Laboratory Order Case study 4: Suspected sepsis The patient Sara Speckmann, born 12. 12. 1975, has been in the Cantonal Hospital for some time. Last night her general condition deteriorated massively. As there is a suspicion of sepsis, the senior physician in charge, Dr Hans Hauser, orders Blood to be taken from her in the morning for a Blood culture. 30 minutes later, another aerobic and an anaerobic Blood culture is taken, as well as a urine sample. All five samples are further processed in the external laboratory Pipette. There, germs are detected in all materials and then identified by mass spectrometry. The pathogens “Klebsiella pneumoniae” and “Escherichia coli” were detected in the four Blood culture bottles, and the bacterium “Streptococcus mitis” was also detected in one aerobic bottle. The germ identified in the urine sample is normally not pathogenic. An antibiogram is made of all three pathogens detected in the Blood. This shows that the two active substances “amoxicillin+clavulanic acid” and “ceftriaxone” are effective against all three germs. The microbiologist regularly informs Dr Hans Hauser about the various partial results.
Laboratory Order with Service Request 4-sepsis
id: SaraSpeckmann meta: identifier: 80756011110123400006 name: Sara Speckmann gender: FEMALE birthDate: Dec 12, 1975 maritalStatus: verheiratet (Details : {$ech-11-maritalstatus code '2' = '2', given as 'verheiratet'}) Communications - Language Preferred * Deutsch (Schweiz) (Details : {urn:ietf:bcp:47 code 'de-CH' = 'German (Region=Schweiz)) true
Generated Narrative: Practitioner HansHauser Profile: CH Core Practitioner identifier: GLN/7601000050700, urn:oid:2.16.756.5.30.1.123.100.2.1.1/L248519 name: Hans Hauser (Official) telecom: ph: 038 888 22 11(Work), hans.hauser@gruppenpraxis.ch
Generated Narrative: Organization Kantonsspital Profile: CH Core Organization identifier: GLN/7601000235503 name: Kantonsspital Zug telecom: +41 45 334 55 66, info@kantonsspital.zug.ch, http://www.kanstonsspital.zug.ch address: Seestrasse 14 Postfach 14 Zug 8000 Schweiz (work)
Generated Narrative: PractitionerRole HansHauserKantonsspital Profile: CH Core PractitionerRole practitioner: Practitioner Hans Hauser (official) organization: Organization Kantonsspital Zug
Generated Narrative: Practitioner MarcMustermann Profile: CH Core Practitioner identifier: GLN/7601000050700, urn:oid:2.16.756.5.30.1.123.100.2.1.1/L248519 name: Marc Mustermann (Official) telecom: ph: 033 444 22 11(Work), marc.mustermann@gruppenpraxis.ch
Generated Narrative: Organization Gruppenpraxis Profile: CH Core Organization EPR identifier: GLN/7601000241115 name: Gruppenpraxis Olten telecom: +41555556677, info@gruppenpraxis.ch, http://www.gruppenpraxis.ch address: Gerbergasse 12 Olten 4600 CH
Generated Narrative: PractitionerRole MarcMustermannGruppenpraxis Profile: CH Core PractitionerRole practitioner: Practitioner Marc Mustermann (official) organization: Organization Gruppenpraxis Olten
Generated Narrative: Practitioner EvaErlenmeyer Profile: CH Core Practitioner identifier: GLN/7601000050717, urn:oid:2.16.756.5.30.1.123.100.2.1.1/Y274589 name: Eva Erlenmeyer (Official) telecom: ph: 033 444 55 66(Work), eva.erlenmeyer@labor-pipette.ch
Generated Narrative: Organization LaborPipette Profile: CH Core Organization identifier: GLN/7601000234407 name: Labor Pipette telecom: +41223345566, info@labor-pipette.ch, http://www.labor-pipette.ch address: Laborstrasse 23 Olten 4600 CH
Generated Narrative: PractitionerRole EvaErlenmeyerLaborPipette Profile: CH Core PractitionerRole identifier: urn:oid:2.16.756.5.30.1.123.100.2.1.1/K333333 practitioner: Practitioner Eva Erlenmeyer (official) organization: Organization Labor Pipette
Generated Narrative: Specimen Blood-bactec-plus-4-sepsis status: Available type: Blood sample subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) request: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening Collections - Collector Collected[x] BodySite * Practitioner Hans Hauser (official) 2025-03-16 06:20:17+0000 --> 2025-03-16 06:50:17+0000 Structure of superficial vein of left upper limb (body structure) container identifier: 95ab0fb1-6d1c-40f0-9aaa-a68f29238a4e-bactec-plus description: Two BACTEC™ PLUS Aerobic/F Culture Vial, cap color: grey-blue type: Aerobic blood culture bottle (physical object) container identifier: 92af0fee-1aeb-472e-8b57-a885ba33b745-bactec-plus description: Two BACTEC™ PLUS Anaerobic/F Culture Vial, cap color: purple type: Anaerobic blood culture bottle (physical object) note: Each container type contains two blood samples taken 30 minutes apart, so we get 4 vials in total
Structure of superficial vein of left upper limb (body structure)
Two BACTEC™ PLUS Aerobic/F Culture Vial, cap color: grey-blue
Aerobic blood culture bottle (physical object)
Two BACTEC™ PLUS Anaerobic/F Culture Vial, cap color: purple
Anaerobic blood culture bottle (physical object)
Each container type contains two blood samples taken 30 minutes apart, so we get 4 vials in total
Generated Narrative: Specimen Blood-4-sepsis status: Available type: Blood sample subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) request: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening Collections - Collector Collected[x] BodySite * Practitioner Hans Hauser (official) 2015-08-16 06:40:17+0000 Structure of superficial vein of left upper limb (body structure) Containers - Type * General specimen container (physical object) note: Specimen is grossly lipemic
General specimen container (physical object)
Generated Narrative: Specimen Serum-4-sepsis identifier: 11111-15394-75465 accessionIdentifier: 22222-bc987-dd888 status: Available type: Serum specimen (specimen) subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) receivedTime: 2023-12-01 16:40:17+0000 request: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening Collections - Collector Collected[x] * Practitioner Hans Hauser (official) 2023-12-01 06:40:17+0000 Containers - Type * General specimen container (physical object)
Generated Narrative: ServiceRequest 4-sepsis-ServiceRequest Profile: CH LAB-Order-SR identifier: Placer Identifier/Y274589 status: Active intent: Original Order priority: Urgent subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) requester: PractitionerRole reasonCode: Screening for sepsis (procedure)
Generated Narrative: ServiceRequest 4-sepsis-ServiceRequestHbHt Profile: CH LAB-Order-SR identifier: Placer Identifier/Y274589 basedOn: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening status: Active intent: Original Order priority: Urgent code: Hemoglobin and Hematocrit panel - Blood subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) requester: PractitionerRole reasonCode: Screening for sepsis (procedure) specimen: Specimen: status = available; type = Blood sample; note = Specimen is grossly lipemic
Generated Narrative: ServiceRequest 4-sepsis-ServiceRequestCBCDiff Profile: CH LAB-Order-SR identifier: Placer Identifier/Y274589 basedOn: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening status: Active intent: Original Order priority: Urgent code: CBC W Auto Differential panel - Blood subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) requester: PractitionerRole reasonCode: Screening for sepsis (procedure) specimen: Specimen: status = available; type = Blood sample; note = Specimen is grossly lipemic
Generated Narrative: ServiceRequest 4-sepsis-ServiceRequestGrowth Profile: CH LAB-Order-SR identifier: Placer Identifier/Y274589 basedOn: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening status: Active intent: Original Order priority: Urgent code: Microorganism preliminary growth detection panel - Blood by Culture orderDetail: New order/service subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) requester: PractitionerRole reasonCode: Screening for sepsis (procedure) specimen: Specimen: status = available; type = Blood sample; note = Each container type contains two blood samples taken 30 minutes apart, so we get 4 vials in total
Microorganism preliminary growth detection panel - Blood by Culture
Generated Narrative: ServiceRequest 4-sepsis-ServiceRequestCRP Profile: CH LAB-Order-SR identifier: Placer Identifier/Y274589 basedOn: ServiceRequest: identifier = Placer Identifier: Y274589; status = active; intent = original-order; priority = urgent; reasonCode = Sepsis screening status: Active intent: Original Order priority: Urgent code: C reactive protein [Mass/Volume] in Serum or Plasma subject: Sara Speckmann Female, DoB: 1975-12-12 ( urn:oid:2.16.756.5.30.1.123.100.1.1.1#80756011110123400006) requester: PractitionerRole reasonCode: Screening for sepsis (procedure) specimen: Specimen: identifier = 11111-15394-75465; accessionIdentifier = 22222-bc987-dd888; status = available; type = Serum specimen (specimen); receivedTime = 2023-12-01 16:40:17+0000
C reactive protein [Mass/Volume] in Serum or Plasma