| Document Date: 2013-12-30 08:09:41
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City Atlanta / / Facility *required Facility / / MedicalCondition glaucoma / epidermal necrolysis/Stevens Johnson Syndrome / Mydriasis / Anaphylactic reaction / Antiviral Medication Infectious / Arrhythmia / orthostatic hypotension / Hemorrhagic colitis / stupor Erythema / seizure Delirium / Bronchospasm / Acute respiratory failure / Johnson Syndrome / Urinary retention / Cardiac failure / closure glaucoma / Leukopenia / malignant syndrome / Hepatitis / Cardiac arrest / MS / neutropenia / stupor Erythema multiforme / Pulmonary edema Serious / Hypotension / Influenza *Antiviral Influenza / / Person Stevens Johnson / / Position Reports Clearance Officer / www.cdc.gov/nhsn Healthcare Worker / / Product Tamiflu / Antiviral Medication / Relenza / Flumadine / Healthcare Worker Influenza Antiviral Medication / Influenza *Antiviral Influenza *Indication medication / Symmetrel / / ProvinceOrState Georgia / / URL www.cdc.gov/nhsn / /
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Form Approved OMB No[removed]Exp. Date: [removed]www.cdc.gov/nhsn Healthcare Worker Prophylaxis/Treatment