Hello,
My understanding is that the new standard states your date/time zero starts 
upon physician/LIP documentation or when the last parameter puts them into 
severe sepsis and/or shock- all elements have to be within 6 hours from one 
another.
If they arrive in the ED with severe sepsis / shock – your time zero is triage 
time.

[cid:[email protected]]                                   
[cid:[email protected]]

Brenda ☺

Brenda Downs MSN, APRN, ACNS-BC
Cell: 480-720-6102

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Brenda Prabhakar
Sent: Wednesday, July 08, 2015 12:25 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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