tracsbook

How is everyone defining sepsis? Is it the results of a sputum culture? Wound culture? Blood culture? If it is a blood culture, then we would be entering almost every patient with sepsis in the complication part on NTRACS. And if it is a complication, does it have to be presented at M&M weekly or can it just be entered into NTRACS?

Had that problem when I inherited the burn registry. There was no definition in use that had been agreed upon by the MDs. So, I stole a page from the trauma playbook here at MU and created a data dictionary that the medical director placed his blessing on. The definition for Septicemia (sepsis) is as follows:

Documented by a physician with at least 2 or more of the following: 1. Core temperature of > 38 Centigrade or < 36 Centigrade 2. WBC > 12,000 or < 4000 or > 10% immature bands 3. Positive Blood Culture (excluding contamination) 4. Clinically obvious source of infection 5. HR > 90 beats/min or RR > 20 breaths/min

The above is from the ACS and our trauma services and had to be modified for large burns to account for the consistent fever state of them. The definition for >or= 20% TBSA burn has a temperature ceiling of 39.5 Centigrade. We did this with all of the complications to maintain a consistency in data entry.

At MU we have opted not to present every burn septicemia complication at M&M. Complications are noted on a weekly basis at which time the director determines which need presentation at the surgical M&M. If a trend is noted (e.g. a particular organism), we will follow it and present the trend as well as the resolution at M&M.

Does this help?