RVHS Updates

January 2010

• Jan. 6, 2010 - No changes since December. Don't forget to wash your hands regularly.
  

December

• Dec. 16, 2009 - No changes since Nov. 30, 2009. This will remain the case until further notice.
  

November

• Nov. 30, 2009 - Return to Standard Visiting Rules
  RVHS has returned to its standard visiting rules, as patient volumes at our two hospital campuses is leveling off.
  In order to ensure patient recovery and safety, we ask that there be no more than two visitors at a time please.
  In our emergency departments, only one visitor per patient is allowed.
  Rouge Valley's standard visiting hours are from 11 a.m. to 9 p.m.
  In special circumstances, visitors can make arrangements at the nursing station to obtain a visitor's pass to stay after 9 p.m.
  Please note that some areas of the hospital have special visiting hours, including labour and delivery, paediatrics, mental health, complex continuing care, intensive care units (ICU) and coronary care unit (CCU). Staff will communicate the specific visiting hours to visitors in these areas.
  
• Nov. 19, 2009 - Visiting rules remain on temporary H1N1 status as follows -
  * One visitor per patient per day until further notice
  * Visitors must follow our personal protective equipment (PPE) rules
  The hospital is enacting these rules to ensure we provide the safest, quality care environment for patients, visitors, staff, physicians and volunteers during this H1N1 period. Those not following these rules will not be permitted to visit. Staff and physicians can inform you of any PPE requirements.
  Thank you for your understanding and compliance of this temporary measure.
  
• Nov. 9, 2009 - Note to families and visitors: Temporary change in visiting rules (New sign PDF)
  
• Nov. 6, 2009 - Today RVHS is seeing more patients coming to our emergency departments, at both of its hospital campuses in east Toronto and west Durham, than it had on Wednesday and Thursday. But is is managing this situation well. Patients continue to be seen in a relatively timely manner. Thank you for your patience.
  
• Nov. 3, 2009 - Ontario Ministry of Health introduces flu self-assessment web tool. Click here to use it.
  

• Nov. 2, 2009 - Frequently Asked Questions (FAQ)
  1. Can the hospital give me an H1N1 shot?
  Answer - Rouge Valley Health System does not provide the H1N1 flu vaccine to the general public. Please contact your family doctor, community clinic or public health department for this service.
  2. Can I get my Tamiflu prescription filled at the hospital?
  Answer - Prescriptions are filled at your local pharmacy. The hospital does not provide this service.
  3. I think I have the H1N1 flu as I have some symptoms. Should I come to the hospital?
  Answer - It is best to contact your family doctor or community clinic. Hospital emergency departments are for people with worsening symptoms. Worsening symptoms include: shortness of breath, coughing up blood, ongoing vomiting, dehydration, extreme drowsiness, persistent or recurring fever. A complete severe symptoms' list is available in this document: Symptoms list & how to care for people with symptoms - RVHS fact sheet - PDF.
  4. Can the hospital test me to see whether I have H1N1?
  Answer - Such tests are not done by the hospital for outpatients, coming into our emergency department at both sites. The hospital's staff and physicians will treat patients with worsening conditions. We understand the public anxiety on this health concern. We hope this information is useful.
  

October

• Oct. 30, 2009 - Visiting hours - The hospital is on standard visiting hours. (until announced otherwise)
  Visiting rules: Two visitors per patient, one visitor per emergency patient. Read more in our news release. 
• Oct. 29, 2009 - Symptoms list & how to care for people with symptoms - RVHS fact sheet - PDF
• Oct. 29, 2009 - Get information on the location and times of the public H1N1 vaccination clinics in your area:
  Durham Region Vaccination Clinics, Toronto Public Health Vaccination Clinics
  
• Oct. 29, 2009 - How to prevent the flu - The basics: east Toronto newspaper ad / Durham newspaper ad - PDF
• Oct. 26, 2009 - How to care for people with flu symptoms - from Durham Public Health PDF
  
• Oct. 26, 2009 - General information on pregnancy and the flu
  
• Oct. 22, 2009 - Link to Ontario Ministry of Health and Long-Term Care Announcement on H1N1 vaccine
  
• Oct. 22, 2009 - Frequently Asked Questions on H1N1 and Ontario's flu vaccination program
  

• Oct. 22, 2009 - Visiting hours - The hospital is on standard visiting hours.
  Visiting rules: Two visitors per patient, one visitor per emergency patient. Read more in our news release.

• Oct. 15, 2009 - Tips for businesses and their employees
  Here are some tips on preventing the flu at work, from Tricia Root, RVHS Director of Infection Prevention and Control -
  

  - Regularly wash your hands or use alcohol-based hand sanitizer and encourage staff to do so.

  - Make available a supply of alcohol-based hand sanitizer for employees.

  - Keep tissues handy for staff and customers.
  

  - Encourage employees to stay home when they have flu-like symptoms. (People should stay home for five to seven days after the onset of the flu or when symptoms are gone.

  - Teleconference more often and work from home. If you are feeling sick, but well enough work don't go into the office: join meetings by phone, stay in touch by e-mail, and work from home, if possible.

• Oct. 15, 2009 - Protecting Yourself Against the Flu - 5 pieces of advice: Please read the informative article on the cover of our hospital's official magazine, The Echo, October 2009 edition.
  

September 2009

• Sept. 2, 2009 - Things you can do to protect your family from H1N1 - Autumn not only signals the end of summer; it’s also the beginning of influenza (flu) season. Because the flu virus tends to flourish in cooler, damp conditions, and with the cooler temperatures forcing people indoors, it makes the virus easier to spread. While cases of the flu, during this time of year, are quite common, there could be another health alert on H1N1 (swine flu)  similar to what was experienced in April and May. There are many things that you can do to protect yourself and your family from getting sick.  Read the article.
  
• Current - Visiting rules at Rouge Valley Health System (RVHS) remain as follows: one visitor in the emergency department; two visitors elsewhere in the hospital — unless different arrangements have been made with the manager and/or nursing staff.
  Rouge Valley's visiting hours are from 11 a.m. to 9 p.m.

Recent reports -

• Aug. 5, 2009 - Government of Canada announces intention to order 50.4 million doses of H1N1 vaccine (Ottawa) – Minister of Health, Leona Aglukkaq and Canada’s Chief Public Health Officer, Dr. David Butler-Jones, today announced that the Government of Canada will soon place an order for 50.4 million doses of H1N1 vaccine, which will be available to all Canadians who need and want it in time for the winter flu season. Read more of the Canadian government news release.
  

• July 31, 2009 - WHO Pandemic (H1N1) 2009 briefing note 5 (Geneva) -- Research conducted in the USA and published 29 July in The Lancet [1] has drawn attention to an increased risk of severe or fatal illness in pregnant women when infected with the H1N1 pandemic virus. Read more of the WHO news release.

• Provincial status indicators have been developed by the Ontario Ministry of Health and Long-Term Care. Green (routine) / Yellow (enhanced monitoring) / Red (emergency) / Mauve (recovery stage). Ontario is currently at enhanced monitoring status. Read more here.
  

Index

Symptoms

Influenza A(H1N1)

• H1N1 is the clinical term for the more commonly used term "swine flu."
• Influenza A virus subtype H1N1, also known as A(H1N1), is a subtype of influenzavirus A and the most common cause of influenza (flu) in humans. Some strains of H1N1 are endemic in humans, including the strain(s) responsible for the 1918 flu pandemic, which killed millions of people worldwide. Less virulent H1N1 strains still exist today.

Swine influenza (swine flu)

• Swine influenza A H1N1 (swine flu) is a respiratory infection that regularly causes outbreaks of influenza in pigs.
• Sporadic human infections with swine flu have occurred, however these are usually caused by direct exposure to pigs.
• Human to human transmission of swine influenza has been documented.

• Symptoms include:

• Usually include symptoms similar to season influenza (flu) including headache, chills and cough followed by fever, loss of appetite, muscle aches and fatigue, runny nose, sneezing, watery eyes and throat irritation.
• Nausea, vomiting and diarrhea may occur in adults as well as in children.
• In more severe cases, or in people with chronic conditions, complications such as pneumonia may develop.
• Swine Flu Information from the World Health Organization (PDF)

Severe respiratory illness

• New definition of Severe Respiratory Illness (SRI— A person with respiratory symptoms (April 30, 2009)
  

• Symptoms include:

• Fever (over 38 degrees Celsius) and cough or breathing difficulty
• And radiographic evidence consistent with SRI (i.e. radiographic evidence of infiltrates consistent with pneumonia or acute respiratory distress syndrome (ARDS)). Severe ILI may also include complications such as encephalitis or other severe and life threatening complications
• And no obvious alternate diagnosis

Protect Yourself and Others

All strains of influenza can be dangerous; however, good infection prevention measures can help protect you and others if this virus begins to spread rapidly in Canada.

• Wash your hands often and thoroughly in warm, soapy water or use hand sanitizer
• Cough and sneeze in your arm, not your hand
• Keep common surfaces and items clean and disinfected
• Stay home if you’re sick, unless directed to seek medical care

Learn more about preventing the spread of H1N1.

RVHS Resources

(PDFs - unless stated otherwise)

Handouts

• How to care for people with flu symptoms (HANDOUT)
  
• Protect yourself this flu season (ARTICLE)
• Self-screening for the flu - Notice to visitors (SIGN)
  
• PHAC Fact Sheet on H1N1
  
• Handwashing/mask procedures (HANDOUT)

RVHS bulletins and forms

• Lab Testing Protocol for H1N1 (GUIDELINES)
• FRI-SRI Screening Tool
  
• RVHS Command Centre for H1N1
• Physician Order Sets are on our internal intranet (for staff and physicians only)

• Swine Flu Alert (BACKGROUNDER) (for medical staff)
  
• Diagnostic Imaging screening (GUIDELINES)
  

• Recommended testing for SRI (GUIDELINES, Excel)
  

Public Health Bulletins

World Health Organization

• Swine Flu Information

Public Health Agency of Canada (PHAC)

• Oct. 30, 2009 - PHAC Information on H1N1 and Pregnancy - PDF
  
• August 17, 2009 - latest update
  
• April 25, 2009 - Travel Advisory

Ontario Ministry of Health and Long-Term Care

• Nov. 1, 2009 - Guidance for critical care PDF
  
• August 12, 2009 H1N1 report
  
• May 5, 2009 - Health Notice
  
• May 1, 2009 - Read the Ministry of Health news release update
• April 30, 2009 - Health Notice
• April 23, 2009 - Health Notice

Toronto Public Health

• April 22, 2009 - Surveillance Alert

Media

• RVHS will continue to keep all staff, physicians and volunteers informed in a timely fashion. We are also answering calls from the media. We are also informing the public through this web section and through interviews with the media.
  
• Please refer all media to David Brazeau, director of public affairs, at 647-294-8885 or at dbrazeau@rougevalley.ca  .

Index