Heather, You hit the nail on the head. Early intervention can prevent progression to shock which is more costly to manage.
-----Original Message----- From: Heather McClelland [mailto:[email protected]] Sent: Tuesday, December 18, 2012 7:27 AM To: Cormack, Patricia (WS); Steve Chabala; [email protected] Subject: RE: [Sepsis Groups] flu and sepsis screening Hi all, Really interesting discussion. This is surely the age-old public health debate about the cost of screening programmes. But for me, the implication of missing something as life-threatening as a sepsis episode warrants the extra cost involved. I am unsure of any health economic data around this, but certainly evidence from other screening studies would probably reflect this. ED presentations are always challenging, and evidence from our work has been that although many are sepsis positive on screening, they will quickly settle following early intervention with our Sepsis 6 bundle of care. Whether this is a sign that the patient did not have sepsis or whether we prevented deterioration into severe sepsis due to our action, is difficult to tell. Rather to err on the side of caution. Equally, most of these patients will respond to basic intervention, and will not need critical care support, and the added expense attached. Heather McClelland Nurse Consultant - Emergency Care -----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Cormack, Patricia (WS) Sent: 17 December 2012 13:05 To: Steve Chabala; [email protected] Subject: Re: [Sepsis Groups] flu and sepsis screening If a young person has signs of organ dysfunction, despite the initial insult, they need to be aggressively managed. SIRS alone does not qualify anyone for EGDT. It's the organ dysfunction that should spring us into action, no matter how young the patient. We had a 20 year old who presented with what we thought was a viral illness- turned out to be toxic shock syndrome. She lived. In an organization that did not perform aggressive EGDT, that may not have been the outcome. She was already on our radar before she crashed. Patty -----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Steve Chabala Sent: Friday, December 14, 2012 8:32 AM 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 This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. This footer also confirms that this email message has been scanned for the presence of computer viruses. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. This footer also confirms that this email message has been scanned for the presence of computer viruses. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
