Thank you for your responses. Your endorsement provides valuable ammo! Sent from Rich's iPhone
On Jan 20, 2013, at 6:56 AM, Ron Daniels <[email protected]> wrote: > Agree entirely. > > Dr Ron Daniels > Chair: UK Sepsis Trust > CEO: Global Sepsis Alliance > > Sent on the move from my iPhone, excuse brevity! > > On 19 Jan 2013, at 21:24, Jeffrey R Hanlon RN <[email protected]> wrote: > >> Again I think we are making this more complicated than it needs to be. If >> you are SIRS positive and have a confirmed or suspected source YOU ARE >> SEPTIC by definition. Treat them or the mortality rate will continue to >> rise. The evidence is there. >> Jeffrey R Hanlon RN >> Stamp Out Sepsis >> >> ---- Original Message ---- >> From: Rich Levrault <[email protected]> >> To: Ron Daniels <[email protected]> >> Cc: sepsisgroups <[email protected]>; Sue Beswick >> <[email protected]> >> Sent: Sat, Jan 19, 2013 1:17 pm >> Subject: Re: [Sepsis Groups] changing the sepsis screen for flu season >> >> Do facilities screen all pts w sirs and source at triage?? Our Ed is >> worried about over screening and the potential for sending labs on everyone. >> There are pts who present w fever and tachycardia who routinely don't have >> labs sent. What are other facilities doing? Sean or Mitchell can you >> provide some backup for a former fellow who's pushing to cast a broad net >> and is advising to screen everyone? Ron...another sepsis guru .. Advice? I >> feel like I'm losing ground at our institution. >> >> Rich Levrault >> >> Sent from Rich's iPhone >> >> On Jan 8, 2013, at 9:46 AM, Ron Daniels <[email protected]> wrote: >> >>> If I could retweet this, I would!! >>> >>> The discussion is largely academic unless we have a viral PCR which is 100% >>> sensitive, 100% specific, and the results are available within the hour. In >>> a patient who clearly has evidence of impending or actual organ >>> dysfunction, I'd treat for both groups of pathogens until we know which is >>> the culprit (and even then we may not be convinced the virus is acting >>> alone!) >>> >>> Ron >>> >>> On Mon, Jan 7, 2013 at 8:43 PM, Thomas Morris <[email protected]> >>> wrote: >>>> Dear Lisa >>>> >>>> Even though a virus, flu can also induce a cytokine storm, in fact this is >>>> apparently the mechanism by which people who are dying of influenza die. >>>> I'm sure 5 days of Antibiotics wouldn't cause much harm, indeed it would >>>> be quite hard to tell in the most severe cases and we do know that flu >>>> increases the chance of bacterial pneumonia >>>> >>>> Tom Morris >>>> >>>> Infectious Diseases SpR, Leicester >>>> >>>> >>>> >>>> On Sat, 5 Jan 2013 17:01:09 +0000 >>>> "D'Amico, Lisa L" <[email protected]> wrote: >>>>> If the patient is identified as having the flu are you still using >>>>> antibiotics with the patient? Or are you using both antibiotic and >>>>> antiviral? >>>>> >>>>> Lisa >>>>> >>>>> >>>>> Lisa D'Amico, DNP, MSN, RN >>>>> Clinical Quality Consultant >>>>> Provider Engagement Performance Partnerships2 >>>>> Highmark, Inc. >>>>> Fifth Avenue Place >>>>> 120 Fifth Avenue, Suite 893 >>>>> Pittsburgh PA 15222-3099 >>>>> Office:412-544-6804 >>>>> Fax:412-544-8135 >>>>> [email protected] >>>>> >>>>> >>>>> >>>>> From: [email protected] >>>>> [mailto:[email protected]] On Behalf Of Sara >>>>> Valentine >>>>> Sent: Thursday, January 03, 2013 3:53 PM >>>>> To: 'Sue Beswick'; [email protected] >>>>> Subject: Re: [Sepsis Groups] changing the sepsis screen for flu season >>>>> >>>>> 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]> >>>>> [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. 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The views expressed in this e-mail message >>>>> do not necessarily represent the views of Highmark Inc., its >>>>> subsidiaries, or affiliates. >>>> _______________________________________________ >>>> Sepsisgroups mailing list >>>> [email protected] >>>> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >>> >>> >>> >>> -- >>> Dr Ron Daniels >>> >>> CEO: Global Sepsis Alliance >>> Chair: United Kingdom Sepsis Group >>> Principal Trustee: U.K Sepsis Trust >>> Founding Director: Survive Sepsis >>> Fellow: NHS Improvement Faculty >>> >>> >>> >>> Suspect Sepsis: save someone's life today. >>> >>> Join us for World Sepsis Day on September 13th >>> >>> Twitter: @sepsisuk >>> >>> _______________________________________________ >>> Sepsisgroups mailing list >>> [email protected] >>> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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