I'd look first at the CDC report from Hall et al.

On 1/25/13, Miller, Kevin - SFMH <[email protected]> wrote:
> Hello,
>      We are writing to request information on the inclusion and exclusion
> criteria is for Sepsis mortalities nationally (U.S.).  Can you provide us
> with that information, or steer us in the right direction of where to obtain
> that information?
> Thank you,
>
>
> [cid:[email protected]]
>
> "Procrastination is the thief of time"
>
> Kevin P. Miller, RN, BSN
> Senior Clinical Analyst
> Quality Department
> Saint Francis Memorial Hospital
> Phone:  (415) 353-6296
> Fax:   (415) 353-6177
> Right Fax:  (415) 591-6364
> [email protected]
> [cid:[email protected]]
>
>
>
> Confidentiality Notice: This message and any attachments are for the sole
> use of the intended recipient(s) and may contain information that is legally
> privileged and/or confidential. This message may also contain confidential
> health information. If you are not the intended recipient or a person
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> protected by state and federal law, including but not limited to, the Health
> Insurance Portability and Accountability Act (HIPAA) of 1996 and related
> regulations.
>
> From: [email protected]
> [mailto:[email protected]] On Behalf Of seyed
> mohammad reza hashemian
> Sent: Wednesday, January 23, 2013 4:40 AM
> To: Jeffrey R Hanlon RN; [email protected]; [email protected]
> Cc: [email protected]; [email protected]
> Subject: [Sepsis Groups] New Sepsis Guideline
>
> Dear friends;
> It was a great  day for Sepsis campaign group for presentation of new sepsis
> guideline here in SCCM congress ,if you like to read the new guideline and
> more details please see the  link:
>
> Seyed Mohammadreza Hashemian.MD.FCCM
> Associate professor of NRITLD/SBMU
> http://www.survivingsepsis.org/Guidelines/Pages/default.aspx
>
> From: Jeffrey R Hanlon RN <[email protected]>
> To: [email protected]; [email protected]
> Cc: [email protected]; [email protected]
> Sent: Saturday, January 19, 2013 4:24 PM
> Subject: Re: [Sepsis Groups] changing the sepsis screen for flu season
>
> 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]<mailto:[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]<mailto:[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]<mailto:[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]<mailto:[email protected]>
>
>
>
> From:
> [email protected]<mailto:[email protected]>
> [mailto:[email protected]<mailto:[email protected]>]
> On Behalf Of Sara Valentine
> Sent: Thursday, January 03, 2013 3:53 PM
> To: 'Sue Beswick';
> [email protected]<mailto:[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]<mailto:[email protected]>>
> [mailto:[email protected]<mailto:[email protected]>]
> On Behalf Of Sue Beswick
>
> Sent: Wednesday, January 02, 2013 2:21 PM
> To:
> '[email protected]<mailto:[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?
>
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>
> --
> 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<http://www.globalsepsisalliance.org/>
>
> Twitter: @sepsisuk
>
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>


-- 
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<http://www.globalsepsisalliance.org/>

Twitter: @sepsisuk
*
*
*
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