I am reaching out to anyone with scientific data of the use of procalcitonin as 
a screening tool.  I am finding that the latest guidelines from the SCCM does 
not recommend the use of procalcitonin as a screening tool but as a biomarker 
to assist the clinician in the discontinuation of empiric antibiotic therapy in 
patients who appeared septic.  Would like to hear comments from others.  
Thank-you.  


Jeanie Bollinger MSN,RN,ACCNS-AG, CCRN
Sepsis Clinical Nurse Specialist
Nursing Department of Excellence
Mission Health
Asheville, NC

Phone: 828-213-5878
Beeper: 828-207-2363



-----Original Message-----
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Sent: Monday, March 02, 2015 3:07 PM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 146, Issue 1

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Today's Topics:

   1. Sepsis screening in a maternity population (Riley, Bonnie S.)
   2. Re: Sepsis in obstetrical patients (Dr.Sunil T Pandya)


----------------------------------------------------------------------

Message: 1
Date: Fri, 27 Feb 2015 20:38:20 +0000
From: "Riley, Bonnie S." <[email protected]>
To: "[email protected]"
        <[email protected]>
Subject: [Sepsis Groups] Sepsis screening in a maternity population
Message-ID: <[email protected]>
Content-Type: text/plain; charset="utf-8"

I am reaching out to anyone who is working on a sepsis protocol for a maternity 
population.

We use the SSC bundles for all our patients except the women's health 
population.

Bonnie Riley MSN, RNC, CPHQ
Performance Improvement Coordinator
Medical Staff Services M2843
Houston Methodist Sugar Land Hospital
Office: 281-274-7869
Fax:  281-274-8028

Houston Methodist. Leading Medicine. Houston Methodist is ranked by U.S.News & 
World Report as one of America's "Best Hospitals" in 11 specialties and 
designated as a Magnet hospital for excellence in nursing.  Houston Methodist 
has also been named to FORTUNE?  Magazine's "100 Best Companies to Work For?" 
list for nine years in a row. Visit us at  houstonmethodist.org. Follow us at  
twitter.com/MethodistHosp and facebook.com/HoustonMethodist.  
***CONFIDENTIALITY NOTICE*** This e-mail is the property of Houston Methodist 
and/or its relevant affiliates and may contain restricted and privileged 
material for the sole use of the intended recipient(s). Any review, use, 
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Message: 2
Date: Sat, 28 Feb 2015 02:43:36 +0530
From: "Dr.Sunil T Pandya" <[email protected]>
To: "Riley, Bonnie S." <[email protected]>
Cc: "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] Sepsis in obstetrical patients
Message-ID:
        <CAJ5VsPR7JmV+pLsm_yvkka_F+MNU0gVp3e_=REoBQEDK=gx...@mail.gmail.com>
Content-Type: text/plain; charset="utf-8"

Yes, we do have implemented the same protocol if pregnant women...with early 
CVP, arterial and Ultrasound guided fluid resuscitation.
Well, what we have additionally found and incorporated in our protocol are as 
follows:

1. Atonic PPH management under these settings...quite common 
(Uterotonics...oxytocin can exaggerate hypotension, B-Lynch procedure etc)

2. CUlture placental bed tissue

3. Send immediately neonatal cultures...even if the new born appears normal!

4. Anticipate and prevent hypotension if LSCS is done under regional 
anaesthesia....they have exaggerated hypotension...in fact, we have diagnosed 
occult sepsis in retrospect by this exaggerated hypotensive response work-up!

5. Early ScVO2 measurements and lactate clearance are good markers for 
improvements. Total leukocyte counts are invariably elevated and are unreliable 
marker during peripartum period.

6. Beware of occult sepsis creeping in parturients with HELLP, AFLP and 
Thrombotic micro-angiopaties! High vigil is warranted.

Best wishes,
Sunil

*------------*

*Dr.Sunil T Pandya*

*Medical Director*
*Director, Anaesthesia, Pain and Surgical Intensive Care,* *Century Hospital, 
Hyderabad, India (www.centuryhospital.in
<http://www.centuryhospital.in>)*

*Organizing Secretary, 8th Annual Conference of AOA India and 1st World 
Obstetric Anaesthesia **Congress, Hyderabad, 2015.*

*Hon. Secretary, Association of Obstetric Anaesthesiologists, India 
(www.aoaindia.com <http://www.aoaindia.com>)* *Hon. Secretary, Society of 
Obstetric Medicine, India* *EC member, Obstetric Anaesthesia Society Asia 
Oceania (OASAO)* *EC member, Academy of Regional Anaesthesia, India 
(www.aoraindia.com
<http://www.aoraindia.com>)*

 *Programme director, Post doctoral fellowship in Anaesthesia for High risk
Obstetrics,*
*Head, **Dept. of Anaesthesia, Obstetric Critical care and Pain medicine,* 
*Fernandez Hospital (Health care for Women and the Newborn), 
**www.fernandezhospital.com
<http://www.fernandezhospital.com>*

*Director, Prerna Anaesthesia and Critical Care Services Pvt Ltd 
(www.prernaanaesthesia.com <http://www.prernaanaesthesia.com>)*
*Hyderabad, India.*


On Mon, Feb 23, 2015 at 11:02 PM, Riley, Bonnie S. < 
[email protected]> wrote:

>  Hello,
>
>
>
> Is anyone here using any version of the Surviving Sepsis Campaign in 
> an obstetrical population?
>
>
>
> If so, would you share your experience?  I work Risk Management.  My 
> background is both ICU and L&D.  I see a need for the protocol, and so 
> does one of the physicians.  We are researching successful strategies 
> for implementation.
>
>
>
> Thanks
>
>
>
> Bonnie Riley MSN, RNC, CPHQ
>
> Performance Improvement Coordinator
>
> Medical Staff Services M2843
>
> Houston Methodist Sugar Land Hospital
>
> Office: 281-274-7869
>
> Fax:  281-274-8028
>
>
>
> Houston Methodist. Leading Medicine.
>
> Houston Methodist is ranked by *U.S.News & World Report* as one of 
> America's "Best Hospitals" in 11 specialties and designated as a 
> Magnet hospital for excellence in nursing. Houston Methodist has also 
> been named to *FORTUNE? * Magazine's "100 Best Companies to Work For?" 
> list for nine years in a row. Visit us at houstonmethodist.org. Follow 
> us at twitter.com/MethodistHosp and facebook.com/HoustonMethodist.
>
> ***CONFIDENTIALITY NOTICE*** This e-mail is the property of Houston 
> Methodist and/or its relevant affiliates and may contain restricted 
> and privileged material for the sole use of the intended recipient(s). 
> Any review, use, distribution or disclosure by others is strictly prohibited.
> If you are not the intended recipient (or authorized to receive for 
> the recipient), please contact the sender and delete all copies of the 
> message.
> Thank you.
>
> _______________________________________________
> Sepsisgroups mailing list
> [email protected]
> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o
> rg
>
>
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