Wiki SEPSIS

[oceangirl752002]

So my understanding about sepsis is that if sepsis is present on admission, it should be coded primary unless it's a catheter associated UTI for example, then that would be primary with sepsis following... my question is this though... a patient has been in the hospital for 4 days due to sepsis and acute respiratory failure. Overnight our nocturnist has a rapid response call to the pnt room due to worsening/acute respiratory failure. In that particular instance, would ARF be the primary dx since that is what the provider was called for or would sepsis still be primary? The documentation reads:

"Rapid response called at approx. 4am in response to her becoming acutely hypoxic, less responsive and oxygen saturation in 70s-80s per RN report. Bipap initiated, she had previously been on Vapotherm to maintain her oxygenation. Transferred back to ICU for acute respiratory deterioration in setting of chronic respiratory failure, pneumonia, sepsis, and COPD."

Thanks.

 

[terribrown]

The sequencing guidelines do not change for your scenario. The only time sepsis would not be sequenced first is if the patient is admitted for a localized infection and develops sepsis after admission. In your description, severe sepsis and acute respiratory failure was present on admission. Just because the patient deteriorated after admission, does not change the sequence required.