Hello Dr. Townsend,

The successful systematic approach to the determination of Severe Sepsis has
no choice but the ICU.  The death statistics used to propagate the protocols
adoption have left no other choice but an all out attempt to prevent the
patient's well researched impending death.  That being the ICU as universal
best place to try and prevent it.

Saying you don't need the ICU to those who have yet to adopt a sepsis
protocol is to say to them that they're not really in that great of danger.

An awareness campaign is a double edged sword.


Matt Reavill


-----Original Message-----
From: [email protected]
[mailto:[email protected]] On Behalf Of Townsend,
Sean, M.D.
Sent: Friday, March 15, 2013 1:32 AM
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
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