Anita; Yes, it produces over-sensitivity to SIRS, which as you likely know, can occur from the surgical procedure, anesthesia, or other reasons Also; if the patient has a surgical procedure specifically for the purpose of source control, which could occasionally happen for the ortho patient - the patient may still be septic or severely septic, but no additional sepsis bundle elements are required if the bundle was implemented at the time of recognition of the infection. If the patient is simply having an ortho procedure, the case would likely be cancelled if an infection was present - so sepsis bundle would not come into play.
So in general - if the patient's condition worsens after a surgical procedure, as always, contact the surgeon for whatever is required - fluid, antibiotic, blood, etc. But a sepsis screen will likely be falsely positive during the first 12-24 hours post operatively. Most sites who recognize this phenomenon resume sepsis screening on the day following the sx procedure and/or 24 hours after sx. Hope this helps Thanks, MARY ANN BARNES-DALY RN BSN CCRN DC | Clinical Performance Improvement Consultant Sutter Health - Clinical Integration Department | 2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| Office 916.286.6717 | [email protected] "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." ~R. Buckminster Fuller From: Sepsisgroups [mailto:[email protected]] On Behalf Of Anita D. Schrad Sent: Thursday, September 03, 2015 7:31 AM To: [email protected] Subject: [Sepsis Groups] sepsis screening Hello Everyone, We are in the process of implementing the sepsis screening tool and bundles at our facility. We are a small rural hospital, with a 28 bed Med-Surg unit, 13 bed Orthopedic unit and a 6 bed ICU. Some of the physicians have questioned whether we should complete the screening tool on fresh post op Orthopedic patients, as they are likely to have at least one of the SIRS criteria. This may equal a lot of unnecessary lactate levels and cultures being drawn on these patients. Most of which are here for elective surgery. Could some of you share what your facility is doing? Anita Schrad Director of Critical Care & Orthopedics [cid:[email protected]] St. Anthony Regional Hospital 311 South Clark Street, Carroll, IA 51401 Office Phone (712)794-5569 [email protected]<mailto:[email protected]> Electronic Mail Confidentiality Notice: This email and any files transmitted with it may contain confidential information and is intended solely for the use of the individual or entity to who it is addressed. If you are not the intended recipient you are notified that disclosing, copying, distributing or taking any action in reliance on the contents of this information is strictly prohibited and the email should be deleted immediately.
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
