Do other hospitals follow the 3 hr sepsis bundle (ie lactate, antibiotics) or do you check lactate levels as well as antibiotics within the first hour of recognition?
Thanks Robyn Crosswhite BSN, RN,CCRN Nurse Educator Sepsis Coordinator Medical Center Hospital Odessa TX 79758 Sent from my iPhone On Sep 30, 2013, at 9:59 AM, "[email protected]" <[email protected]> wrote: > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: Sepsisgroups Digest, Vol 76, Issue 3 (Yash Javeri) > 2. Pre-hospital Antibiotic Administration (Josie Gray) > 3. Re: Where Does Severe Sepsis Belong? (Martha Mattson) > 4. IMPRESS Study Update - November 7 right around the corner > (Lori Harmon) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Sat, 28 Sep 2013 22:25:00 +0530 > From: Yash Javeri <[email protected]> > To: "Rohrbach, Dawn" <[email protected]> > Cc: "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 76, Issue 3 > Message-ID: <[email protected]> > Content-Type: text/plain; charset=us-ascii > > Very valid point. To whom does the septic > patient belong? Where should be a > septic patient treated? > The septic patient belongs to intensivist Ownership should be with ICU team. > This will give them much deserved comprehensive care. > They should be treated in ICU inclined to aggresive sepsis care > On 28-Sep-2013, at 0:49, "Rohrbach, Dawn" > <[email protected]> wrote: > >> We recommend admitting patients with a lactate> 3 to our ICU in our >> facility. Most of the time this is the case. The other elements are only if >> patient is ubstable. >> >> -----Original Message----- >> From: [email protected] >> [mailto:[email protected]] On Behalf Of >> [email protected] >> Sent: Friday, September 27, 2013 1:09 PM >> To: [email protected] >> Subject: Sepsisgroups Digest, Vol 76, Issue 3 >> >> Send Sepsisgroups mailing list submissions to >> [email protected] >> >> To subscribe or unsubscribe via the World Wide Web, visit >> >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> or, via email, send a message with subject or body 'help' to >> [email protected] >> >> You can reach the person managing the list at >> [email protected] >> >> When replying, please edit your Subject line so it is more specific >> than "Re: Contents of Sepsisgroups digest..." >> >> >> Today's Topics: >> >> 1. Re: Where Does Severe Sepsis Belong? (Jamie Roney) >> >> >> ---------------------------------------------------------------------- >> >> Message: 1 >> Date: Thu, 26 Sep 2013 16:05:06 -0500 >> From: Jamie Roney <[email protected]> >> To: "Townsend, Sean, M.D." <[email protected]>, >> "'[email protected]'" >> <[email protected]> >> Subject: Re: [Sepsis Groups] Where Does Severe Sepsis Belong? >> Message-ID: >> <cb901ca1ec8d2340a5cc967135b59200013a5a2...@sjsnt-txmail01.stjoe.org> >> Content-Type: text/plain; charset="us-ascii" >> >> Dr. Townsend, >> Is there a sepsis specific risk/treatment stratification tool available to >> assist in answering your question of placement in a possible lower level of >> care? Or is there a tool to assist with septic patients who can be >> discharged home versus admitted due to probable deterioration into severe >> sepsis? >> >> Thank you, >> Jamie >> >> Jamie Roney, BSN, RN-BC, BSHCM, CCRN >> COVENANT HEALTH SEPSIS COORDINATOR >> "Be a yardstick of quality. Some people aren't used to an environment where >> excellence is expected." ~Steve Jobs >> >> 3615 19th Street, Lubbock, TX 79410 >> T: (806) 725-4689 C: (806) 773-1914 >> www.covenanthealth.org >> ...................................................................................... >> >> >> >> -----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 >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> Notice from St. Joseph Health System: >> Please note that the information contained in this message may be privileged >> and confidential and protected from disclosure. >> >> >> ------------------------------ >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> >> End of Sepsisgroups Digest, Vol 76, Issue 3 >> ******************************************* >> >> >> This message is intended for the sole use of the addressee, and may contain >> information that is privileged, confidential and exempt from disclosure >> under applicable law. If you are not the addressee you are hereby notified >> that you may not use, copy, disclose, or distribute to anyone the message or >> any information contained in the message. If you have received this message >> in error, please immediately advise the sender by reply email and delete >> this message. >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > ------------------------------ > > Message: 2 > Date: Mon, 30 Sep 2013 12:31:53 +0100 > From: Josie Gray <[email protected]> > To: "[email protected]" > <[email protected]> > Subject: [Sepsis Groups] Pre-hospital Antibiotic Administration > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii" > > Hi there, > > I am a third year student Paramedic, studying at the University of Brighton. > An assignment we have been given involves researching and suggesting an > improvement our local ambulance service can make to improve patient care. > > I recently attended a male suffering signs of severe sepsis. He had been > getting progressively worse following an untreated chest infection and had > been in the condition we found him for around 3 hours before his wife decided > to call an Ambulance. > > We initiated a fluid challenge and took him to A&E under a blue light > priority. Along with all our regular checks. > > My thoughts from this were, had paramedics been allowed to give broad > spectrum antibiotics, would this have been of benefit to the patient at all > as apposed to receiving these in hospital, considering his potential to > deteriorate rapidly? Our transport time being 20-25 minutes. And would this > have given the hospital more time to complete other tasks required for this > patient, e.g blood cultures, imaging etc and enable him to get the care he > needs as quickly as possible? > > I would be very grateful for your opinion on this and if you would have any > suggestions or recommendations I could research into, on what more the > Ambulance service can do for this group of patients? > > Kind Regards, > Josie Gray > > Third year student Paramedic, > University of Brighton. > > ------------------------------ > > Message: 3 > Date: Sat, 28 Sep 2013 11:50:33 -0700 > From: "Martha Mattson" <[email protected]> > To: "'Mary Draper'" <[email protected]>, "'Jamie Roney'" > <[email protected]> > Cc: [email protected] > Subject: Re: [Sepsis Groups] Where Does Severe Sepsis Belong? > Message-ID: <[email protected]> > Content-Type: text/plain; charset="utf-8" > > I would think that one of the criteria for lower level care for those > patients would be the ability to get q 2 hours vital signs for at least 24 > hours, and do serial lactates q 6 hours for 24 hours as well. If staffing or > new technology in a step-down or telemetry would support this, then > deterioration would be able to be picked up more quickly and it should be > safe to admit the patient there, rather than ICU. > > > > Martie > > Martie Mattson, RN, MSN, CNS, CCRN(a) > > Critical Care Consultant and Educator > > <mailto:[email protected]> [email protected] > > (415) 412-2364 > > > > > > From: [email protected] > [mailto:[email protected]] On Behalf Of Mary Draper > Sent: Friday, September 27, 2013 7:32 AM > To: Jamie Roney > Cc: [email protected] > Subject: Re: [Sepsis Groups] Where Does Severe Sepsis Belong? > > > > If they are hemodynamically stable and have responded to fluids, they could > go to a telemetry unit but those nurses have 4-5 patients and subtle changes > leading to instability can get missed. > > > > > Mary Draper RN BSN CCRN > > Quality Manager-Best Practice Support > > Quality Management Supervisor > > Office (925) 674-2045 <tel:(925)%20674-2045> > > Cell (925) 451-8792 <tel:(925)%20451-8792> > > Fax (925) 674-2373 <tel:(925)%20674-2373> > > <mailto:[email protected]> [email protected] > > > On Sep 27, 2013, at 7:05 AM, "Jamie Roney" <[email protected] > <mailto:[email protected]> > wrote: > > Dr. Townsend, > Is there a sepsis specific risk/treatment stratification tool available to > assist in answering your question of placement in a possible lower level of > care? Or is there a tool to assist with septic patients who can be discharged > home versus admitted due to probable deterioration into severe sepsis? > > Thank you, > Jamie > > Jamie Roney, BSN, RN-BC, BSHCM, CCRN > COVENANT HEALTH SEPSIS COORDINATOR > "Be a yardstick of quality. Some people aren't used to an environment where > excellence is expected." ~Steve Jobs > > 3615 19th Street, Lubbock, TX 79410 > T: (806) 725-4689 C: (806) 773-1914 > www.covenanthealth.org <http://www.covenanthealth.org> > ...................................................................................... > > > > -----Original Message----- > From: [email protected] > <mailto:[email protected]> > [mailto:[email protected]] On Behalf Of Townsend, > Sean, M.D. > Sent: Friday, March 15, 2013 1:32 AM > To: '[email protected] > <mailto:[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] <mailto:[email protected]> > office (415) 600-5770 > fax (415) 600-1541 > _______________________________________________ > Sepsisgroups mailing list > [email protected] > <mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > Notice from St. Joseph Health System: > Please note that the information contained in this message may be privileged > and confidential and protected from disclosure. > _______________________________________________ > Sepsisgroups mailing list > [email protected] > <mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20130928/c77f892c/attachment-0001.htm> > > ------------------------------ > > Message: 4 > Date: Mon, 30 Sep 2013 08:49:21 -0500 > From: Lori Harmon <[email protected]> > To: "[email protected]" > <[email protected]> > Cc: Melissa Nielsen <[email protected]> > Subject: [Sepsis Groups] IMPRESS Study Update - November 7 right > around the corner > Message-ID: > <[email protected]> > Content-Type: text/plain; charset="us-ascii" > > Colleagues, > > Dr. Rhodes has reported that there are now over 700 sites enrolled for the > IMPRESS<http://impress-ssc.com/> study. You can see below the breadth of > countries represented and the number from each. We are still striving for > 1000 sites so if you can share this opportunity with your colleagues please > do so. > > Count of Country > > Row Labels > > Total > > Argentina > > 3 > > Australia > > 5 > > Austria > > 3 > > Bangladesh > > 2 > > Belgium > > 23 > > Bolivia > > 4 > > Bosnia and Herzegovina > > 2 > > Brasil > > 29 > > Brunei > > 1 > > Bulgaria > > 1 > > Canada > > 9 > > Chile > > 1 > > China > > 16 > > Colombia > > 6 > > Croatia > > 3 > > Cuba > > 1 > > Cyprus > > 1 > > Czech Repiblic > > 15 > > Denmark > > 15 > > Ecuador > > 6 > > Egypt > > 5 > > Estonia > > 1 > > Finland > > 1 > > France > > 9 > > Georgia > > 1 > > Germany > > 10 > > Greece > > 14 > > Guatemala > > 1 > > Haiti > > 1 > > Hungary > > 6 > > Iceland > > 1 > > India > > 53 > > Indonesia > > 1 > > Iran > > 5 > > Ireland > > 3 > > Israel > > 3 > > Italy > > 25 > > Japan > > 18 > > Jordan > > 1 > > Kenya > > 1 > > Kuwait > > 1 > > Lebanon > > 1 > > Libya > > 2 > > Lithuania > > 2 > > Malawi > > 1 > > Malaysia > > 6 > > Malta > > 1 > > Martinique > > 1 > > Mexico > > 10 > > Netherlands > > 15 > > Nigeria > > 3 > > Norway > > 1 > > Oman > > 2 > > Pakistan > > 2 > > Peru > > 7 > > Philippines > > 2 > > Poland > > 10 > > Portugal > > 9 > > Puerto Rico > > 1 > > Romania > > 3 > > Russian Federation > > 15 > > Saudi Arabia > > 10 > > Serbia > > 3 > > Singapore > > 5 > > Slovakia > > 4 > > Slovenia > > 2 > > South Korea > > 5 > > Spain > > 56 > > Sri Lanka > > 1 > > Sudan > > 4 > > Sweden > > 6 > > Switzerland > > 5 > > Thailand > > 1 > > Turkey > > 21 > > UAE > > 4 > > Uganda > > 1 > > UK > > 94 > > USA > > 115 > > Grand Total > > 738 > > > > Lori A. Harmon, RRT, MBA| Director, Program Development| Society of Critical > Care Medicine > 500 Midway Drive, Mount Prospect, IL 60056-5811 USA > t: +1 847.493.6403 | f: +1 847.493.6428 | www.sccm.org > www.facebook.com/SCCM1<http://www.facebook.com/SCCM1> | > www.twitter.com/SCCM<http://www.twitter.com/SCCM> | > www.youtube.com/SCCM500<http://www.youtube.com/SCCM500> > > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20130930/b03fcaab/attachment.htm> > > ------------------------------ > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > End of Sepsisgroups Digest, Vol 77, Issue 1 > ******************************************* > CONFIDENTIALITY NOTICE: The documents accompanying this email transmission contain confidential information belonging to the sender that is legally privileged. 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