http://reference.medscape.com/viewarticle/827504?src=wnl_edit_specol&uac=61764CK
Above is a link to a decent Medscape question/summary on hypertensive urgency and emergency, one of our Express Care bread and butter topics.
My only add on is to remember to thoroughly document your "end organ targets" in your note. For instance, don't forget to document your (undilated) fundoscopic exam. Get an urinalysis if you feel the need, or an EKG. Keep the end organ targets in mind to keep your documentation on target!
Wednesday, July 30, 2014
An Early Flu Guidance Tip
http://www.jwatch.org/fw108998/2014/06/27/cdc-panel-recommends-nasal-flu-vaccine-over-shot-kids?query=pfw
At the end of June 2014- for the 2014-2015 flu season, the CDC's Advisory Council on Immunization Practices (ACIP) formally voted that for healthy children ages 2-8, that the FluMist (the nasal flu vaccine that is attenuated- not killed like the shot) be the flu shot of choice for this age group. The reasoning was studies show much greater immunogenicity to the nasal spray as opposed to the shot.
While we do not give flu shots in this age at the Express Cares, this is a key guidance item to stay up to date on since we field many flu questions in our clinic.
Just to add to the controversy, the American Academy of Pediatrics disagrees with the ACIP, citing the higher cost of the FluMist and it's restriction to healthy kids, including excluding those with a history of asthma.
I think common sense here is to advocate as the first priority for all people over 6 months of age to simply get vaccinated. Then, for this age group and if accessibility is not an issue, one can show preference for the nasal vaccine. As always, www.cdc.gov and www.immunize.org are supreme, reliable resources for all vaccine information, and you can print out any VISs if needed.
At the end of June 2014- for the 2014-2015 flu season, the CDC's Advisory Council on Immunization Practices (ACIP) formally voted that for healthy children ages 2-8, that the FluMist (the nasal flu vaccine that is attenuated- not killed like the shot) be the flu shot of choice for this age group. The reasoning was studies show much greater immunogenicity to the nasal spray as opposed to the shot.
While we do not give flu shots in this age at the Express Cares, this is a key guidance item to stay up to date on since we field many flu questions in our clinic.
Just to add to the controversy, the American Academy of Pediatrics disagrees with the ACIP, citing the higher cost of the FluMist and it's restriction to healthy kids, including excluding those with a history of asthma.
I think common sense here is to advocate as the first priority for all people over 6 months of age to simply get vaccinated. Then, for this age group and if accessibility is not an issue, one can show preference for the nasal vaccine. As always, www.cdc.gov and www.immunize.org are supreme, reliable resources for all vaccine information, and you can print out any VISs if needed.
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