Currently we are monitoring for SIRS, known or suspected infection, Sepsis and 
then following guidelines for our severe sepsis and septic shock patients.  We 
actually are doing the lactate, CBC and BC  after a positive screening for 
sepsis. We do these screenings on the floor and the ED.


We are trying to roll out a screening process for the ICU but most of our 
patients meet criteria for sepsis. Does anyone have a process that works for 
them in the ICU.

From: [email protected] 
[mailto:[email protected]] On Behalf Of Mary Draper
Sent: Tuesday, November 20, 2012 9:43 AM
To: 'Hefton, Suzanne'; [email protected]
Subject: Re: [Sepsis Groups] use of vasopressors

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]>
 [mailto:[email protected]] On Behalf Of Hefton, 
Suzanne
Sent: Monday, November 19, 2012 5:55 PM
To: 
[email protected]<mailto:[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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