Get the free Influenza or other Respiratory Illnesses Specimen Submittal Form - cdph ca

This form provides instructions for collecting and submitting specimens related to influenza and other respiratory illnesses, including patient information and laboratory details.

How to fill out influenza or other respiratory

How to fill out Influenza or other Respiratory Illnesses Specimen Submittal Form

1. Begin by entering the patient's personal information in the designated fields, including name, date of birth, and contact details.
2. Fill out the clinical information section, including symptoms, onset date, and relevant medical history.
3. Specify the type of specimen being submitted (e.g., nasal swab, throat swab, etc.) in the appropriate section.
4. Indicate the date and time the specimen was collected.
5. Complete any additional required fields, such as physician information or lab requisition number.
6. Review the entire form for accuracy and completeness before submission.
7. Submit the form along with the specimen as per the laboratory's instructions.

Who needs Influenza or other Respiratory Illnesses Specimen Submittal Form?

1. Individuals experiencing symptoms of influenza or respiratory illnesses.
2. Healthcare providers submitting specimens for testing on behalf of patients.
3. Laboratories conducting diagnostic testing for influenza or respiratory pathogens.

People Also Ask about

What is the specimen for the flu test?

Alternatively, a combined nasal and throat swab specimen or aspirate specimens can provide good influenza virus yield. Some influenza tests are approved only for use with certain kinds of respiratory tract specimens, so follow guidelines provided by test.

What specimen should be collected from a patient with suspected influenza quizlet?

For suspected influenza outbreaks in institutions, respiratory specimens should be collected from patients with suspected influenza as early as possible once the outbreak is suspected.

What specimen should be collected from a patient with suspected influenza?

A nasopharyngeal (NP) swab is the optimal upper respiratory tract specimen collection method for influenza testing. However, such specimens cannot be collected from infants and many older patients may not allow an NP specimen to be collected.

What is laboratory confirmed influenza?

A laboratory confirmed influenza-associated hospitalization is defined as a patient hospitalized greater than 24 hours with a positive influenza diagnostic test. Laboratory confirmation includes RT-PCR, viral culture, DFA, IFA, and rapid tests.

What are the laboratory tests for influenza?

Diagnostic tests available for detection of influenza viruses in respiratory specimens include molecular assays (including rapid molecular assays, reverse transcription polymerase chain reaction (RT-PCR) and other nucleic acid amplification tests); and antigen detection tests (including rapid influenza diagnostic tests

Which of the following specimens would be the best choice to test a patient for influenza virus?

The gold standard for confirming influenza virus infection is reverse transcription-polymerase chain reaction (RT-PCR) or viral culture of nasopharyngeal or throat secretions.

How do you write influenza?

Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue.

What type of sample is needed for influenza test?

All flu tests require a respiratory sample. This can include samples from: Your nasal cavity (nostrils) with a swab around your nasal walls. The upper part of your throat (nasopharynx) with a swab through your nose.

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What is Influenza or other Respiratory Illnesses Specimen Submittal Form?

The Influenza or other Respiratory Illnesses Specimen Submittal Form is a document used to provide necessary information about respiratory specimens being submitted for laboratory testing. It ensures that the specimens are properly identified and routed for accurate analysis.

Who is required to file Influenza or other Respiratory Illnesses Specimen Submittal Form?

Healthcare providers, laboratories, and public health agencies involved in the collection and submission of respiratory specimens for influenza testing are required to file the Influenza or other Respiratory Illnesses Specimen Submittal Form.

How to fill out Influenza or other Respiratory Illnesses Specimen Submittal Form?

To fill out the Influenza or other Respiratory Illnesses Specimen Submittal Form, the healthcare provider should complete sections including patient identification, specimen information, clinical history, and any relevant epidemiological data. Ensure all required fields are accurately filled out.

What is the purpose of Influenza or other Respiratory Illnesses Specimen Submittal Form?

The purpose of the Influenza or other Respiratory Illnesses Specimen Submittal Form is to collect essential data to aid in the diagnosis of influenza and other respiratory illnesses, facilitate public health surveillance, and track the spread of these illnesses in the community.

What information must be reported on Influenza or other Respiratory Illnesses Specimen Submittal Form?

The information that must be reported includes patient demographics, date of specimen collection, type of specimen, clinical symptoms, healthcare provider's information, and geographical location. Additional information may be required depending on local surveillance needs.