Sepsis protocol?

Specialties MICU

Published

My co-worker showed me this website last week that graphed how the number of deaths r/t sepsis is increasing and becoming just as high as those r/t MI's. (I wish I would have written down the site, but I didn't.)

Where I'm at, we don't have a set protocol for septic pts like we do for pts with MI's, CHF, PNE. For ex, for a MI pt, we have a protocol for aspirin, beta blocker, ACE/ARB at discharge, etc... (something called "core measures")

And I've only had a few septic pts (still a new grad), but I haven't noticed a "trend" or protocol that the docs might go by.

Do any of you have such a thing?

Although I know every pt has a unique situation in one way or another, are there things you can just expect to be done w/ septic pts that are universal?

Thanks in advance :)

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Specializes in CCU/CVU/ICU.
My co-worker showed me this website last week that graphed how the number of deaths r/t sepsis is increasing and becoming just as high as those r/t MI's. (I wish I would have written down the site, but I didn't.)

Where I'm at, we don't have a set protocol for septic pts like we do for pts with MI's, CHF, PNE. For ex, for a MI pt, we have a protocol for aspirin, beta blocker, ACE/ARB at discharge, etc... (something called "core measures")

And I've only had a few septic pts (still a new grad), but I haven't noticed a "trend" or protocol that the docs might go by.

Do any of you have such a thing?

Although I know every pt has a unique situation in one way or another, are there things you can just expect to be done w/ septic pts that are universal?

Thanks in advance :)

Yes we have a sepsis 'protocol'...or 'algorhythm' or something like that. At my facility it was a push to get things started as soon as possible, and treat the patients in a timely manner. However, MOST of the time this 'protocol' is just disregarded and things just get done. (it's basically an order-set...so if not pulled and signed by an MD it stays out of the chart...and is not a mandatory process).

Just an FYI... a big reason why some hospitals have gone to these 'protocols' is because of the advent of Xigris.Eli Lilly has pushed this drug down the throats of hospitals/doctors throughout the country and have regurgitated ad-nauesum its potential benefits (and spent bazillions in the process). Because of this, Lilli reps are self-described 'sepsis experts' (and bring my unit lunch once every few months!)... Now, if you look at any(vast majority) sepsis protocol/algorhythm you'll note that near the end the path leads to the initiation of Xigris. Hmmm.

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Specializes in icu,ccu, er, corrections.

I have worked in several ER's and some have a protocol and some don't. I think it is better to have one....get these pts identified and started on the antibiotics, etc.

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Specializes in Emergency, Trauma.

Sepsis is a huge deal at our hospital and we do have a protocol that starts with a sepsis screening sheet to indentify SIRS, MODS, and pts who are candidates for Early Goal Directed Therapy. If the pt is a candidate for EGDT, then we have an algorithm to follow with the goal of CVP>=8, MAP>=65, and mixed venous saturation of >=70% within 6 hours of initiating the protocol. The algorithm includes orders for IVF, pressors, and PRBC transfusions to meet these goals if needed.

There's a lot of information/research out there on this topic; try www.sepsis.com or go on www.ihi.org and look up the Surviving Sepsis Campaign.

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although the unit that i work doesnt have a sepsis protocol..we would be guided by the recommendation from the surviving sepsis campaign.

surviving sepsis campaign guidelines for management of severe sepsis and septic shock -- ngc - n...

source control interventions may cause further complications such as bleeding, fistulas, or inadvertent organ injury; in general, the intervention that acc...

http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=4911 | email | save

try checking the site very useful and informative

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Specializes in Critical Care, Pediatrics, Geriatrics.

we use a screening tool and a sepsis bundle (protocol) that focuses on early identification, cultures, ID consult, abx therapy...the nurse can screen the pt and initiate a few things, but we mainly contact ID asap and get a physician on the case

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Specializes in critical care,flight nursing.

WE have a protocol at our hospital. It start right at triage in the ER and from there 3 possibilites: they go to the ICU,get admited by what we call hospitalist or medecine. Basicly the role of triage is to try to catch patient when in SIRS or early sepsis and prevent them to go further. Then we have pre set oder sheet. When move to the ICU they have a similar aproach. They have objectives to reach in the first 24 hour. Unfortunetly, I did't work there since the protocol has started. But I will soon!8)

!8)

SEPSISTREATMENTCHECKLISTJuly15.doc

SepsisERalgorithm0705.doc

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Yes we have a sepsis 'protocol'...or 'algorhythm' or something like that. At my facility it was a push to get things started as soon as possible, and treat the patients in a timely manner. However, MOST of the time this 'protocol' is just disregarded and things just get done. (it's basically an order-set...so if not pulled and signed by an MD it stays out of the chart...and is not a mandatory process).

Just an FYI... a big reason why some hospitals have gone to these 'protocols' is because of the advent of Xigris.Eli Lilly has pushed this drug down the throats of hospitals/doctors throughout the country and have regurgitated ad-nauesum its potential benefits (and spent bazillions in the process). Because of this, Lilli reps are self-described 'sepsis experts' (and bring my unit lunch once every few months!)... Now, if you look at any(vast majority) sepsis protocol/algorhythm you'll note that near the end the path leads to the initiation of Xigris. Hmmm.

Have you ever used it? The first time I did was on a friend and coworker with severe pancreatitis..it is some kick butte stuff. We wanted to asked Lillies to have t-shirts made "I survived Xigris" still waiting on reply.

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Specializes in icu.

We have recently developed and implemented a sepsis protocol at my hospital for our ICU. We are currently working on expanding the program to include the ER and med-surg floors.

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We don't have a protocol at our hospital but we follow the SEPSIS SIX PACK recommendations. We have had successful outcomes using this as a tool. I think the most important is early recognition and early treatment. I think there needs to be more education in ER departments and on the floors on how to treat sepsis i.e adequate volume resusitation, blood cultures and antibiotic therapy. If we start these early the pt has better outcomes.

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We don't have a protocol at our hospital but we follow the SEPSIS SIX PACK recommendations. We have had successful outcomes using this as a tool. quote]

Would you mind sharing what the Sepsis Six Pack recommendations consist of? I've never heard of it.

Thanks for all of your replies! All of your info has been very helpful...for me and hopefully soon, for my hospital...as I hope to see a standard regarding sespis come soon.

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Hello

The sepsis six pack is early goal directed therapy that entails fluid to keep cvp greater than 12, pressors, xigris, steroids, antibiotics and cultures. If you read the River's Trial it is good article on treating sepsis.

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