Hi Sean, Certainly in the UK, to take all patients with severe sepsis to ITU would swamp our services very quickly! We have relatively few ITU beds per capita and would adopt a more pragmatic approach, assessing first response to therapy and admitting those requiring haemodynamic and/or other organ support only.
That said, we do have the luxury of Critical Care Outreach to keep an eye on such patients on the wards... BW Ron On Friday, March 15, 2013, Townsend, Sean, M.D. wrote: > It's been a long time since I've had to ask this question. I used to think > I knew the answer. > > Here it is: do all patients who meet severe sepsis criteria need to be > admitted to the ICU ? > > Examples: > > 1. Pneumonia, fever, tachycardia, INR 1.5. > 2. Cellulitis, leukocytosis, fever, creatinine 2.0. > 3. UTI, leukocytosis, fever, lactate 3.0. > > Where do people put these patients in reality? What mind of monitoring do > they deserve? > > By prevailing bundles, each gets lactate checked, blood cultures, broad > spectrum antibiotics. That's it. Good enough? Good enough for the floor? > Need the ICU? Why? > > Sean > > > Sean R. Townsend, M.D. > Vice President of Quality & Safety > California Pacific Medical Center > 2330 Clay Street, #301 > San Francisco, CA 94115 > email [email protected] <javascript:;> > office (415) 600-5770 > fax (415) 600-1541 > _______________________________________________ > Sepsisgroups mailing list > [email protected] <javascript:;> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > -- Dr Ron Daniels *Chair- UK Sepsis Trust* *Chief Executive- Global Sepsis Alliance Founding Fellow- Faculty of Intensive Care Medicine* *Suspect sepsis- save someone’s life today!* * Twitter: @Sepsis UK*
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