In addition to the timeline for antibiotic administration, the SSC guidelines also say to obtain culture specimens before said administration. I hadn't thought anyone was suggesting folks wait for results of those cultures before treating empirically...but EMS would need to be getting cultures before administering any antibiotics.
With what we know about the benefit of decreasing the time to antibiotics, it might be worth considering EMS culture collection if the quality of the cultures was reliable. This could be of benefit for patients with protracted transport times that are common in rural areas and can occur during peak travel times in urban areas. If the multivariate challenges of creating an EMS antibiotic protocol were too great, at least such medication could be administered on ED arrival if the cultures were already obtained. I'd be interested to hear how the folks looking at increasing EMS involvement in the bundle handle it! Sam -- Sam Farrell, RN CCRN Intensivist Program Manager West Coast Critical Care Specialists office: 805.988.7004 fax: 805.988.7101 cell: 805.444.3730 *wcintensivist.com* <http://wcintensivist.com/> *CONFIDENTIALITY NOTICE : This message and any included attachments are intended only for the addressee and may contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail. Thank you.* On Mon, Jul 21, 2014 at 9:00 AM, <[email protected]> wrote: > The Guidelines say do not delay antibiotics awaiting cultures. > > > > *From:* Sepsisgroups [mailto:[email protected]] *On > Behalf Of *Angela Craig > *Sent:* Friday, July 18, 2014 7:47 PM > *To:* Kelly Kragenbrink > *Cc:* [email protected] > *Subject:* Re: [Sepsis Groups] EMS and lactates > > > > I respectfully disagree. If we wait the two days until the culture grows > out our patients may not survive. Patients that meet the criteria that the > surviving sepsis campaign have outlined in the guidelines call for a 1 hour > goal to antibiotic. That is one of our focus elements at my hospital. > > Angela Craig APN, MS, CCNS > > CRMC ICU CNS > > Sent from my iPhone > > > On Jul 18, 2014, at 10:18 AM, "Kelly Kragenbrink" < > [email protected]> wrote: > > You really need blood cultures for sensitivity before you give a broad > spectrum antibiotic. > > > > Kelly Kragenbrink, RN > > Peer Review Coordinator > > McLaren Northern Michigan > > 416 Connable Avenue > > Petoskey, MI 49770 > > Phone: 231.487.3474 > > Fax: 231.487.3139 > > <image001.jpg> <http://northernhealth.org/><image002.jpg> > <http://www.facebook.com/northernhealthsystem/><image003.jpg> > <http://www.mclaren.org/northernmichigan/MagnetRecognitionnm.aspx> > > *P **Please consider the environment before printing this email.* > > > > > > *Confidentiality Notice:* This e-mail message, including any attachments, > may contain confidential information or privileged peer information > protected by law. The information is intended only for the use of the > individual(s) or entity named above. If you are not the intended recipient, > you are notified that any disclosure, copying, distribution, or the taking > of any action in reliance on the contents of this e-mail information is > prohibited. If you have received this e-mail in error, please contact the > sender by reply e-mail and destroy all copies of the original message. > > > > *Privileged/Confidential* > > Reports of Peer Review-Pursuant to MCL > > 333.20175; 333.21513; 333.21515; 331.531; 331.532; 331.533; 331.534, > 330.1748; 330.1750; 330.1143a; 330.1748(8) > > > > Confidentiality Notice: This e-mail message, including any attachments, > may > contain confidential information. The information is intended only for the > use of the individual(s) or entity named above. If you are not the intended > recipient, you are notified that any disclosure, copying, distribution, or > the > taking of any action in reliance on the contents of this e-mail > information is > prohibited. If you have received this e-mail in error, please contact the > sender by reply e-mail and destroy all copies of the original message. > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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