WILLMAR -- If you show up in Rice Memorial Hospital's emergency room with symptoms of influenza, be prepared to put on a mask.
It's one of the steps the hospital is taking to try to limit the growing spread of influenza.
The number of people arriving in the emergency room with influenza-like illnesses has been on the rise, said Kathy Hunt, director of critical care services at Rice.
"I'm thinking we're gearing up for the real thing," she said. "We're seeing more of it."
A hospital team led by an infection control nurse has been meeting at least once a week to plan and coordinate the hospital's response to influenza. The flu outbreak, which is currently widespread in Minnesota, also dominates much of the day-to-day conversation among department directors, Hunt said.
"It is a constant part of our daily planning," she said. "We're keeping in touch with what's happening in a lot of ERs around the country. We're connecting with public health and with the clinics so we're on the same page."
One of the first, and most visible, steps the hospital has taken: the installation of kiosks stocked with masks, hand sanitizers and tissues for patients and the public. There are two of them in the emergency room and another one in the main lobby.
"If you come in with flu-like symptoms, you will be asked to put on a mask," Hunt said.
The same precautions will apply to family members and visitors who have contact with a hospitalized patient who has influenza, she said.
One of the big challenges in the emergency room is protecting people in the waiting room from exposure to others who may have influenza.
Some hospitals have been setting up special triage areas to separate the potential flu cases from everyone else. The Rice ER hasn't done this yet, but it's being considered, Hunt said.
The triaging will be especially important during weekends, when the ER sees its highest patient volume, she said. "We have to find another place where we can monitor people. We haven't come to grips with that yet."
Because the emergency room could easily be swamped by an influx of people with flu, Rice is adopting the same guidelines being used by local clinics and the Minnesota Department of Health: If you're young and otherwise healthy, you don't need to visit the ER unless you're severely ill.
Public education on this issue is important, Hunt acknowledged. "It completely contradicts what people want to do."
There's no rapid test commercially available yet for the H1N1 novel flu virus, often called swine flu, so ER patients should not expect to be tested. That will be reserved for people who are sick enough to be hospitalized, Hunt said.
"A lot of folks are going to get told to go home," she said.
The rising tide of influenza comes at the same time the Rice ER has been experiencing a significant spike in patient volume, especially on weekends. Nurse practitioners and a second physician have been added to the weekend schedule. A triage nurse also was recently added to provide more frequent checking-up on patients still in the waiting room.
Despite these measures, waiting times can be lengthy for people who are less urgently in need of care -- and this could get worse if the emergency room is overwhelmed with people with influenza.
"You head into a weekend just holding your breath, because it just doesn't slow down," Hunt said.