clinicians Concerning Antiviral Treatments for 2009 H1N1: Health Alert Network (HAN) Message
  • Antiviral Recommendations
  • Antiviral Safety Information
  • Questions and Answers for Health Care Providers: Renal Dosing and Administration Recommendations for Peramivir IV (PDF - 22 KB)
  • Clinicians Considering the Use of Peramivir IV
  • Emergency Use Authorization of Peramivir IV
  • Antiviral Treatment Options, including Intravenous Peramivir, for Treatment of Influenza in Hospitalized Patients for the 2009-2010 Season
  • Antiviral Drugs for the 2009-2010 Influenza Season - Podcast for Clinicians (7:04 | 10/19/2009 | CDC )
    
  Diagnostic Tests
  • Interim Recommendations for Clinical Use of Influenza Diagnostic Tests During the 2009-10 Influenza Season
  • Questions & Answers: Interim Recommendations for Clinical Use of Influenza Diagnostic Testing During the 2009-2010 Influenza Season - For Health Care Providers
  • Medical Devices and Flu Emergencies
  • Emergency Use Authorization (EUA): Medical Products
  • Interim Guidance for the Detection of Novel Influenza A Virus Using Rapid Influenza Diagnostic Tests
  • Interim Biosafety Guidance for All Individuals handling Clinical Specimens or Isolates containing 2009-H1N1 Influenza A Virus (Novel H1N1), including Vaccine Strains  

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Emergency Medical Services 

• Managing Calls and Call Centers during a Large-Scale Influenza Outbreak: Implementation Tool
• EMS and 9-1-1 Personnel:  Managing Confirmed or Suspected Infections

Hospitals, Clinics, Medical Offices 

• Questions and Answers for Health Care Providers: Renal Dosing and Administration Recommendations for Peramivir IV (PDF - 22 KB)
• Quick Facts for Clinicians on Antiviral Treatments for 2009 H1N1
• Key Issues for Clinicians Concerning Antiviral Treatments for 2009 H1N1: Health Alert Network (HAN) Message
• Clinicians Considering the Use of Peramivir IV
• Emergency Use Authorization of Peramivir IV
• Antiviral Treatment Options, including Intravenous Peramivir, for Treatment of Influenza in Hospitalized Patients for the 2009-2010 Season
• 10 FAQs for Immunization Programs and Providers
• Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices: Guidance from Stakeholders (PDF)
• Healthcare Providers and Facilities - Decision Tree for 2009 H1N1 Vaccination
• Hospitalized Patients with 2009 H1N1 Influenza in the United States- April-June 2009: Questions and Answers, NEJM
• CDC 2009 H1N1 Vaccination Campaign Planning Checklist
• Vaccine Distribution Q&A
• H1N1 Vaccine Tort Liability Immunity
• Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel
• Questions and Answers about Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings
• Actions for Novel H1N1 Influenza Planning and Response for Medical Offices and Outpatient Facilities
• Infection Control in Outpatient Hemodialysis Centers
• Interim Guidance: Considerations Regarding 2009 H1N1 Influenza in Intrapartum and Postpartum Hospital Settings
• Post-mortem Care and Safe Autopsy Procedures for Novel H1N1 Influenza
• Health Care Personnel Initiative to Improve Influenza Vaccination and Toolkit
• National Strategic Plan for Emergency Department Management of Outbreaks of Novel H1N1 Influenza

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Laboratories 

• Interim Guidance for the Detection of Novel Influenza A Virus Using Rapid Influenza Diagnostic Tests
• Interim Guidance for Influenza Surveillance: Prioritizing RT-PCR Testing in Laboratories
• Specimen Collection, Processing, and Testing for Suspected Infection 
• Submission of Tissue Specimens for Pathologic Evaluation
• Protocol for Antiviral Susceptibility Testing by Pyrosequencing
• Sequencing Primers and Protocol
• CDC Protocol of Realtime RTPCR for Swine Influenza A(H1N1)
• DSAT Guidance on CDC Import Permits for Swine-Originated Flu
• Interim Biosafety Guidance for All Individuals handling Clinical Specimens or Isolates containing 2009-H1N1 Influenza A Virus (Novel H1N1), including Vaccine Strains

Pharmacies 

• FDA Guidance to Pharmacies on Advance Compounding of Tamiflu Oral Suspension to Provide for Multiple Prescriptions
• Stockpiled Antivirals at or Nearing Expiration
• Tamiflu Oral Suspension Shortage Information
• 2009-2010 Influenza Season: Information for Pharmacists
• Monovalent Influenza Vaccine Dosage, Administration and Storage

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Specific Audiences 

• Updated Interim Recommendations for Obstetric Health Care Providers Related to Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season
• Use of Influenza A (H1N1) 2009 Monovalent Influenza Vaccine in Pregnant Women
• Interim Guidance: Considerations Regarding 2009 H1N1 Influenza in Intrapartum and Postpartum Hospital Settings
• Pregnant Women
• Updated Interim Recommendations: Special Considerations for Clinicians Regarding 2009 H1N1 Influenza in Severely Immunosuppressed Patients
• HIV-Infected Adults and Adolescents
• Planning Guide for Vaccinating Pediatric Patients against 2009 H1N1 Influenza in Primary Healthcare Settings
• Surveillance for Pediatric Deaths Associated with 2009 Pandemic Influenza A (H1N1) Virus Infection
• Use of Antiviral Medications for the Management of Influenza in Children and Adolescents -- Pediatric Supplement for Health Care Providers
• Guidance from Pediatric Stakeholders: A Coordinated Approach to Communicating Pediatric-related Information on Pandemic Influenza at the Community Level
• Infants and Young Children
• Patients With Cardiovascular Disease
• Information for Rheumatology Health Professionals
• Caring for a Sick Person in Your Home
• Home Care Guidance: Physician Directions to Patient/Parent

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