---------- Forwarded message ---------- From: Maria Hoertz Date: Tuesday, December 20, 2011 Subject: [Sepsis Groups] FW: SSC guidelines To: "Cachecho, M.D., Riad" <[email protected]>
As a nocturnist, i thankfully agree with your thoughts. I although do love the protocol, for it has substance to allow me to educate my ED colleagues in early recognition. When i am on at night , I sit right next to the ED doctors and can discuss cases with them, and have found that our discussions have lead to much earlier interventions. I am new on this list serve and appreciate reading about how others perceive the protocols and bundles and their implementation. My best wishes for the season, Maria Maria J Hoertz, DO, MPH Mulberry Medicine, PLLC Ph: 5616994488 Fx: 5624318141 [email protected] On Tuesday, December 20, 2011, Cachecho, M.D., Riad < [email protected]> wrote: > Ron, I agree with you. It is not any individual part of the protocol that makes the difference. It is early recognition, appropriate antibiotic and fluid management altogether. In addition, the end goal must be tailored to the individual patient. > > > > Jeffrey, protocols do not save lives, health care professionals do. > > > > Riad Cachecho,MD,MBA > > Director of Trauma > > Crozer Chester Medical Center > > One Medical Center Boulevard > > Vivaqua Pavillion, suite 440 > > Upland, PA 19013 > > 610-447-6090 > > THIS EMAIL CONTAINS CONFIDENTIAL INFORMATION. ANY INFORMATION CONTAINED IS USED FOR PEER REVIEW PURPOSES ONLY. > > ________________________________ > > From: [email protected] [mailto: [email protected]] On Behalf Of Jeffrey R Hanlon RN > Sent: Monday, December 19, 2011 10:27 PM > To: [email protected]; [email protected] > Cc: [email protected] > Subject: Re: [Sepsis Groups] SSC guidelines > > > > All I can say is the protocol has and continues to save lives! > > Jeffrey R Hanlon RN > Stamp Out Sepsis > > > > > -----Original Message----- > From: [email protected] > To: Joan Greene > Cc: sepsisgroups > Sent: Thu, Dec 15, 2011 3:46 am > Subject: Re: [Sepsis Groups] SSC guidelines > > Hi Joan, > > > > My views (for what they're worth): > > > > Key issue is ScvO2 as sole indicator of O2 delivery. Agree other modalities of assessment of volume responsiveness and O2 delivery have equal or greater role, but I believe answer lies in a colleciton of clinical information: dangerous for anyone to run too fast with a single modality! > CVC is necessary for a majority of these patients for pressors/ tropes anyway. The authors don't argue against CVC but against over-reliance on CVP and ScvO2. Pragmatically, we need to build a larger picture: we assimilate informaiton from multiple sources to build our picture > Slight concerns with article. It confuses septic shock with severe sepsis which is not helpful or appropriate (see criteria fig 1). Referencing is somewhat author-centric > > > > Summary: Don't let this hold you back. EDs get excited about EGDT and forget the basics. Let's try not to get hung up on individual modalities (esp until we have ARISE/ ProCESS/ ProMISe) but recognise and intervene quickly using the monitoring strategies we have to hand and an assimilation of information. Rivers' protocol is good- and prob better than random care- but no-one ever suggested it was the ultimate answer! > > > > What do others think? > > > > kind regards > > > > Ron > > > > On Mon, Dec 12, 2011 at 4:37 AM, Joan Greene <[email protected]> wrote: > > > > Has anyone else received push-back in their early goal-directed therapy protocols after the attached article was published? We recently implemented the SSC guidelines for EGDT -- Maria J. Hoertz, DO, MPH Mulberry Medicine, PLLC Nocturnist-Hospitalist-Family Medicine 561-699-4466 Phone and Voicemail 561-699-4488 Voicemail to Email SecureFax: 561-431-8141 Email is covered by the Electronics Privacy Act, 18 USC Sections 2510-2521, and is legally privileged. This e-mail transmission message, together with any other documents or attachments contains CONFIDENTIAL INFORMATION WHICH IS ALSO LEGALLY PRIVILEGED and which is intended only for the use of the intended recipient identified above and may contain personal information that is subject to confidential privacy regulations such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you are the intended recipient of this communication, you are hereby notified that any use, sharing with others, allowing others to read , forwarding, dissemination, distribution, downloading or copying of this communication is strictly prohibited. If you are not the intended recipient of this communication, you are hereby notified that any use, sharing with others, allowing others to read, forwarding, dissemination, distribution, downloading or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, by telephone at 561-699-4488 or fax at 561-431-8141 and delete the communication and destroy all copies. Please respect all copyright laws. Anything written by the sender of this email may be copyrighted. Please visit http://www.copyright.gov/title17/92appii.html for any information. Thank you for your cooperation. -- Maria J. Hoertz, DO, MPH Mulberry Medicine, PLLC Nocturnist-Hospitalist-Family Medicine 561-699-4466 Phone and Voicemail 561-699-4488 Voicemail to Email SecureFax: 561-431-8141 Email is covered by the Electronics Privacy Act, 18 USC Sections 2510-2521, and is legally privileged. This e-mail transmission message, together with any other documents or attachments contains CONFIDENTIAL INFORMATION WHICH IS ALSO LEGALLY PRIVILEGED and which is intended only for the use of the intended recipient identified above and may contain personal information that is subject to confidential privacy regulations such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you are the intended recipient of this communication, you are hereby notified that any use, sharing with others, allowing others to read , forwarding, dissemination, distribution, downloading or copying of this communication is strictly prohibited. If you are not the intended recipient of this communication, you are hereby notified that any use, sharing with others, allowing others to read, forwarding, dissemination, distribution, downloading or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, by telephone at 561-699-4488 or fax at 561-431-8141 and delete the communication and destroy all copies. Please respect all copyright laws. Anything written by the sender of this email may be copyrighted. Please visit http://www.copyright.gov/title17/92appii.html for any information. Thank you for your cooperation.
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