Cold vs. Flu, or RSV? How Telehealth Nurses Can Use Triage Protocols to Address All Three

Colds

Although common, colds are typically mild. They usually begin slowly, starting with a sore throat before leading to nasal congestion and drainage. Common symptoms a few days after infection include coughing, sneezing, as well as a slight fever that usually doesn’t exceed 101 degrees. As symptoms progress, nasal drainage can change from clear to dark, and become thicker. Many patients who come down with colds find it difficult to perform activities of daily living (ADL) compared to their normal energy levels. It’s also possible that colds will lead to other complications, like sinus congestion and ear infections. 

Flu

A case of the flu is more severe than a cold, and has faster onset symptoms. Because sore throats and fevers are common with both ailments, they can sometimes be confused. That said, coughing and congestion are more likely to be worse with the flu, and are usually accompanied by headaches, muscle aches, general soreness, and even severe exhaustion. In layman’s terms, a bout of the flu usually makes patients “feel rundown” for a week or longer. Complications can also be harder on the body, including sinusitis, bronchitis, ear infections, and pneumonia.

RSV

The Centers for Disease Control and Prevention (CDC) notes that, as a respiratory illness, “RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States,” and that the vast majority of all children have experienced it by the time they turn two. Initial symptoms are usually in the form of runny noses, decreased appetites, and coughs that may evolve into wheezing and trouble breathing. Infants may also be irritable and experience apnea. Older adults with heart or lung disease, or those who have weakened immune systems, are also at risk. Similar to colds, there is no vaccine that can prevent an RSV infection, although palivizumab is a commonly prescribed medicine for young children who are more susceptible to extreme illness, including bronchiolitis or pneumonia.

There were already expectations that flu and COVID would both see higher case counts as we continued into the fall and winter months. But many health systems are now seeing a surge in RSV cases, and MassLive notes how this has pushed some of them to delay elective procedures for children in order to conserve available beds. One doctor is quoted as saying that you typically have “hand-foot-mouth in the summer, RSV in the winter, [and] flu in the winter,” but that de-masking has now allowed all of them to spread sooner, and “with a vengeance.”

With RSV season here early, it can be difficult for parents (especially new ones) to evaluate potential cases in their children — not simply because the symptoms are similar to other respiratory viruses, but because their children aren’t able to verbalize what hurts. Telephone and telehealth triage nurses — who are trained on how to obtain information about physical symptoms that they can’t see — also rely on Schmitt-Thompson protocols to evaluate these symptoms and select the best dispositions for care.

Protocols

These protocols are considered the gold standard for telephone triage because they cover symptoms for infants, children, and adults, including concerns about colds, the flu, and RSV. They do this by offering a decision-tree to nurses for identifying and evaluating all patient symptoms, which then determines where those patients should receive care — either from themselves at home, from a primary care physician, or a medical professional at an urgent care or emergency room.

These protocols are ideal for a number of reasons:

1. All calls are standardized and treated with the same procedures.
2. Patient needs are evaluated in the appropriate windows of time.
3. Patients are guided to the correct care providers, which means less chance for delayed care, potential health complications, or overcrowded ERs.

When selecting the appropriate protocol for cold, flu, or RSV, the best triage nurses know that you always give the highest acuity — or the safest outcome — for the patient.

Do You Need Triage Protocols?

If you’re in the market for the latest nurse triage protocols, we have both daytime and after-hours versions available. We also offer the most intuitive telehealth and telephone nurse triage software that uses these protocols to document all patient interactions and share that information securely with the appropriate providers. Contact us when you’re ready to learn more about either of these solutions.