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H1N1 flu: When to go to the hospital ER

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An Israeli nurse injects a medical worker with an injection of Focetra, a vaccine against Swine Flu, at the emergency room at the Tel Aviv Soraksy Medical Center in Tel Aviv, Israel on November 2, 2009. Israel officially began its campaign against Swine Flu this week focusing initially on some one million people in high risk groups and medical personnel.Thirty-five Israelis have so far died due to complications of swine flu, including three who did not have any history of other underlying diseases. An increase in the incidence of swine flu has been reported recently at community health clinics and among school children. UPI/Heidi Levine/POOL 
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Published: Nov. 3, 2009 at 1:32 PM

BETHESDA, Md., Nov. 3 (UPI) -- U.S. emergency physicians have issued guidelines to help people determine whether their flu symptoms warrant a hospital emergency room visit.

Dr. Angela Gardner, president of the American College of Emergency Physicians, said the guidelines, posted at http://www.acep.org/WorkArea/DownloadAsset.aspx?id=46870, are directed at adults age 18 and older.

The guidelines first ask, "Do you have a fever or feel feverish and have a cough and/or sore throat?" If the answer is no, then emergency medical care is probably unwarranted. If yes, the guidelines ask, "Do you have any of the following warning signs of severe illness?"

-- Difficulty breathing or chest pain?

-- Breathing rate over 24 breaths per minute?

-- Purple or blue discoloration of the lips?

-- Vomiting and inability to keep liquids down?

-- Signs of dehydration, headache, extreme thirst, dizziness when standing and decreased urination"

-- Confusion or change in either behavior or alertness?

-- Convulsions or seizure?

-- If you have a blood pressure device, is the top number less than 100?

If the answer is yes to any of these questions, it is advised to go to the emergency department, the guidelines said.

However, if all answers above are no, and you have a fever or feel feverish and have a cough and/or sore throat plus any of the following conditions, call your primary care physician:

-- Age 65 or older.

-- Diabetes.

-- Pregnant.

-- Severely overweight.

-- Have an organ transplant.

-- HIV/AIDS.

-- Require kidney dialysis

-- Chronic heart disease.

-- Receiving or completed chemotherapy in past 30 days.

-- Have an immune compromised condition.

-- Sickle cell.

-- Cirrhosis.

-- Chronic breathing difficulty such as asthma, cystic fibrosis, emphysema or chronic

obstructive pulmonary disease.

-- Multiple sclerosis or spinal cord injury.

-- Stroke, brain injury, dementia, or Alzheimer's.

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