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. 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. >>>> >>>> ________________________________ >>>> >>>> This e-mail and any attachments to it are confidential and are intended >>>> solely for use of the individual or entity to whom they are addressed. If >>>> you have received this e-mail in error, please notify the sender >>>> immediately and then delete it. If you are not the intended recipient, you >>>> must not keep, use, disclose, copy or distribute this e-mail without the >>>> author's prior permission. 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
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
