I would always do the CXR, as "occult" sepsis can still
end up being a pneumonia. Re. screening bloods, I would
also always do the FBC, U+E, LFT, CRP and coag as well as
lactate as if any of those are deranged you will get a
score in the sepsis criteria. More sensitive that way.
It might also flag up another source, in particular if
lfts are looking deranged then you might be looking at a
biliary infection (if bili and ALP up) or something else
in the liver itself if alt/ast up (although that can, as
above, just go up in sepsis)
Tom Morris
Infectious Diseases Registrar, Leicester Royal Infirmary,
UK
On Wed, 2 Jan 2013 20:20:45 +0000
Sue Beswick <[email protected]> wrote:
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?
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