Thank you: That is exactly what we are thinking about: the clinical signs of organ dysfunction, etc, We are trying to separate out the severely septic from the "merely septic"
--------- Joan M. Grand Medical Center Administrative Director Kaiser Permanente Capitol Hill Medical Center 700 2nd Street North East Washington, DC 20001 202-346-3058 (office) 202-346-3061 (fax) 202-603-5482 (mobile phone) [email protected] --------- kp.org/thrive NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. From: Ron Elkin <[email protected]> To: [email protected] Cc: Joan M Grand/DC/KAIPERM@KAIPERM, [email protected], [email protected] Date: 04/10/2013 05:11 PM Subject: Re: [Sepsis Groups] Sepsis screening in the outpatient setting One obvious method for outpatients parallels ED or inpatient evaluation: !) Suspicion of infection? 2) Any new signs of SIRS? 3) Is there apparent acute organ dysfunction on questioning and exam, such as altered mental status, dyspnea or desaturation, history of oliguria, soft BP, mottled skin, increasing insulin requirements or sugars monitored at home (none of which require lab work)? YES to ANY of these 3 questions may prompt consideration of severe sepsis and prompt further evaluation. Ron Elkin, MD California Pacific Medical Center San Francisco On 4/10/13, Ron Daniels <[email protected]> wrote: > For me, community screening is about safety netting rather than 100% > sensitivity for uncomplicated sepsis. It's not yet certain whether SIRS > criteria have any place in the community setting, and resources to identify > non-shock severe sepsis are limited. > > We are piloting schemes in the UK using a safety netting approach to > identify the sickest, but I believe this has to be in collaboration between > patient and community health worker- one strategy has been to use the > attached cards. > > BW > > Ron > > 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* > > > > On Tue, Apr 9, 2013 at 11:00 PM, <[email protected]> wrote: > >> Is there anyone doing this? Specifically in internal medicine clinics >> and free standing urgent care centers? >> >> Screening everyone is proving to be difficult giving the setting: many >> patients may not meet severe sepsis criteria (some do)... >> How do we bridge the gap between sepsis and severe sepsis without missing >> people? >> >> Our goal, of course is to catch these patients before the move along the >> sepsis continuum or end up in the ED. >> >> Any advice is welcome. >> thanks >> joannie >> >> ---------* >> Joan M. Grand* >> Medical Center Administrative Director >> >> *Kaiser Permanente* >> Capitol Hill Medical Center >> 700 2nd Street North East >> Washington, DC 20001 >> >> 202-346-3058 (office) >> 202-346-3061 (fax) >> 202-603-5482 (mobile phone) >> [email protected] >> ---------* >> **kp.org/thrive* <http://kp.org/thrive> >> >> *NOTICE TO RECIPIENT:* If you are not the intended recipient of this >> e-mail, you are prohibited from sharing, copying, or otherwise using or >> disclosing its contents. If you have received this e-mail in error, >> please >> notify the sender immediately by reply e-mail and permanently delete this >> e-mail and any attachments without reading, forwarding or saving them. >> Thank you. >> >> >
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