If they are hemodynamically stable and have responded to fluids, they could go 
to a telemetry unit but those nurses have 4-5 patients and subtle changes 
leading to instability can get missed.

Mary Draper RN BSN CCRN
Quality Manager-Best Practice Support
Quality Management Supervisor
Office (925) 674-2045<tel:(925)%20674-2045>
Cell (925) 451-8792<tel:(925)%20451-8792>
Fax (925) 674-2373<tel:(925)%20674-2373>
mary.dra...@johnmuirhealth.com<mailto:mary.dra...@johnmuirhealth.com>

On Sep 27, 2013, at 7:05 AM, "Jamie Roney" 
<jro...@covhs.org<mailto:jro...@covhs.org>> wrote:

Dr. Townsend,
Is there a sepsis specific risk/treatment stratification tool available to 
assist in answering your question of placement in a possible lower level of 
care? Or is there a tool to assist with septic patients who can be discharged 
home versus admitted due to probable deterioration into severe sepsis?

Thank you,
Jamie

Jamie Roney, BSN, RN-BC, BSHCM, CCRN
COVENANT HEALTH SEPSIS COORDINATOR
"Be a yardstick of quality. Some people aren't used to an environment where 
excellence is expected." ~Steve Jobs

3615 19th Street, Lubbock, TX 79410
T: (806) 725-4689    C: (806) 773-1914
www.covenanthealth.org<http://www.covenanthealth.org>
......................................................................................



-----Original Message-----
From: 
sepsisgroups-boun...@lists.sepsisgroups.org<mailto:sepsisgroups-boun...@lists.sepsisgroups.org>
 [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On Behalf Of Townsend, 
Sean, M.D.
Sent: Friday, March 15, 2013 1:32 AM
To: 
'sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>'
Subject: [Sepsis Groups] Where Does Severe Sepsis Belong?

It's been a long time since I've had to ask this question. I used to think I 
knew the answer.

Here it is: do all patients who meet severe sepsis criteria need to be admitted 
to the ICU ?

Examples:

1. Pneumonia, fever, tachycardia, INR 1.5.
2. Cellulitis, leukocytosis, fever, creatinine 2.0.
3. UTI, leukocytosis, fever, lactate 3.0.

Where do people put these patients in reality? What mind of monitoring do they 
deserve?

By prevailing bundles, each gets lactate checked, blood cultures, broad 
spectrum antibiotics. That's it. Good enough? Good enough for the floor? Need 
the ICU? Why?

Sean


Sean R. Townsend, M.D.
Vice President of Quality & Safety
California Pacific Medical Center
2330 Clay Street, #301
San Francisco, CA 94115
email towns...@sutterhealth.org<mailto:towns...@sutterhealth.org>
office (415) 600-5770
fax (415) 600-1541
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