Hi Robyn, You misunderstand the bundle. The guidelines still say 1 hour for BC/Abx: the bundle allows 3 h for other elements but these should still be completed within 1 hour.
In UK, Sepsis 6 asks that we achieve all within the hour. Kind regards Ron Dr Ron Daniels Chair: UK Sepsis Trust CEO: Global Sepsis Alliance Sent on the move from my iPhone, excuse brevity! > On 30 Sep 2013, at 19:18, Robyn Haddock Crosswhite <[email protected]> wrote: > > 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. This information is intended only for the use of the individual > or entity named above. The authorized recipient of this information is > prohibited from disclosing this information to any other party and is > required to destroy the information after its stated need has been fulfilled. > If you are not the intended recipient, you are hereby notified that any > disclosure, copying, distribution, or action taken in reliance on the > contents of these documents is strictly prohibited. If you have received this > email in error, please notify the sender immediately to arrange for return of > these documents. > > > _______________________________________________ > 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
