Brenda,
CMS has redefined “triage” time to be “time of presentation is defined as the 
time of earliest chart annotation consistent with all the elements severe 
sepsis or septic shock ascertained through chart review.”
I hope this helps?
Amy

Amy L. Sprague MSN, RN, ACNS-BC, CCRN
Clinical Nurse Speciliast ~ Critical Care
Sepsis Committee Chairperson
Franciscan ST. Francis Health
8111 South Emerson Ave.
Indianapolis, IN. 46237
“There is no greatness where there is not simplicity, goodness, and truth.” Leo 
Tolstoy


From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Brenda Prabhakar
Sent: Wednesday, July 08, 2015 3:25 PM
To: [email protected]
Subject: [Sepsis Groups] Triage Time Zero and delayed presentation of symptoms

Hello-

After reading through the specifications manual and many of the posts here, I 
still wonder what to do when reviewing charts of patients who do NOT initially 
present with any signs of SIRS and show no SIRS criteria during their first 3 
hrs in the ED.  If a patient becomes hypotensive, tachycardic, and febrile 3 
hours after triage, how can you meet the 3 hr bundle?  I would think these 
patients should NOT be included the measure as they are not "presenting" with 
symptoms of severe sepsis.  Or should we expect to have a small percentage of 
fall-outs?
Any input would be greatly appreciated.

Brenda Prabhakar RN BSN
Doylestown Hospital
Sepsis Steering Committee Co-Chair

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