Scenario:  female pt to ED -
Arrival time:  015
Triage:  0151
SIRS  temp 102.8,  hr 141 , resp 34  all at  0154  ,  wbc
                                                 CPap   0154    BiPap at 0210 
(new for this pt)   Initial Lactate  1.6 at 0205
                                                Documentation of Septic shock   
 0245 on ED physician note

Is this case a present on arrival ?   What time do I use for Severe Sepsis 
Presentation.

Thank you

Lori Bly, RN
Quality Management Department
ACMH Hospital
One Nolte Drive
Kittanning, PA 16201
Extension: 8459

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