I would like to ask if anyone here can tell me how they determine the time that
should be used as Time Zero for those patients who are transferred to the ICU
from either the floor or an IMC unit. I understand that for septic patients
admitted through the ED, Time Zero is generally considered to be the time of ED
registration. However, I am asking here about those patients who present with
sepsis symptoms elsewhere in the hospital and need to be transferred to the
ICU. What time do you consider to be Time Zero? Is it the time at which the
onset of hypotension is first charted? Or do you use some other indicator?
Since hypotension is not always the first sign of severe sepsis, it seems that
the time of onset of hypotension (while perhaps the "easiest" indicator to use)
is not always the best time to use in establishing a Time Zero. I am
interested to know if hypotension onset or some different criteria is thought
to be best in establishing a
Time Zero for these patients.
Also, for those working in the ED, what have your experiences been with using
ED registration time as Time Zero? Has doing so (rather than using, say, the
time of hypotension onset) helped to improve sepsis recognition/treatment times?
Thanks,
Erin Tallon, RN, BSN
Memorial Medical Center (Springfield, IL)
Critical Care Sepsis Team
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