Data of 1396 ED patients from a three-month period were automatically evaluated using an application according to SEP-1 (2 SIRS, source of infection, and organ dysfunction, all criteria presented within six-hour timeframe, or provider’s documentation) and qSOFA (at least two of the following: RR>22, BP<100, and altered mental status in presence of infection). · 169 patients were identified with sepsis or septic shock by SEP-1. · qSOFA: provider advisory for sepsis for 57 patients. · 36 of qSOFA patients were also identified by SEP-1. · 6 of (qSOFA and SEP-1) patients had the same Time Zero. · 25 of (qSOFA and SEP-1) patients had Time Zero identified earlier by SEP-1 in average of 1 hour 57 minutes. 5 patients had earlier Time Zero by qSOFA in average of 49 minutes. · 21 patients not identified by SEP-1. Main reason – not at least two SIRS criteria Conclusion: SEP-1 is superior in identifying sepsis and septic shock patients in ED. qSOFA is useful for additional clinical advisory especially for patients that didn’t exhibit at least of 2 SIRS criteria in the six-hour timeframe. SEP-1 might consider adding altered mental status as an organ dysfunction. SEP-1 might consider BP<100 instead of BP<90. Daniela Markova, Nursing Informatics student (graduation April, 2016) 281-814-8833 > From: [email protected] > Subject: Sepsisgroups Digest, Vol 196, Issue 4 > To: [email protected] > Date: Tue, 15 Mar 2016 12:08:43 -0700 > > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Severe Sepsis with Initial Lactate <4, repeat 3hrs later > >4-?Shock or not (PAMELA J. ANDERSON) > 2. Severe sepsis with inital lactate <4, repeat >4 > (PAMELA J. ANDERSON) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Thu, 10 Mar 2016 14:19:40 +0000 > From: "PAMELA J. ANDERSON" <[email protected]> > To: "[email protected]" > <[email protected]>, > "[email protected]" > <[email protected]> > Subject: [Sepsis Groups] Severe Sepsis with Initial Lactate <4, repeat > 3hrs later >4-?Shock or not > Message-ID: > > <ac508240ef24e743a1e86965de72ace28b2a8...@sb01mstmbx07.sb.trinity-health.org> > > Content-Type: text/plain; charset="iso-8859-1" > > > > v5.0b Specs indicate septic shock presentation date and time is determined by > persistent hypotension... OR tissue perfusion present as evidenced by INITIAL > lactate >=4. > > Severe sepsis was present @ 09:12, with the initial lactate of 3.6. The > repeat done @ 12:01 was 6.7 (30cc/kg was given). > > Because there was no documentation of "septic shock", and the patient was not > hypotensive at the end of the bolus, based on the verbiage from the specs, I > would answer, "NO" to the question of whether Septic Shock was present. > Any thoughts? > Thanks- > Pam > > Pamela Anderson, BSN, RN > Clinical Data Abstractor > Sepsis Coordinator > Loyola University Health System > Center for Clinical Excellence > 2160 S. First Avenue | Bldg 105-3915 | Maywood, IL 60153 > (O) 708-216-5544 | (F) 708-216-7867 | (E) [email protected] > > > > CONFIDENTIALITY NOTICE** This email communication and any attachments may > contain confidential and privileged PHI for the use of the designated > recipients named above. Distribution, reproduction or any other use of this > transmission by any party other than the intended recipient is prohibited. > If you have received this communication in error, please notify the sender > immediately. > > > > > Confidentiality Notice: > This e-mail, including any attachments is the property of Trinity Health and > is intended for the sole use of the intended recipient(s). It may contain > information that is privileged and confidential. Any unauthorized review, > use, disclosure, or distribution is prohibited. If you are not the intended > recipient, please delete this message, and reply to the sender regarding the > error in a separate email. > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160310/229af46a/attachment.html> > > ------------------------------ > > Message: 2 > Date: Thu, 10 Mar 2016 14:35:51 +0000 > From: "PAMELA J. ANDERSON" <[email protected]> > To: HQTH DISGROUP SEPSIS COORDINATORS DG U > <[email protected]>, > "[email protected]" > <[email protected]>, > "[email protected]" > <[email protected]> > Subject: [Sepsis Groups] Severe sepsis with inital lactate <4, repeat > >4 > Message-ID: > > <ac508240ef24e743a1e86965de72ace28b2a8...@sb01mstmbx07.sb.trinity-health.org> > > Content-Type: text/plain; charset="iso-8859-1" > > Good Morning! Just looking for some verification of what I'm thinking- > > Based on what I see in the v5.0b specs, Septic Shock present, using the > criteria of severe sepsis present + lactate >=4 is based on the INITIAL > lactate done related to the time of presentation for severe sepsis, so that > if the repeat lactate done 3 hours later is now >4, I would answer "No" to > the question of whether shock was present since it was not the initial > lactate. The patient did receive 30cc/kg, did not have persistent > hypotension, and there was no documentation of septic shock in the record. > > Any thoughts? Thanks! > Pam > > Pamela Anderson, BSN, RN > Clinical Data Abstractor > Sepsis Coordinator > Loyola University Health System > Center for Clinical Excellence > 2160 S. First Avenue | Bldg 105-3915 | Maywood, IL 60153 > (O) 708-216-5544 | (F) 708-216-7867 | (E) [email protected] > > > > CONFIDENTIALITY NOTICE** This email communication and any attachments may > contain confidential and privileged PHI for the use of the designated > recipients named above. Distribution, reproduction or any other use of this > transmission by any party other than the intended recipient is prohibited. > If you have received this communication in error, please notify the sender > immediately. > > > > > Confidentiality Notice: > This e-mail, including any attachments is the property of Trinity Health and > is intended for the sole use of the intended recipient(s). It may contain > information that is privileged and confidential. Any unauthorized review, > use, disclosure, or distribution is prohibited. If you are not the intended > recipient, please delete this message, and reply to the sender regarding the > error in a separate email. > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160310/86483700/attachment-0001.htm> > > ------------------------------ > > Subject: Digest Footer > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > ------------------------------ > > End of Sepsisgroups Digest, Vol 196, Issue 4 > ********************************************
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