That is exactly how I approach my data collection as well. Worth the $.02 !

From: [email protected] 
[mailto:[email protected]] On Behalf Of Nancy Brunner
Sent: Wednesday, February 06, 2013 7:53 PM
To: 'Martie Mattson'; 'Ann Knight'; [email protected]
Subject: Re: [Sepsis Groups] General Sepsis Questions

Agree with Martie and this is exactly what we do.

Nancy
Nancy Brunner RN CCRN
Boulder Community Hospital
Boulder, Co
vm 303-938-5128
[email protected]<mailto:[email protected]>

________________________________
From: 
[email protected]<mailto:[email protected]>
 [mailto:[email protected]] On Behalf Of Martie 
Mattson
Sent: Tuesday, February 05, 2013 7:32 PM
To: 'Ann Knight'; 
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] General Sepsis Questions
Hello all,

As Dr. Elkin frequently says, this is my $.02.

The guidelines (2012) define severe sepsis as sepsis -induced tissue 
hypoperfusion or organ dysfunction and the 1 hour  antibiotic recommendation is 
for severe sepsis and septic shock - not simple sepsis.  So to meet the 
requirement to have an antibiotic within 1 hour severe sepsis would need to be 
diagnosed.   So, for example,  if a patient presented to triage with a 
confirmed or suspected infection and was hypotensive or had other obvious organ 
failure (acute respiratory failure, acute mental status change etc) thought 
related to the infection, that patient would meet the criteria for severe 
sepsis and time zero would be the time of triage.  If the patient presented to 
triage with a confirmed or suspected infection, signs of SIRS, but no obvious 
signs of organ failure, then, in my opinion. time zero would be when severe 
sepsis was first obvious -  patient developed obvious organ failure or lab work 
came back consistent with organ failure.

Martie
Martie Mattson, RN, MSN, CNS, CCRN(a)
Critical Care Consultant and Educator
(415) 412-2364
[email protected]<mailto:[email protected]>

From: 
[email protected]<mailto:[email protected]>
 [mailto:[email protected]] On Behalf Of Ann Knight
Sent: Monday, February 04, 2013 7:36 AM
To: 
[email protected]<mailto:[email protected]>
Subject: [Sepsis Groups] General Sepsis Questions

To Whom It May Concern:

After reviewing the new guidelines I have a few questions:

1.     What are your experiences with Procalcitonin and the usefulness of it? 
It seems to be a pricey lab draw and I am wondering if it is worth the cost to 
the patient.
2.     In the ABX recommendations it states giving antibiotics within one hour 
of identification of sepsis or septic shock. Does this mean one hour for both 
ED patients and in-patients who might develop sepsis on the med surg floors? In 
the bundle changes it simply states giving proper broad spectrum coverage 
within the first three hours. Simply want to clarify since this would be a 
process change for our ED
3.     In regards to the ED patients, is the start of bundle time the triage 
time? I have heard many different things regarding this. Any advice would be 
much appreciated!


Ann Knight
Clinical Nurse Specialist, Critical Care
Northside Hospital System
[email protected]<mailto:[email protected]>
404-851-6514




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