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Multi-agency Information for Patients and Providers: e-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI)
Posted By: Susanne J. Phillips, DNP, APRN, FNP-BC | November 26, 2019
By now, we have all heard the news concerning the dangers of e-cigarettes and vaping and have likely received a myriad of updates in our ever-growing e-mail inboxes. As a busy clinician and educator, I enjoy bringing quick references to our blog readers. If you are like me, you have just enough (or not enough) time to open and respond to only your most critical e-mails. With this in mind, I recently sent the CDC's EVALI Guidelines—which are updated every week—to our faculty practice NPs.
With flu season upon us, we need to be cognizant of how similarly EVALI and the flu can present, as progression of EVALI is rapid, with a short window for intervention. Just to recap the news, the CDC has identified vitamin E acetate as a "chemical of concern" among those affected with EVALI. Additionally, the CDC recommends avoiding use of e-cigarette and vaping products that contain THC. The investigation is ongoing and will likely continue to evolve over the coming weeks and months, but the CDC confirmed the following statistics as of November 13, 2019: 2172 cases of EVALI from 49 states (exception: Alaska), Washington DC, and Puerto Rico and U.S. Virgin Islands; and 42 deaths in 24 states and Washington DC.
I would recommend printing the fact sheet for Evaluating and Caring for Patients with Suspected E-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI). This convenient resource provides clinical evaluation pearls including relevant history and physical, lab testing, and imaging recommendations, as well as treatment and follow-up guidance. There are additional resources available on the CDC's website. You can view some of them through the links in the references below. Consider linking them to your practice webpages or electronic media platforms.
- Centers for Disease Control and Prevention. Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information. Accessed November 25, 2019.
- Centers for Disease Control and Prevention. Update: interim guidance for health care providers evaluating and caring for patients with suspected e-cigarette, or vaping, product use associated lung injury — United States, October 2019. www.cdc.gov/mmwr/volumes/68/wr/mm6841e3.htm?s_cid=mm6841e3_w. Accessed November 26, 2019.