Sounds like an education issue. I feel your pain. I'm trying to get pts screened at triage w sirs but sometimes get pushback for asking for lactates w the argument that lactate wasn't ordered because the pt wasn't hypotensive. I'm re-educating w a renewed focus on cryptic shock.
Sent from Rich's iPhone On Feb 7, 2013, at 7:01 PM, <[email protected]> wrote: > Our ED Physicians are wanting to call “time zero” the time of the first BP > with systolic below 90. I have not found any research to support this > approach. Any information I can share with them to bring them along would be > welcome. (in particular research that looks at the issue) > > Thanks > > From: [email protected] > [mailto:[email protected]] On Behalf Of Jeffrey R > Hanlon RN > Sent: Wednesday, February 06, 2013 6:58 PM > To: [email protected]; [email protected] > Cc: [email protected]; [email protected]; > [email protected]; [email protected] > Subject: Re: [Sepsis Groups] Time Zero > > Our time zero starts when the patient declares. If the SIRS criteria are met > at triage then that is time zero. Should the patient for example have just > tachycardia noted in triage and the WBC count comes back elevated that is > time zero. > Jeffrey R Hanlon RN > Stamp Out Sepsis > > -----Original Message----- > From: Ron Daniels <[email protected]> > To: Karin Molander <[email protected]> > Cc: Jacqui.Jones <[email protected]>; f.gaosmith > <[email protected]>; sepsisgroups <[email protected]>; > isabel.gonzalez <[email protected]> > Sent: Wed, Feb 6, 2013 3:18 pm > Subject: Re: [Sepsis Groups] Time Zero > > Thanks Karin, > > I understand the pragmatic reasons behind it, but personally I'm > uncomfortable with using ICU admission time unless you can be certain there > are never any delays in recognition, referral and ICU admission for > ward-based patients. > > In the UK, this is far from the case and I would urge organizations not to > measure only the performance of their ED and ITU (if there is no reliable > temporal relationship between ward-based onset and ICU admission, this will > ultimately have the effect of demonstrating non-efficacy of EGDT anyway). > > Kind regards > > Ron > > On Tue, Feb 5, 2013 at 3:58 PM, Karin Molander <[email protected]> wrote: > We use Triage Time in ED for Sutter system. For those cases of sepsis caught > on the wards, we use time of arrival to the ICU for time zero for start of > EGDT bundle. > Karin Molander MD FACEP > Mills Peninsula Hospital > Sutter > > On Tue, Feb 5, 2013 at 2:10 AM, Heather McClelland > <[email protected]> wrote: > Happy to be involved. > > Heather > -------------------------- > Sent from my BlackBerry Wireless Device > > > ----- Original Message ----- > From: Ron Daniels [mailto:[email protected]] > Sent: Friday, February 01, 2013 10:08 PM > To: Jones Jacqui (RTR) South Tees NHS Trust <[email protected]> > Cc: Gonzalez Isabel (SOUTH TEES HOSPITALS NHS FOUNDATION TRUST) > <[email protected]>; Fang Gao Smith <[email protected]>; > <[email protected]> <[email protected]> > Subject: Re: [Sepsis Groups] Time Zero > > Fang, this sounds like an opportunity for a global sampling of volunteer > organizations. > > Ron > > Dr Ron Daniels > Chair: UK Sepsis Trust > CEO: Global Sepsis Alliance > > Sent on the move from my iPhone, excuse brevity! > > On 1 Feb 2013, at 13:40, "Jones Jacqui (RTR) South Tees NHS Trust" > <[email protected]> wrote: > > > Hi Dr Fang Gao > > > > I would be very interested in participating in your next prospective > > cohort study on behalf of South Tees NHS Trust. I currently collect data > > on around 35 of our patients with severe sepsis each month. I look at > > the time to each element of the sepsis six from time zero alongside > > factors which influence the standards of care delivery. > > > > > > > > Regards > > > > Jacqui > > > > Jacqui Jones > > Sepsis Specialist Nurse > > South Tees Hospitals NHS Foundation Trust > > 01642 850850 ext 56969 bleep 1008 > > email [email protected] > > > > Suspect Sepsis: save someone's life today. > > > > > > Sign our e-petition at http://epetitions.direct.gov.uk/petitions/19602 > > > > > > > > > > -----Original Message----- > > From: [email protected] > > [mailto:[email protected]] On Behalf Of Fang > > Gao Smith > > Sent: 31 January 2013 21:01 > > To: Jessica Harkey; [email protected] > > Cc: Melody Teresa > > Subject: Re: [Sepsis Groups] Time Zero > > > > Dear Jessica > > We did a prospective cohort study on determining 'time zero' of severe > > sepsis amongst critical care team 3-4 years ago with very interesting > > results. Teresa, our dept manage should be able to feed you with more > > information. Your suggestion has prompted us to consider to repeat this > > study after 3-4 years sepsis education. Would you be interested to > > participate? > > > > Best wishes > > Fang > > > > > > Fang Gao > > Professor in Anaesthesia, Critical Care and Pain > > Perioperative, Critical Care and Trauma Trials Group > > School of Clinical and Experimental Medicine > > University of Birmingham > > > > Academic Department of Anaesthesia, Critical Care, Pain and > > Resuscitation > > MIDRU Building > > Birmingham Heartlands Hospital > > Heart of England NHS Foundation Trust > > > > > > [email protected]; [email protected]<mailto:[email protected]>; > > 07711823212 > > > > Patricia Mponela: 0121 3713243; > > [email protected]<mailto:[email protected]> > > > > Dawn Hill: 0121 424 2966; > > [email protected]<mailto:[email protected]> > > > > > > > > From: Jessica Harkey <[email protected]<mailto:[email protected]>> > > Date: Thu, 31 Jan 2013 17:10:03 +0000 > > To: > > "[email protected]<mailto:[email protected] > > ups.org>" > > <[email protected]<mailto:[email protected] > > ups.org>> > > Subject: [Sepsis Groups] Time Zero > > > > Hello, all- > > We had some very good discussion at our last team meeting about defining > > "time zero" for the bundle. Currently for the ED we use triage time. > > Would anyone be willing to share what you use as time zero to begin > > implementation of the bundle? > > Thank you, > > > > > > Jessica Harkey, RN, BSN, CCRN > > Sepsis Program Coordinator > > San Joaquin Community Hospital > > 2615 Chester Avenue > > Bakersfield, CA 93303 > > 661-869-6874 > > [email protected]<mailto:[email protected]> > > > > [cid:MBFOHERTDJDT.IMAGE_5.BMP] > > _______________________________________________ > > Sepsisgroups mailing list > > [email protected] > > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > > > -- > Dr Ron Daniels > > CEO: Global Sepsis Alliance > Chair: United Kingdom Sepsis Group > Principal Trustee: U.K Sepsis Trust > Founding Director: Survive Sepsis > Fellow: NHS Improvement Faculty > > > > Suspect Sepsis: save someone's life today. > > Join us for World Sepsis Day on September 13th > > Twitter: @sepsisuk > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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