Our facility continues to bolus an additional 3-5 liters if the lactate comes 
back ≥ 4. If after that and we have a CVP that is still < 8, we would continue 
to bolus.
Thanks.



Mary Draper RN BSN CCRN
Quality Manager-Best Practice Support
Quality Management Supervisor
Office (925) 674-2045
Cell (925) 451-8792
Fax (925) 674-2373
[email protected]<mailto:[email protected]>
[cid:[email protected]]

From: [email protected] 
[mailto:[email protected]] On Behalf Of Hefton, 
Suzanne
Sent: Monday, November 19, 2012 5:55 PM
To: [email protected]
Subject: [Sepsis Groups] use of vasopressors

New to the list serve so I apologize if this has been asked 
previously....Currently, we report Fluid Bolus of 20ml/kg, CVP for lactate > 4 
or inability to maintain MAP and initiation of vasopressors if MAP < 65 as 
separate measures. Some of our ED physicians have questioned if we should wait 
to start pressors until we have gotten to a CVP of 8.
 Example: pt has a  MAP of 60 and a CVP of 4 after the fluid bolus -we look for 
the physician to start pressors.
I'm wondering what other facilities are doing?
Thanks!

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