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 [email protected]
office (415) 600-5770
fax (415) 600-1541
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