In this situation, you would use 9:40 - because this is the moment when you have all three criteria met: SIRS, Infection, and organ dysfunction. You use the latest time of those three elements. If you also have physician documentation of severe sepsis, you would that time, if it were earlier.
In this case, 9:40 would ALSO be your septic shock presentation time because of the LA >4. joe Joseph Clement, MS, RN, CCNS Clinical Nurse Specialist San Francisco General Hospital ph: 415206-6174 pg: 415 327-0220 ________________________________ From: Sepsisgroups <[email protected]> on behalf of Jennifer L Halligan [SJGH] <[email protected]> Sent: Thursday, October 8, 2015 10:07 AM To: [email protected] Subject: [Sepsis Groups] lactate >4 prior to meeting severe sepsis criteria question Hello group, My question is regarding septic shock r/t lactate > 4. What if the lactate returns/reports prior to the criteria met for severe sepsis? For example: 0900 tachycardia and suspected source. 0930 lactate 4.1. 0940 WBC 14.0. What would be "septic shock presentation time"? (just making sure as per guidelines must have severe sepsis AND lactate > 4, does severe sepsis have to be present BEFORE lactate or is it okay to abstract 09:40?) Jennifer Jennifer Halligan, RN Quality Review Nurse San Joaquin General Hospital Tel: 209-468-7471 Fax: 209-468-7011
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