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| '''IF''' a patient has been on a device to assist respiration (ventilator) either continuously or intermittently through a tracheostomy or endotracheal tube (ETT) for at least '''48 hours before onset of infection, or new infection.''' (start counting the 48 hours from the time of intubation no matter where this intubation occurs '''before''' or '''during''' an admission to the ICU.) per Dr. Olafson. | | '''IF''' a patient has been on a device to assist respiration (ventilator) either continuously or intermittently through a tracheostomy or endotracheal tube (ETT) for at least '''48 hours before onset of infection, or new infection.''' (start counting the 48 hours from the time of intubation no matter where this intubation occurs '''before''' or '''during''' an admission to the ICU.) per Dr. Olafson. |
| *Keep in mind [[VAP#VAP_Attribution_Transfer_Rule | VAP Attribution TRANSFER RULE]] when transferring between ICU's, in that a patient could aready have been on a ventilator for 48 hrs or more prior to transferring into to your ICU.
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| *If a patient had a CAP or HAP previously during the same admission and then develops pneumonia again, meeting the VAP criteria, it is only a VAP if it is a new organism. If it is the same original organism, then the CAP or HAP has not completely been resolved. Do not code these as a VAP.
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| {{Discussion}}
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| * What about early VAP with a different organism(within a week of CAP for example) can it develop in a patient with unresolved CAP? Or are we saying the CAP needs to be resolved before we can call anything past the 48 hour mark VAP?
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| ** If at the time of the new, different organism culture, there is an apparent obvious occurance or worsening of the VAP criteria (fever, sputum, vent, etc) then I would say it is a VAP even if it is close in timing to the original CAP or HAP.
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| ** I believe we chose that definition because it is clear and unambiguous. Any definition that accommodates a possibly resolved CAP would lead to endless discussions, and also would be open to different interpretations by different collectors or physicians. Ttenbergen 09:42, 2017 January 19 (CST)
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| **I am not sure what you are saying here Tina. We use VAP criteria that is with the CDC. We don't write our own criteria. Everyone understands the criteria. This discussion is about a unique case that we are sorting out. This discussion will need to be moved because it is currently located in the middle of the VAP criteria which is important to remain separate to maintain the flow.--[[User:LKolesar|LKolesar]] 13:53, 2017 January 19 (CST)
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| '''AND''' if they demonstrate new, worsening or persistent infiltrate on x-ray compatible with pneumonia | | '''AND''' if they demonstrate new, worsening or persistent infiltrate on x-ray compatible with pneumonia |