That is a good question. I wouldn't take infiltrates, as that could be anything. It's often an infection, but it could also be pulmonary edema, hemorrhage, etc. I would be interested to hear if others are taking infiltrates in the xray.
Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center 484-476-8092 Pager: 5240 [cid:[email protected]] From: Weber, Melissa [mailto:[email protected]] Sent: Tuesday, February 16, 2016 8:04 AM To: Belfi, Karen; [email protected] Subject: RE: Severe and shock presentation times Thank you Karen. Wouldn't bilateral infiltrates count as infection??? What are your thoughts on the prior antibiotics? From: Belfi, Karen [mailto:[email protected]] Sent: Monday, February 15, 2016 10:27 AM To: Weber, Melissa; [email protected]<mailto:[email protected]> Subject: RE: Severe and shock presentation times Do you have documentation of infection? If not, you don't have severe sepsis, and therefore don't have septic shock. Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center 484-476-8092 Pager: 5240 [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Weber, Melissa Sent: Friday, February 12, 2016 10:38 AM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] Severe and shock presentation times I am not sure how to post this or reply to the feed. Can you please post for me or tell me how and I would be happy to do it myself. Thanks... Difficult case can somebody please help.... 1/21 Patient in ICU on Bipap with RAF and CHF. Not on antibiotics since 1/18. (Was on Zosyn from 1/3 through 1/18) 1/22 patient becomes more lethargic with increased SOB and bilateral infiltrates on CXR: 1000 MAP 44 1045 Intubated 1059 Fluids started No documentation of severe sepsis or septic shock at all. No blood cultures drawn 1139 Pressors started 1518 Antibiotics restarted 1726 Fluids finished No persistent hypotension (patient maintained on pressors already) 1805 First lactic acid drawn 1857 Results of LA 2.3 The initial LA is <4, No persistent hypotension (but on pressors already) and no MD or MLP documentation of severe or shock.... Is shock present at all by definition????? Can I exclude this case based on prior antibiotics? Thoughts on a severe sepsis time and/or a septic shock time? Thank you in advance, Melissa Weber RN, BSN St. Charles Hospital Infection Prevention [email protected]<mailto:[email protected]> Phone (631) 474 - 6110 Beeper 558 - 0405 The information in this e-mail, and any attachments therein, is confidential and for use by the intended addressee only. If this message is received by you in error please do not disseminate or read further. Please reply to the sender that you have received the message in error, then delete the message. Although Catholic Health Services of Long Island attempts to sweep e-mail and attachments for viruses, it does not guarantee that either are virus-free and accepts no liability for any damage sustained as a result of viruses. Thank you. The information in this e-mail, and any attachments therein, is confidential and for use by the intended addressee only. If this message is received by you in error please do not disseminate or read further. Please reply to the sender that you have received the message in error, then delete the message. Although Catholic Health Services of Long Island attempts to sweep e-mail and attachments for viruses, it does not guarantee that either are virus-free and accepts no liability for any damage sustained as a result of viruses. Thank you.
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