Joyce, Your mention of using 38 degrees celsius as a screening criteria at your triage desk makes me curious: what criteria are you using at your triage and what percentage of sepsis cases are you picking up on?
There was a study published in the European Journal of Emergency Medicine a few months back (http://www.ncbi.nlm.nih.gov/pubmed/24080997?dopt=Abstract) which attempted to validate a couple of prehospital sepsis screening methods, and found that one used numbers that would be pretty common at most ED triage desks (Temp, HR, Respiratory rate, presence of altered mental status, and blood glucose levels) picked up on roughly 75% of sepsis cases. The screening tool here hewed pretty close to thos variables of the 2001 consensus criteria which are field-testable (i.e. T > 38.3C or < 36.0, HR > 90) in everything except blood glucose (it used bG > 6.6 mmol/L vs. the consensus criteria's 7.7 mmol/L) and the fact that it ignored BP. This 75% is the best published prehospital sepsis detection rate out there so far, even compared with screening tools that use point-of-care lactate testing. Thus, I'm curious; what criteria are you using to screen sepsis at your triage desk, and what kinds of numbers are you getting in terms of detection rates? Triage is one of the only spots in the hospital environment where the available tools are similar to those in the prehospital environment, and if you're beating that 75% detection rate by loosening up from the consensus criteria that could be a significant finding for us in the prehospital world as well. Thanks, Jason Merrill Primary Care Paramedic On Mon, Feb 24, 2014 at 2:05 PM, < [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: ED to ICU ([email protected]) > 2. Re: SIRS criteria (Mickanin, Joyce V) > 3. Re: ED to ICU (Mary Draper) > 4. Re: SIRS criteria (Ron Daniels) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Fri, 21 Feb 2014 18:06:20 -0600 > From: [email protected] > To: "DanaMarie Smith" <[email protected]> > Cc: "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] ED to ICU > Message-ID: <[email protected]> > Content-Type: text/plain; charset="utf-8" > > Our average is 5 hours, and we are trying to make that less also. We found > that the work up takes the most time. > > Hesham A. Hassaballa, MD, FCCP > Program Medical Director > Critical Care > Rush-Copley Medical Center > > Assistant Professor of Medicine > Rush University Medical Center > > Phone: (331) 454-6572 > > > On Feb 21, 2014, at 4:10 PM, "DanaMarie Smith" < > [email protected]> wrote: > > > > Hi everyone, > > I was wondering what your Hospital policy was for sepsis patients from > arrival to er to ICU bed time. Our hospital average is 6 hrs and we want to > change that and make it much less but don't know what the standard is > across other hospitals. I would appreciate some feedback. Thank you. > > Dana > > > > > > Dana Marie Smith RN > > Clinical Data Analyst > > Quality/Performance Improvement > > Phone # 215- 612-4888 > > Fax # 215-612-4463 > > > > > > ________________________ > _______________________ > > Sepsisgroups mailing list > > [email protected] > > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > > This message, including any attachments, is for the sole use of the > intended recipient(s) > and may contain confidential and privileged information. Any unauthorized > review, > use, disclosure or distribution is prohibited. If you are not the > intended recipient, > please contact the sender by reply email and destroy all copies of the > original message. > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: < > http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20140221/7f08c71a/attachment-0001.htm > > > > ------------------------------ > > Message: 2 > Date: Sat, 22 Feb 2014 15:24:26 +0000 > From: "Mickanin, Joyce V" <[email protected]> > To: "Seckel, Maureen" <[email protected]>, > "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] SIRS criteria > Message-ID: > <3b03dfd26ae0164d8287b6133a87728a35ee6...@tn001wexmbx16.us.chs.net > > > Content-Type: text/plain; charset="us-ascii" > > I posed this same question and have not yet received any response. In our > EDs, we use the 38C, but our hospitalists have selected 38.3C as inpatient > criteria. Since our criteria are inherently different (we have no lab > results available at initial screen at triage), we opted to use the 38C as > this seems fairly standard for ED screening in the lit search I did. > Perhaps more sensitive for capturing those subtle presentations when vital > signs and S&S are all that's available? Would appreciate feedback from > others. > > Joyce V. Mickanin, MSN, RN I Director of Emergency Services I Community > Health Systems I 4000 Meridian Blvd., Franklin, TN 37067 I Office: > 615-628-6573 I Fax: 615-373-7969 I Cell: 615-887-0008 l > [email protected] > > From: [email protected] [mailto: > [email protected]] On Behalf Of Seckel, Maureen > Sent: Wednesday, February 19, 2014 9:41 AM > To: [email protected] > Subject: [Sepsis Groups] SIRS criteria > > Simple question. > > Why is SIRS criteria for Temperature written as 38 degrees for high in > some articles and medical calculators and 38.3 in others. Which really is > it? > > The SS Campaign guidelines and data base uses 38.3. > > Thanks, > > > Maureen A. Seckel, APN, ACNS-BC, CCNS, CCRN > CNS Medical Pulmonary Critical Care > Sepsis Coordinator > Christiana Care Health System > 4755 Ogletown-Stanton Road > 3E29 > Newark, DE 19718 > Office 302 733-6023 > > > > > > > > -------------------------------------------------------------------------- > Disclaimer: This electronic message may contain information that is > Proprietary, Confidential, or legally privileged or protected. It > is intended only for the use of the individual(s) and entity named > in the message. If you are not an intended recipient of this > message, please notify the sender immediately and delete the > material from your computer. Do not deliver, distribute or copy > this message and do not disclose its contents or take any action in > reliance on the information it contains. > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: < > http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20140222/423db383/attachment-0001.htm > > > > ------------------------------ > > Message: 3 > Date: Fri, 21 Feb 2014 16:34:42 -0800 > From: Mary Draper <[email protected]> > To: DanaMarie Smith <[email protected]> > Cc: "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] ED to ICU > Message-ID: <[email protected]> > Content-Type: text/plain; charset="utf-8" > > We have worked hard to get the transfer time to 4 hours. The ED MDs call > the intensivists directly to expedite transfer to Critical Care. > > 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> > [email protected]<mailto:[email protected]> > > On Feb 21, 2014, at 2:10 PM, "DanaMarie Smith" < > [email protected]<mailto:[email protected]>> > wrote: > > Hi everyone, > I was wondering what your Hospital policy was for sepsis patients from > arrival to er to ICU bed time. Our hospital average is 6 hrs and we want to > change that and make it much less but don't know what the standard is > across other hospitals. I would appreciate some feedback. Thank you. > Dana > > > Dana Marie Smith RN > Clinical Data Analyst > Quality/Performance Improvement > Phone # 215- 612-4888 > Fax # 215-612-4463 > > > _______________________________________________ > 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/20140221/1744d3f1/attachment-0001.htm > > > > ------------------------------ > > Message: 4 > Date: Fri, 21 Feb 2014 22:44:17 +0000 > From: Ron Daniels <[email protected]> > To: "Seckel, Maureen" <[email protected]> > Cc: "<[email protected]>" > <[email protected]> > Subject: Re: [Sepsis Groups] SIRS criteria > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii" > > 38: Bone, 1992. 38.3: Levy, 2001. > > Same consensus group, 10 years, different lead authors. 38.3 is current. > > R > > Dr Ron Daniels > Chair: UK Sepsis Trust > CEO: Global Sepsis Alliance > > Sent on the move from my iPhone, excuse brevity! > > > On 19 Feb 2014, at 15:40, "Seckel, Maureen" <[email protected]> > wrote: > > > > Simple question. > > > > Why is SIRS criteria for Temperature written as 38 degrees for high in > some articles and medical calculators and 38.3 in others. Which really is > it? > > > > The SS Campaign guidelines and data base uses 38.3. > > > > Thanks, > > > > > > Maureen A. Seckel, APN, ACNS-BC, CCNS, CCRN > > CNS Medical Pulmonary Critical Care > > Sepsis Coordinator > > Christiana Care Health System > > 4755 Ogletown-Stanton Road > > 3E29 > > Newark, DE 19718 > > Office 302 733-6023 > > > > > > > > > > > > _______________________________________________ > > Sepsisgroups mailing list > > [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/20140221/96187aa1/attachment.htm > > > > ------------------------------ > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > End of Sepsisgroups Digest, Vol 98, Issue 1 > ******************************************* > -- Jason Merrill Primary Care Paramedic/EMT-A *Do you know the warning signs of a heart attack <http://www.heartandstroke.nf.ca/site/c.inKLKTOwHoE/b.3654523/k.C091/Heart_Disease__Warning_signs.htm#warningsignals>, stroke <http://www.heartandstroke.nf.ca/site/c.inKLKTOwHoE/b.3654543/k.760A/Stroke__Warning_Signs.htm>, or serious allergic reaction <http://www.anaphylaxis.ca/en/anaphylaxis101/the_basics.html>?* *This e-mail is intended as a private communication with its intended recipient, and may contain confidential information which is protected by law. 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