VAP - Ventilator Associated Pneumonia: Difference between revisions
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'''Ventilator Associated Pneumonia (VAP) Criteria''': | '''Ventilator Associated Pneumonia (VAP) Criteria''': | ||
*NOTE: We are tracking HOSPITAL ACQUIRED VAP's & not patient's who have acquired an pneumonia while on long term home ventilators (LTV) in the community. If a LTV patient is admitted from the community with an pneumonia, they are to coded as community acquired pneumonia (CAP). (as per Dr. Bruce Light).[[User:TOstryzniuk|TOstryzniuk]] 17:38, 15 December 2008 (CST) | *NOTE: We are tracking HOSPITAL ACQUIRED VAP's & not patient's who have acquired an pneumonia while on long term home ventilators (LTV) in the community. If a LTV patient is admitted from the community with an pneumonia, they are to coded as community acquired pneumonia (CAP). (as per Dr. Bruce Light).[[User:TOstryzniuk|TOstryzniuk]] 17:38, 15 December 2008 (CST) | ||
'''If''' a patient has been on a device to assist respiration (ventilator) continuously through a tracheostomy or endotracheal tube (ETT) for at least '''48 hours''' '''before onset of infection''' | '''If''' a patient has been on a device to assist respiration (ventilator) continuously through a tracheostomy or endotracheal tube (ETT) for at least '''48 hours''' '''before onset of infection''' | ||
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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 | ||
'''and | '''and if at least one''' of the following criteria is met: | ||
* Fever (T > 38) with no other cause | * Fever (T > 38) with no other cause | ||
* Leukopenia WBC(<4X10(9)) or leukocytosis (>12x 10(9)). | * Leukopenia WBC(<4X10(9)) or leukocytosis (>12x 10(9)). | ||
* Altered mental status with no other causes in >69 year old. | * Altered mental status with no other causes in >69 year old. | ||
'''and | '''and if at least one''' of the following criteria is met: | ||
* New onset of purulent secretions | * New onset of purulent secretions | ||
* Change in character of sputum | * Change in character of sputum | ||
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* Increased oxygen or ventilation requirement | * Increased oxygen or ventilation requirement | ||
'''and | '''and if at least one''' of the following criteria is met: | ||
* Pathogen isolated from sputum in the last 48 hours | * Pathogen isolated from sputum in the last 48 hours | ||
* Positive blood cultures not related to another infection | * Positive blood cultures not related to another infection | ||
* Positive pleural fluid culture. | * Positive pleural fluid culture. | ||
== Clarification of coding VAP when moving patients between units in the city == | == Clarification of coding VAP when moving patients between units in the city == | ||