We typically use ICU standards to determine if the patient is required to be in the ICU (frequency and level of monitoring, vasopressors, etc). Our sepsis protocol requires placement of the Presep and Scvo2 monitoring for septic shock (hypotensive and/or Lactate 4.0 or greater) - patient must go to ICU. If the ED provider decides that patient's condition is tenuous enough (your example #3), and they still choose to start scvo2 monitoring, that patient will go to the ICU. Other patients that are severely septic, may either go to PCU (Progressive Care Unit) or floor. Does that answer your question???
Lana Adzhigirey, RN MN Performance Improvement RN Critical Care - Regional Franciscan Health System ph. 253.426.4086 pg. 253.416.0306 Mailstop 01-20 -----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Townsend, Sean, M.D. Sent: Thursday, March 14, 2013 11:32 PM To: '[email protected]' 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 [email protected] office (415) 600-5770 fax (415) 600-1541 _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. If you are not an addressee, or responsible for delivering this email to an addressee, you have received this email in error and are notified that reading, copying, or disclosing this email is prohibited. If you received this email in error, immediately reply to the sender and delete the message completely from your computer system. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
