Re: [Sepsis Groups] Septic shock question

2017-03-28 Thread Nielsenshultz, Yara 
I would say yes. A lactate >/= 4 is automatically septic shock (as long as the 
patient also meets criteria for severe sepsis, which it looks like they do).

YARA NIELSENSHULTZ, RN, BSN, MS
Clinical Quality Manager
EmCare, North Division
Direct: (215) 442-5122
Fax: (215) 957-2875
www.EmCare.com

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Davis, Diana
Sent: Monday, March 20, 2017 1:59 PM
To: 'sepsisgroups@lists.sepsisgroups.org' 
Subject: [Sepsis Groups] Septic shock question


Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator
CMH Regional Health System
937-382-9315



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[Sepsis Groups] Septic shock question

2017-03-28 Thread Mills, Mary 
For CMS , you have to have severe sepsis before you have septic shock.
When you say no source identified, are you saying that there is no 
documentation of a suspected infection within the 6 hr window criteria?  If 
that is the case, then you can't meet all the criteria components for severe 
sepsis.

Is there a reason the white count was so low documented in the note (recent 
chemo, etc)? If there is and the provider has documented it as such, you can't 
use that white count as your 2nd SIRS.

In terms of just good patient care and reality, yes, this pt clinically is in 
septic shock. Per the most recent specs manual, a decrease of 10% of the 
30mL/kg of crystalloids is acceptable, but that would be 1978.56. Not enough

I hope this help :-)
Sepsis, she is a nasty little bugger :-)

Mary Mills RN, BSN, CPHQ, CPPS
Centegra Health System

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   1. Septic shock question (Davis, Diana)


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To: "'sepsisgroups@lists.sepsisgroups.org'"

Subject: [Sepsis Groups] Septic shock question
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Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator
CMH Regional Health System
937-382-9315

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Re: [Sepsis Groups] Sepsisgroups Digest, Vol 239, Issue 1

2017-03-28 Thread Pierce1, Marie 
Potential shock pt:

If there is any documentation within the 6 hour timeframe to indicate lactate 
elevation is due to an infectious process with unknown source--then I would say 
yes.

Otherwise, if no indication of infectious source it would be excluded.

Marie Pierce MSN, RN, CCDS
Quality Specialist
Quality and Resource Management
McLaren Bay Region
email: marie.pier...@mclaren.org
office phone: (989) 894-3881

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   1. Septic shock question (Davis, Diana)


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Message: 1
Date: Mon, 20 Mar 2017 17:58:40 +
From: "Davis, Diana" 
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Subject: [Sepsis Groups] Septic shock question
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Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator CMH Regional Health System
937-382-9315

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Re: [Sepsis Groups] Septic shock question

2017-03-28 Thread Carter, Anne 
We also need a source, or at least suspected source though……

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Gibbs, Katie
Sent: Tuesday, March 21, 2017 10:46 AM
To: 'Davis, Diana' ; 
'sepsisgroups@lists.sepsisgroups.org' 
Subject: Re: [Sepsis Groups] Septic shock question

Note, THIS IS AN EXTERNAL EMAIL. It did not originate at Hackensack Meridian 
Health Network.

Yes pt is considered septic shock for lactate greater than 4.

One thing on the fluids/weight…Something I have learned is that my triage in 
the ED the nurse’s enter the weight, so this is the weight that shows up for 
the ED docs to get there 30cc/kg bolus amount from.  The weight is often 
significantly different later in the visit, especially the discharge weight, so 
I am always sure to check the initial documented weight and use it for my fluid 
calculation.  It has helped my compliance with this measure several times.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Davis, Diana
Sent: Monday, March 20, 2017 1:59 PM
To: 'sepsisgroups@lists.sepsisgroups.org'
Subject: [Sepsis Groups] Septic shock question


Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator
CMH Regional Health System
937-382-9315



Disclaimer

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Re: [Sepsis Groups] Potential new treatments for sepsis being studied

2017-03-28 Thread Amanda Sigala 
Dr. Marik spoke last week at the UW Medicine Pacific Northwest Sepsis
Conference on "The Cure for Sepsis" and "Fluid Management of Hemodynamic
Assessment." He gave very interesting and popular talks, and I'm
recommending to the planning committee that he come back for next year's
conference.

 

Amanda Sigala RN, BSN, MPH

Clinical Quality Specialist

Quality Improvement

Harborview Medical Center

Box 359731

325 Ninth Avenue

Seattle, WA 98104

Phone: 206-744-9433

af...@uw.edu

 

 

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-Original Message-
From: lucinda.brasw...@hcahealthcare.com
[mailto:lucinda.brasw...@hcahealthcare.com] 
Sent: Thursday, March 23, 2017 2:52 PM
To: sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] Potential new treatments for sepsis being studied

 

 

http://www.npr.org/sections/health-shots/2017/03/23/521096488/doctor-turns-u
p-possible-treatment-for-deadly-sepsis

 

This was very interesting.  Looking forward to the completed study to see if
it works out as a viable treatment. 

 

Lucinda Rosebush, RN, BSN 

Sepsis Coordinator 

Capital Regional Medical Center

Tallahassee, Florida 

 
lucinda.brasw...@hcahealthcare.com  

 

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Today's Topics:

 

   1. Re: Antibiotics >24 prior to presentation of Sepsis

  (DHILLON, ROOPINDER)

 

 

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Subject: Re: [Sepsis Groups] Antibiotics >24 prior to presentation of

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