Dear Lisa
Even though a virus, flu can also induce a cytokine storm,
in fact this is apparently the mechanism by which people
who are dying of influenza die. I'm sure 5 days of
Antibiotics wouldn't cause much harm, indeed it would be
quite hard to tell in the most severe cases and we do know
that flu increases the chance of bacterial pneumonia
Tom Morris
Infectious Diseases SpR, Leicester
On Sat, 5 Jan 2013 17:01:09 +0000
"D'Amico, Lisa L" <[email protected]> wrote:
If the patient is identified as having the flu are you
still using antibiotics with the patient? Or are you
using both antibiotic and antiviral?
Lisa
Lisa D'Amico, DNP, MSN, RN
Clinical Quality Consultant
Provider Engagement Performance Partnerships2
Highmark, Inc.
Fifth Avenue Place
120 Fifth Avenue, Suite 893
Pittsburgh PA 15222-3099
Office:412-544-6804
Fax:412-544-8135
[email protected]
From: [email protected]
[mailto:[email protected]] On
Behalf Of Sara Valentine
Sent: Thursday, January 03, 2013 3:53 PM
To: 'Sue Beswick'; [email protected]
Subject: Re: [Sepsis Groups] changing the sepsis screen
for flu season
When assessing for severe sepsis, we adjust our
treatment (appropriate volume of fluid and early
antibiotics) depending on both assessment and symptoms.
So, for instance, if the patient does test positive for
flu, and has SIRS plus elevated lactate (>2.2-4) and/or
new organ dysfunction, then they are treated for severe
sepsis, regardless of infection. If the flu is the cause,
just because it is viral doesnt mean that it isnt
sepsis. Labs we run initially are the same as yours.
Lactic acid is a good indicator of hypoperfusion, but
doesnt pertain just to sepsis, as lactic acid can be
elevated for other physiologic reasons. But according to
the SSC Guidelines, severe sepsis is defined as
sepsis-induced tissue hypoperfusion or organ dysfunction
OR Lactate 2.2-4 mg/dL.
Sara Valentine, BSN, RN, CNRN
Nurse Educator/Clinical Sepsis Coordinator
Medical Center Hospital
500 West 4th Street
Odessa, Texas 79761
ph: 432.640.1085
fax:432.640.2885
From:
[email protected]<mailto:[email protected]>
[mailto:[email protected]] On
Behalf Of Sue Beswick
Sent: Wednesday, January 02, 2013 2:21 PM
To: '[email protected]'
Subject: [Sepsis Groups] changing the sepsis screen for
flu season
Thank you all who responded. It was pretty clear that
the majority do not adjust your screen during the flu
season.
But related to that exactly what is your screen. Our
is that when sepsis criteria is met the RN gets a CBC
with diff, serum lactate (we run on our ABG machine),
metabolic pane, the first bld culture, a UA/urine culture
and chest X-ray if resp symptoms.
We are wondering if just the Lactate might be a good
first step to rule out severe sepsis and then treat the
flu. Or do you do all the same tests/labs that we do?
Thanks
Sue
Sue Beswick RN, MS, CCNS, CCRN
Clinical Nurse Specialist - MSICU
Greenville Hosptial System
University Medical Center
Greenville, SC
Office: 864-455-4884
AACN Theme "Dare To" What are you going to dare to do
this year?
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