Sue Beswick RN, MS, CCNS, CCRN
MSICU
Greenville Health System
701 Grove Road l Greenville, SC 29605
Office:  864-455-4884

During flu season - for those patients that meet SIRS/Sepsis but don't look 
that sick, we ask for the lactate level at a minimum to help guide next 
decision.  We can do them quickly in the ED.  Some of the other ED docs also 
use LA in this fashion.  

Sue

Today's Topics:

   1. Screening (William Haik)
   2. Re: Repeat sepsis screens. (Angela Craig)


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Message: 1
Date: Mon, 9 Jun 2014 10:16:49 -0500
From: William Haik <[email protected]>
Cc: "<[email protected]>"
        <[email protected]>
Subject: [Sepsis Groups] Screening
Message-ID: <[email protected]>
Content-Type: text/plain; charset="us-ascii"

So if you have a patient who has two criteria for sepsis (pulse 90 and RR 20) 
and an underlying infection such as a urinary track infection are we all saying 
that we going to draw lactate levels, blood cultures, and begin antibiotics 
with fluids. 
Don't you think this is overkill since we do not have confirmatory studies for 
sepsis. Using this screening criteria I would suspect every patient I have  in 
the office with an exacerbation of COPD related to a bacterial bronchitis would 
be "septic".

William E. Haik, M.D., F.C.C.P., C.D.I.P.
AHIMA Approved ICD-10-CM/PCS Trainer
Office: (850) 863-2110
Cell: (850) 803-5854
Fax: (850) 864-4438
 

> On Jun 5, 2014, at 4:59 PM, idiesca <[email protected]> wrote:
> 
> No we do not include the antibiotics. 
> 
> Sincerely,
> Carina RN BSN CCRN
> 
> 
> Sent from my Verizon Wireless 4G LTE Smartphone
> 
> 
> -------- Original message --------
> From: [email protected]
> Date:06/05/2014 3:07 PM (GMT-05:00)
> To: [email protected]
> Subject: Sepsisgroups Digest, Vol 112, Issue 4
> 
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> Today's Topics:
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>    1. IVF and Abx's during resuscitation (Hussey, Joann)
> 
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> ----------------------------------------------------------------------
> 
> Message: 1
> Date: Wed, 4 Jun 2014 18:37:52 +0000
> From: "Hussey, Joann" <[email protected]>
> To: "[email protected]"
>         <[email protected]>
> Subject: [Sepsis Groups] IVF and Abx's during resuscitation
> Message-ID:
>         
> <[email protected]>
> Content-Type: text/plain; charset="us-ascii"
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> Good afternoon,
> Can anyone tell me, during initial resuscitation, if  the amount of IV fluid 
> administered as an antibiotic piggyback be counted  toward the of 30 ml/kg 
> fluid challenge?
> 
> JoAnn Hussey, BSN, RN
> PI Coordinator
> Robert Wood Johnson University Hospital Ext. 8210
> 
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Message: 2
Date: Mon, 9 Jun 2014 13:26:13 -0500
From: Angela Craig <[email protected]>
To: "Holton, Wilma S." <[email protected]>
Cc: "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] Repeat sepsis screens.
Message-ID: <[email protected]>
Content-Type: text/plain; charset="utf-8"

We continue to screen. We want to see a trend down in their SIRS criteria and 
their lactic acid so our thoughts are if they are truly getting better they 
will not screen positive over and over. If they do we have to look and see if 
we need to change up our antibiotics or treatment plan. The positive screen 
should keep us on our toes to make sure we are on track.  Hope that helps

Angela Craig APN, MS, CCNS
CRMC ICU CNS
Sent from my iPhone

On Jun 9, 2014, at 7:47 AM, "Holton, Wilma S." 
<[email protected]><mailto:[email protected]>> wrote:


Can anyone tell me what they do about pt who have repeat positive screens 
within 24 hrs of the first screen? Do you stop screening once a patient screens 
positive? If so how long do you stop screens? How do you track and restart the 
screens when the time period is over?



Wilma Holton, RN CCRN

Medical Emergency Team



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