When assessing for severe sepsis, we adjust our treatment (appropriate volume of fluid and early antibiotics) depending on both assessment and symptoms. So, for instance, if the patient does test positive for flu, and has SIRS plus elevated lactate (>2.2-4) and/or new organ dysfunction, then they are treated for severe sepsis, regardless of infection. If the flu is the cause, just because it is viral doesn't mean that it isn't sepsis. Labs we run initially are the same as yours. Lactic acid is a good indicator of hypoperfusion, but doesn't pertain just to sepsis, as lactic acid can be elevated for other physiologic reasons. But according to the SSC Guidelines, severe sepsis is defined as sepsis-induced tissue hypoperfusion or organ dysfunction OR Lactate 2.2-4 mg/dL.
Sara Valentine, BSN, RN, CNRN Nurse Educator/Clinical Sepsis Coordinator Medical Center Hospital 500 West 4th Street Odessa, Texas 79761 ph: 432.640.1085 fax:432.640.2885 From: [email protected] [mailto:[email protected]] On Behalf Of Sue Beswick Sent: Wednesday, January 02, 2013 2:21 PM To: '[email protected]' Subject: [Sepsis Groups] changing the sepsis screen for flu season Thank you all who responded. It was pretty clear that the majority do not adjust your screen during the flu season. But related to that - exactly what is your screen. Our is that when sepsis criteria is met - the RN gets a CBC with diff, serum lactate (we run on our ABG machine), metabolic pane, the first bld culture, a UA/urine culture and chest X-ray if resp symptoms. We are wondering if just the Lactate might be a good first step to rule out severe sepsis and then treat the flu. Or do you do all the same tests/labs that we do? Thanks Sue Sue Beswick RN, MS, CCNS, CCRN Clinical Nurse Specialist - MSICU Greenville Hosptial System University Medical Center Greenville, SC Office: 864-455-4884 AACN Theme "Dare To" What are you going to dare to do this year? CONFIDENTIALITY NOTICE: The documents accompanying this email transmission contain confidential information belonging to the sender that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this email in error, please notify the sender immediately to arrange for return of these documents.
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