From our recent study on the coding of severe sepsis cases, in whittaker s, et al CCM 2013, where our gold standard reference group was all ED pt's prospectively screened for severe sepsis, the proportion of severe sepsis cases that were cared for in the ICU vs floors was ~ 50%. As was previously stated, the icu cohort are primarily EGDT eligible, hemodynamically unstable, pt's as well as those with acute respiratory failure that complicates or follows presentation. Of note, this study did not include severe sepsis cases that developed in-house, but there is no reason to think that the care venue would differ in these cases. Hope this helps. Barry Fuchs
Sent from my iPhone On Mar 17, 2013, at 11:51 AM, "Terry Clemmer" <[email protected]> wrote: > Severe sepsis no, it depends on what organs are failing, septic shock yes. > > Terry P. Clemmer, MD > Director of Critical Care Medicine > LDS Hospital > 8th Ave and 'C' Street > Salt Lake City, Utah 84143 > > Phone 801-408-3661 > E-mail: [email protected] > > > "Confidential Report for Improvement of Hospital, Facility and Patient > Care--Not Part of Medical Record and Not to be Used in Litigation--Prepared > Pursuant to Utah Code Ann. § 26-25-1 et seq., or Idaho Code Ann. § 39-1392 et > seq." > > > -----Original Message----- > From: [email protected] > [mailto:[email protected]] On Behalf Of Townsend, > Sean, M.D. > Sent: Friday, March 15, 2013 12:32 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 > _______________________________________________ > 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 The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
