Hi Joe,

We have had the same problem regarding the "evidence of infection" question in 
the ED.  Does the dialysis patient with mild SIRS criteria presenting with 
diarrhea need a serum lactate and blood cultures drawn?  What about the 
postoperative patient with abdominal pain?  Are these patients infected?  
Maybe, but do their presentations constitute "evidence of infection" and 
require review by our ED sepsis committee looking for sepsis guideline 
compliance?  Application of the surviving sepsis guidelines requires clinical 
judgement at the bedside.  Clinical judgement is shades of gray.  The 
guidelines are black and white.  Therein lies the rub.

Steve Chabala D.O. F.A.C.E.P.
On Sep 19, 2013, at 6:00 PM, Joseph Clement wrote:

> 
> Hello, 
> 
> We are seeing great variation in how "suspected infection" is interpreted by 
> triage RNs in our ED, resulting in patients being missed. Has anybody created 
> any guidelines to define this and make it more consistent/objective? 
> 
> Thank you, 
> 
> Joe 
> Joseph Clement RN, MS, CCNS
> Clinical Nurse Specialist
> 
> San Francisco General Hospital
> phone: (415) 206-6174
> pager: (415) 327-0220
> [email protected]
> 
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