Time zero in acute care is the first time the patient meets all criteria for severe sepsis= suspected or confirmed infection + 2 signs and symptoms of infection (mod SIRS criteria) + any organ dysfunction that is new. This is time zero. Information trickles in at different times in acute care. Systematic screening by nursing, basically looking at most recent vital signs, labs, and the head to toe assessment, is how screening is done and then PRN with a change in condition. When all 3 criteria are met during screening, that is Time zero. Reliable and reproducible. If creatinine > 2.0 is the organ dysfunction, that is time zero. Hypotension is one organ dysfunction. I recommend going to the surivingsepsis.org website. All criteria, examples of screens, guidelines , can be found there. Great resource.
Patty From: [email protected] [mailto:[email protected]] On Behalf Of Erin Tallon Sent: Tuesday, March 11, 2014 1:26 AM To: Suriving Sepsis Campaign Listserve Subject: [Sepsis Groups] Time Zero for patients transferred from the floorto the ICU 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 This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. This footer also confirms that this email message has been scanned for the presence of computer viruses.
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