Client Interim Guidelines for Paediatric Health Services

For attending the EPT Clinic

1. Introduction

All members of the EPT Team are involved in the fight against pandemic influenza (flu) in terms of managing the impact it will have on delivery of services in the clinic, the impact on society and preventing further spread of the infection.

This guidance has been developed to raise awareness of the measures that may be employed to reduce the spread of flu in the EPT Clinic. It aims to:

allow the clinic to evaluate potential situations where there may be possible exposure to the flu virus
describe the steps that can be taken to moderate any potential exposure to the flu virus in the workplace
set out the measures that might be used to reduce the spread of the flu virus in the workplace
provide a response plan if an outbreak were to occur

We are working in line with national and international guidelines.

2. What is Pandemic Flu?

Flu is a familiar infection throughout the world, especially during winter months. The illness, caused by the flu virus, can be mild or severe and occasionally, can lead to death. Generally, some groups of people are more susceptible to the complications of flu than others, especially older people and people of any age with certain medical conditions or during pregnancy.

A pandemic is a worldwide epidemic. Pandemic flu is different from seasonal flu because it occurs when a new flu virus emerges into the human population to which most people will be susceptible, and which can spread easily from person to person worldwide – all countries will be affected. This will result in many more people becoming severely ill and potentially many more deaths than occur due to seasonal flu.

The circumstances exist now for a new flu virus to emerge and spread worldwide. New flu viruses can arise from re-assortment of the human flu virus or evolve from animal influenza viruses e.g. bird, equine and swine flu.

3. Signs and symptoms of flu

It is likely that the signs and symptoms of pandemic flu will be the same as for seasonal flu but may be more severe and cause more serious complications.

The most significant symptoms are the sudden onset of:

Fever
Cough or shortness of breath

Other symptoms may include:

Headache
Tiredness
Chills
Aching muscles
Sore throat
Runny nose
Sneezing
Loss of appetite

The incubation period (time between contact with the virus and the onset of symptoms)

The range is from one to fourteen days, though for most people it will be two to three days.

The infection period (how long you are infectious to others)

People are most infectious soon after they develop symptoms. They can continue to spread the virus, for example in coughs and sneezes, for up to five days after they first exhibit symptoms (seven days in children). People become less infectious as their symptoms subside and once symptoms are gone, they are considered no longer infectious to others.

4. How is Pandemic Flu caught and spread to others?

It is likely that pandemic flu, just like seasonal flu, will spread from person to person by close contact. Some example of how it can spread include:

Large droplets from coughing and/or sneezing by an infected person within a short distance (usually 1 meter or less) of someone
Touching or shaking the hand of an infected person and then touching your mouth, eyes or nose without first washing your hands
Touching surfaces or objects (e.g. door handles) that have become contaminated with the flu virus and then touching your mouth, eyes or nose without first your washing hands

5. What should clients do if they have symptoms or are ill?

If an individual feels ill with symptoms consistent with influenza, it is important that they separate and isolate ASAP. The also need to inform the Clinical Director of their symptoms so that anyone that has been in contact with the person with symptoms can be informed.

Symptoms should be reported immediately to the clinic and if they are consistent with flu, the individual should go home and not return to the clinic until the symptoms have cleared and they feel well enough to return. They also need to attend their GP and, where appropriate be tested for COVID.

If colleagues develop symptoms while at home, they should adhere to the following advice:

Stay at home (self-isolate)
Do not come to the clinic until fully recovered
If they were in contact with an EPT member in person, they should inform the clinic to let them know that they are ill
Seek medical assistance as appropriate

6. What are the EPT Clinic doing to protect themselves and others from Pandemic flu?

Clients and the team should clean their hands frequently, especially after coughing, sneezing and using tissues. Soap and water are a perfectly effective means of cleaning hands; however, hand rubs, can be used as an alternative.

Every effort should be made to use Personal Protective Equipment (masks, visors or screens) where possible. Situations where this is not always possible include some assessments and therapy.
Clients are encouraged to bring their own PPE with them to the clinic.
Client’s temperature will be taken upon arrival.
Normal household detergent and water or disinfectant sprays should be used to clean surfaces frequently touched by hands.
Normal household detergent and water or disinfectant sprays should be used to clean surfaces after every client that attends the EPT Clinic
Clients and the team should use a tissue to cover their nose and mouth when coughing and/or sneezing, dispose of the tissue promptly and then wash their hands
Tissues should be disposed of in domestic waste – they do not require any special treatment
Clients and the team should not use cloth handkerchiefs or reuse tissues. This practice carries a risk of contaminating pockets or bags which may then re-contaminate hands every time they go into those pockets or bags
Clients and the team should minimise touching of the mouth, eyes and/or nose, unless they have recently cleaned their hands
Clients and the team should clean their hands as soon as they get to work, when they arrive home and after contact with money
Prominently displayed signs should be used to discourage the EPT Team and visitors with flu symptoms from entering the workplace and remind people of the signs and precautions required.
Surfaces and shared equipment should be cleaned frequently with the usual cleaning materials
Consideration should be given to improving access to effective hand hygiene facilities. Where practicable, hand rubs (microbicidal) could be made available at entrances to premises which are used by visitors
Where practical, consideration should be given to minimising the amount of soft furnishings and other objects that could become contaminated and are difficult to clean
Clients will be sent this guideline document and screening items via email prior to attending the clinic
The EPT website will outline the necessary precautions that clients and the EPT Team are asked to consider
Consider alternatives to direct meetings and visits (video or phone conferencing)
Where practicable, direct contact should be avoided and where possible, a distance of more than 1 meter should be kept between employees and visitors

7. Risk Management

There is no single approach or measure that can be taken to reduce the spread of pandemic flu. Prompt self-isolation together with proper respiratory etiquette and effective hand hygiene should be actively promoted, encouraged and applied.

8. Response Guidelines

If an EPT Team member or client presents in the clinic with mild to severe flu symptoms or an elevated temperature, the following steps should be adhered to. Your body’s normal temperature is between 36 and 36.8 degrees Celsius.

STEPS:

The person who has symptoms separates from other people, is advised to contact their GP and goes home to self-isolate.
Clinical director Lorraine OB Madden is notified of concern.
Confirmation of virus is sought from person with symptoms.
National guidelines in regard to contract tracing and self-isolation are implemented with support from local services.

If an EPT Team member or client’s relative or someone they were in contact with presents with mild to severe flu symptoms