Urgent message: Just as what is predicted to be a brutal flu season picks up steam, the Infectious Diseases Society of America has released new guidelines stressing the need for timely, dual treatment in adults with community-acquired pneumonia who also test positive for influenza. Cornelius O’Leary, Jr., MD After more than a decade, the Infectious Diseases Society of American has published new guidelines on community-acquired-pneumonia—noteworthy for both its switch from narratives to a Grading of …
Barely a Week into the ‘Season,’ Influenza Shuts Down a School for an Entire Week
The Centers for Disease Control and Prevention recommends all Americans who are eligible for a flu shot (meaning anyone over the age of 6 months, for the most part) get one before the end of this month. That’s too late to prevent a serious outbreak in Baton Rouge, LA, though, where a school saw 38% of its upper-grade students body stricken with flu-like symptoms. While not all cases were confirmed to be influenza infection, the …
As Flu Season Hangs On, Be Vigilant for Patients with Influenza and Heart Failure
We’ve told you about a warning from the Centers for Disease Control and Prevention that influenza season continues to linger, no matter what the calendar says. A new study in JAMA Cardiology serves as reminder that it’s essential—and possibly lifesaving—to remain vigilant for related cardiovascular concerns, especially among heart failure patients with the flu. The authors of the study evaluated the connection between flu activity and hospitalizations for heart failure and myocardial infarction in four …
Treating Patients Infected with Influenza Virus in the Urgent Care Setting
Urgent message: As patients start to feel the effects of the 2018–2019 influenza season, urgent care centers can expect to see visits by patients with related symptoms increase. Providers must be prepared to identify and treat patients most at risk for complications and poor outcomes—armed with old standbys and a newly approved antiviral agent. Samantha Arnold, DO Introduction Last month, JUCM explored prevention, diagnosis, and testing for influenza. In this issue, we focus on management …
An Urgent Care Approach to Influenza—Before Onset
Urgent message: The urgent care clinician must have a thorough understanding of different influenza types and strains, disease course, and preventive measures—including, but not limited to, vaccination—at the outset of flu season.  Introduction Influenza is most deadly in the very young, very old, and those with comorbid conditions. Typically, onset is rapid and seasonal, though patients may initially present with few or nonspecific symptoms. Complicating things further, there are many different strains of the flu. …
Nebulizer Supplies, Diltiazem IV, Influenza Vaccines with E/M Codes, and Critical Care Coding in Urgent Care
Q.I am using an EHR, but it does not seem to code nebulizer treatments correctly. It produces codes 94640 (nebulizer treatment) and J7620 (albuterol/ipra – tropium bromide), but it misses the codes for administration set, with small volume non-filtered pneumatic nebulizer, disposable (A7003) and tubing (A7011 ). Why is this? A.The administration set code (A7003) and tubing code (A7011) code are actually bundled into the code for the treatment (ie, they are included in 94640). …
Preparing for Pandemic Influenza in the Urgent Care Setting
Urgent message: Between the current – and still growing – volume of H1N1 flu cases and fast-approaching influenza season, the urgent care physician will be challenged to distinguish among a variety of common cold and influenza-like conditions. Gary Klein, MD, MPH, MBA, CHS-V, FAADM Introduction The mainstream media have certainly accomplished the mission of alerting the public to the dangers of H1N1 flu – perhaps to the point that many are tempted to dismiss their …
Postpartum Presentations: When Risk Arises After Delivery – Shortness of Breath
Urgent Message: Shortness of breath presentations for postpartum patients in urgent care should prompt consideration of venous thromboembolism or peripartum cardiomyopathy, or more benign conditions like deconditioning, bronchitis, or anxiety. Alexa Bailey, DO; Lauren Kostandaras, DO; Hannah Poorman, BS; Michael Weinstock, MD; Catherine Neal, DO. Key Words: Shortness Of Breath, Postpartum, Venous Thromboembolism, VTE, Deep Vein Thrombosis, DVT, Pulmonary Embolism, PE, Peripartum Cardiomyopathy Editor’s Note: The patient case scenario is hypothetical. Abstract Background: The postpartum …
Door Handles Won’t Give You The Flu: Simulation Study
During flu season, many people go out of their way to wash down high-touch surfaces at home, at work, and in schools, hoping to avoid the spread of germs. An experimental laboratory study published in Microbiology and Immunology that evaluated the risk of influenza transmission through contact with contaminated surfaces, however, found the risk of picking up the flu from touching door handles and other objects is actually quite low. Researchers in Japan simulated “artificial …
Pediatric Deaths Climb in the Current ‘Highly Severe’ Flu SeasonÂ
According to the last weekly report from the Centers for Disease Control and Prevention (CDC), the current influenza season in the United States has resulted in the highest number of pediatric deaths since the H1N1 influenza pandemic in 2009–2010. As of the week ending April 26, 2025, at least 216 influenza-associated pediatric deaths have been reported—well above the 207 deaths recorded during the last flu season and especially concerning given that the season isn’t quite …