Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-21 Thread Belfi, Karen 
Where do the guidelines state that? I was under the impression that it doesn’t 
matter if it’s arterial or venous.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
[cid:image006.png@01D15389.224F1C90]

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Carter, Anne
Sent: Thursday, January 14, 2016 5:22 PM
To: Andre Vovan; Gerolamo, Jeannine
Cc: sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

As long as ALL future lactic acids are drawn arterially; you cant mix and 
match. Once arterial always arterial.

Anne Carter MS, ACNS-BC, CEN
Coordinator
Outcomes Management
Riverview Medical Center
732-450-2735
acar...@meridianhealth.com<mailto:acar...@meridianhealth.com>


“This document and the information attached is Patient Safety Work Product & as 
such, is privileged and confidential pursuant to the N.J. Patient Safety Act 
and the Federal Patient Safety & Quality Improvement Act of 2005 and should not 
be further disclosed except as permitted by law.”



From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Andre Vovan
Sent: Tuesday, January 12, 2016 6:18 PM
To: Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>>
Cc: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

"Note, this is an external email and did not originate at Meridian Health”.

Venous or arterial line samples are both good.

Andre Vovan, MD, MBA
President/CEO
Newport Critical Care, Inc

On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>> wrote:
Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>
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Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-21 Thread Belfi, Karen 
That is true, but the guidelines do not specify so we are able to use either 
interchangeably, for the purposes of the measure.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
[cid:image001.png@01D1538A.49DD30C0]

From: Carter, Anne [mailto:acar...@meridianhealth.com]
Sent: Wednesday, January 20, 2016 1:51 PM
To: Belfi, Karen; Andre Vovan; Gerolamo, Jeannine
Cc: sepsisgroups@lists.sepsisgroups.org
Subject: RE: [Sepsis Groups] Arterial line versus venous draw

This message was sent securely using 
ZixCorp.<http://www.zixcorp.com/get-started/>



It’s a lab thing…at least our lab told us that the machines are calibrated for 
either arterial or venous blood so you can’t compare arterial results with 
venous…they will be off a little bit.  Since we are so particular with our 
lactates, they told me that you should always send from the same source.

From: Belfi, Karen [mailto:bel...@mlhs.org]
Sent: Wednesday, January 20, 2016 1:48 PM
To: Carter, Anne 
<acar...@meridianhealth.com<mailto:acar...@meridianhealth.com>>; Andre Vovan 
<avo...@npccp.com<mailto:avo...@npccp.com>>; Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>>
Cc: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: RE: [Sepsis Groups] Arterial line versus venous draw

This message was sent securely using 
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"Note, this is an external email and did not originate at Meridian Health”.

Where do the guidelines state that? I was under the impression that it doesn’t 
matter if it’s arterial or venous.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
[cid:image001.png@01D1538A.49DD30C0]

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Carter, Anne
Sent: Thursday, January 14, 2016 5:22 PM
To: Andre Vovan; Gerolamo, Jeannine
Cc: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

As long as ALL future lactic acids are drawn arterially; you cant mix and 
match. Once arterial always arterial.

Anne Carter MS, ACNS-BC, CEN
Coordinator
Outcomes Management
Riverview Medical Center
732-450-2735
acar...@meridianhealth.com<mailto:acar...@meridianhealth.com>


“This document and the information attached is Patient Safety Work Product & as 
such, is privileged and confidential pursuant to the N.J. Patient Safety Act 
and the Federal Patient Safety & Quality Improvement Act of 2005 and should not 
be further disclosed except as permitted by law.”



From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Andre Vovan
Sent: Tuesday, January 12, 2016 6:18 PM
To: Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>>
Cc: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

"Note, this is an external email and did not originate at Meridian Health”.

Venous or arterial line samples are both good.

Andre Vovan, MD, MBA
President/CEO
Newport Critical Care, Inc

On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>> wrote:
Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>
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Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-21 Thread Carter, Anne 
It’s a lab thing…at least our lab told us that the machines are calibrated for 
either arterial or venous blood so you can’t compare arterial results with 
venous…they will be off a little bit.  Since we are so particular with our 
lactates, they told me that you should always send from the same source.

From: Belfi, Karen [mailto:bel...@mlhs.org]
Sent: Wednesday, January 20, 2016 1:48 PM
To: Carter, Anne <acar...@meridianhealth.com>; Andre Vovan <avo...@npccp.com>; 
Gerolamo, Jeannine <jgerol...@abingtonhealth.org>
Cc: sepsisgroups@lists.sepsisgroups.org
Subject: RE: [Sepsis Groups] Arterial line versus venous draw

This message was sent securely using 
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"Note, this is an external email and did not originate at Meridian Health”.

Where do the guidelines state that? I was under the impression that it doesn’t 
matter if it’s arterial or venous.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
[cid:25FFED76-F7F0-4047-910F-0D7077ED1E1E]

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Carter, Anne
Sent: Thursday, January 14, 2016 5:22 PM
To: Andre Vovan; Gerolamo, Jeannine
Cc: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

As long as ALL future lactic acids are drawn arterially; you cant mix and 
match. Once arterial always arterial.

Anne Carter MS, ACNS-BC, CEN
Coordinator
Outcomes Management
Riverview Medical Center
732-450-2735
acar...@meridianhealth.com<mailto:acar...@meridianhealth.com>


“This document and the information attached is Patient Safety Work Product & as 
such, is privileged and confidential pursuant to the N.J. Patient Safety Act 
and the Federal Patient Safety & Quality Improvement Act of 2005 and should not 
be further disclosed except as permitted by law.”



From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Andre Vovan
Sent: Tuesday, January 12, 2016 6:18 PM
To: Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>>
Cc: 
sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

"Note, this is an external email and did not originate at Meridian Health”.

Venous or arterial line samples are both good.

Andre Vovan, MD, MBA
President/CEO
Newport Critical Care, Inc

On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>> wrote:
Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>
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**

Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-21 Thread Sam Farrell 
Hi folks,

It has been our understanding that, for all intents and purposes, venous
and arterial lactate levels can be used interchangeably and that the *trend*
is the important point.

In a really quick look online to illustrate, I came across these...

http://www.ncbi.nlm.nih.gov/pubmed/22745117:

RESULTS:

Six hundred seventy-three Lact(cv)/Lact(a) pairs in 188 patients were
analyzed. AUC of Lact(cv) to predict a Lact(a) above 2 and 4 mmol/L was
0.98 (95% confidence interval: 0.97-0.99) and 0.98 (95% confidence
interval: 0.96-0.99), respectively. Lact(cv) with the cutoff value of 2
mmol/L can predict a Lact(a) above 2 mmol/L with sensitivity >92% and
specificity >90%. AUC for Lact(cv) clearance to detect a Lact(a) clearance
<10% or >10% was 0.93 or 0.94, respectively.
CONCLUSION:

Lact(cv) and Lact(a) collected within a 30-minute range are interchangeable
for clinical practice.



http://onlinelibrary.wiley.com/doi/10./j.1553-2712.1996.tb03502.x/epdf

"Even in patients with the highest lactate concentrations, the
arterial-venous discrepancy was relatively small, and probably of little
clinical import."



Would be interested to see what others are doing/thinking about this with
rationale


Sam

--
Sam Farrell, RN  CCRN
Intensivist Program Manager
West Coast Critical Care Specialists

office: 805.988.7004
fax: 805.988.7101
cell: 805.444.3730
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On Thu, Jan 14, 2016 at 2:22 PM, Carter, Anne <acar...@meridianhealth.com>
wrote:

> As long as ALL future lactic acids are drawn arterially; you cant mix and
> match. Once arterial always arterial.
>
>
>
> *Anne Carter MS, ACNS-BC, CEN*
>
> *Coordinator*
>
> *Outcomes Management*
>
> *Riverview Medical Center*
>
> *732-450-2735 <732-450-2735>*
>
> *acar...@meridianhealth.com <acar...@meridianhealth.com>*
>
>
>
>
>
> “This document and the information attached is Patient Safety Work Product
> & as such, is privileged and confidential pursuant to the N.J. Patient
> Safety Act and the Federal Patient Safety & Quality Improvement Act of 2005
> and should not be further disclosed except as permitted by law.”
>
>
>
>
>
>
>
> *From:* Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] *On
> Behalf Of *Andre Vovan
> *Sent:* Tuesday, January 12, 2016 6:18 PM
> *To:* Gerolamo, Jeannine <jgerol...@abingtonhealth.org>
> *Cc:* sepsisgroups@lists.sepsisgroups.org
> *Subject:* Re: [Sepsis Groups] Arterial line versus venous draw
>
>
>
> "Note, this is an external email and did not originate at Meridian Health”.
> --
>
> Venous or arterial line samples are both good.
>
>
> Andre Vovan, MD, MBA
> President/CEO
> Newport Critical Care, Inc
>
>
>
> On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine <
> jgerol...@abingtonhealth.org> wrote:
>
> Are lactic acids drawn from an arterial line acceptable?
>
>
>
> *Jeannine Gerolamo (Fahy), MSN, BS, RN*
>
> Safety/Quality Specialist
>
>
>
> The Center for Patient Safety and Healthcare Quality
>
> 215-481-4334 (Office)
>
> 215-481-3510 (Fax)
>
> jgerol...@abingtonhealth.org
>
> [image: Description: Description: Description: A-J-LogoEmailSig]
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Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-20 Thread Carter, Anne 
As long as ALL future lactic acids are drawn arterially; you cant mix and 
match. Once arterial always arterial.

Anne Carter MS, ACNS-BC, CEN
Coordinator
Outcomes Management
Riverview Medical Center
732-450-2735
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From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Andre Vovan
Sent: Tuesday, January 12, 2016 6:18 PM
To: Gerolamo, Jeannine <jgerol...@abingtonhealth.org>
Cc: sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] Arterial line versus venous draw

"Note, this is an external email and did not originate at Meridian Health”.

Venous or arterial line samples are both good.

Andre Vovan, MD, MBA
President/CEO
Newport Critical Care, Inc

On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine 
<jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>> wrote:
Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>
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Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-14 Thread Andre Vovan 
Venous or arterial line samples are both good.

Andre Vovan, MD, MBA
President/CEO
Newport Critical Care, Inc

On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine <
jgerol...@abingtonhealth.org> wrote:

> Are lactic acids drawn from an arterial line acceptable?
>
>
>
> *Jeannine Gerolamo (Fahy), MSN, BS, RN*
>
> Safety/Quality Specialist
>
>
>
> The Center for Patient Safety and Healthcare Quality
>
> 215-481-4334 (Office)
>
> 215-481-3510 (Fax)
>
> jgerol...@abingtonhealth.org
>
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Re: [Sepsis Groups] Arterial line versus venous draw

2016-01-14 Thread Mary Draper 
Yes, lactates can be run off of either venous or arterial blood.

Mary Draper RN BSN
Coordinator Quality Improvement
Peer Review Support CV/CT
Quality Management JMH
Office (925) 674-2045
Cell (925) 451-8792
Fax (925) 674-2373
mary.dra...@johnmuirhealth.com<mailto:mary.dra...@johnmuirhealth.com>

"O, let us always have a mountain within our soul,  with a peak so high that we 
never quite reach the top...
  For then we will always strive for greater things and will not be content  
with merely climbing hills." Ardath Rodale


From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Gerolamo, Jeannine
Sent: Friday, January 08, 2016 10:42 AM
To: 'sepsisgroups@lists.sepsisgroups.org'
Subject: [Sepsis Groups] Arterial line versus venous draw

Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org<mailto:jgerol...@abingtonhealth.org>
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[Sepsis Groups] Arterial line versus venous draw

2016-01-12 Thread Gerolamo, Jeannine 
Are lactic acids drawn from an arterial line acceptable?

Jeannine Gerolamo (Fahy), MSN, BS, RN
Safety/Quality Specialist

The Center for Patient Safety and Healthcare Quality
215-481-4334 (Office)
215-481-3510 (Fax)
jgerol...@abingtonhealth.org
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