At our institution we had to carve out an exception for flu in the ED to avoid mutiny from the triage nurses who were not getting EKGs done quickly enough in chest pain patients because they were drawing so many lactates. Currently, we complete the screening form on flu-like presentations in triage, but the triage nurse has the discretion to write "flu-like" on the screening form instead of drawing a lactate. The nurse caring for the patient in the ED then draws the lactate at the time the patient is seen in the department. For us, this solution balanced the importance of not missing occult cases of severe sepsis with the practical issues of an overcrowded ER. Rick Rutherford, M.D.VCMC Sepsis Chair
> From: [email protected] > Date: Fri, 14 Dec 2012 09:32:15 -0500 > To: [email protected] > Subject: [Sepsis Groups] flu and sepsis screening > > I think Sue's question gets at the larger question of the need for testing of > ALL patients with SIRS criteria and evidence of infection. All such patients > should be directed by their primary care doctors to come to the ER for sepsis > evaluation? Does the generally healthy college kid with SIRS criteria and a > strep throat really need a lactate and blood cultures drawn? Probably not. > I'm curious to know if there is any literature to address this sort of issue. > When does sepsis screening yield to common sense? > > Steve Chabala D.O., F.A.C.E.P. > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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