So I received a patient into a "Red" Zone... Seizure... within 5 minutes of this patient's arrival, they had been fully intaked (aka Triage done, ESI assignment), physician was at bedside, initial interventions (IV access, blood drawn, etc)...

I had to take the time to actually place a patient sticker on a form, and circle "yes" or "no" on a screening form... answering several questions...

I did this, only after I determined my patient was stable, and I was waiting for our Pharmacy to send me a medication that we don't have/stock in the Emergency Department.  The actual "Nursing Intervention," that is filling out the form, occurred about 30 minutes after the patient arrived, still within the time limit of this Initiative...  but still!

I am disgusted!  I knew that this patient wasn't Septic.  But who am I?  I am, "just a nurse."


Yet I found that this patient fell into the "inclusion" criteria for Sepsis... yet they were not Septic...

Even the subsequent lab results, confirmed they were a candidate for a "pathway" for 'severe' Sepsis...  yet they were not Septic...

Had the ED Physician not listened to me, nor recognized the same thing, there could have been a very different outcome for my patient!  This patient had a lesion on their brain, identified by CT Scan... a cause for there seizure.  Prolonged seizures causes increased body temperature, increased lactate levels, increased CPK... a bump in WBC's...

The next step would have been an LP... that may have been deleterious if it had been performed...

Give thanks to whoever, but my persistence, maybe even my "foot-dragging," as a Professional Nurse... I can honestly say I saved a life!

Yet contrast that with a patient that is hypoxic, hypotensive, tachycardic, tachypnic, mottled, Capillary Refill >5 seconds...again, I as a Professional Nurse knew that this patient was sick!  Luckily the Sepsis Screening wasn't in effect yet!


An ED Physician taking a Respiratory Pathway...  The instance of a nurse, the change of course... Sepsis, an ICU admission, Vascular & Cardiology consults...

I saved a life that day too!


Oh well...