If your patient has a metabolic acidosis with hyperclhoremia will you still be
using normal saline?...because that's one of the circumstances that could
present to you when using high volumes of this solution , in the case discuss
above when the use of inotropics is very close, it should be reasonable to use
a low chlorine solution nevertheless the recomendation of the guidelines is to
use cristaloids (either saline or ringer) but in order to diminish the chances
of a hyperchloremic state the use of ringer looks feasible.
Juan pataro, Md
From my HTC Sensation 4G on T-Mobile. The first nationwide 4G network
----- Reply message -----
De: "Mary Draper" <[email protected]>
Para: "[email protected]" <[email protected]>
CC: "[email protected]" <[email protected]>,
"[email protected]" <[email protected]>
Asunto: [Sepsis Groups] use of vasopressors
Fecha: mié., nov. 21, 2012 1:44 p. m.
We use normal saline which is recommended by the guidelines.
Mary Draper RN BSN CCRNQuality Manager-Best Practice SupportQuality Management
SupervisorOffice (925) 674-2045Cell (925) 451-8792Fax (925)
[email protected]
On Nov 21, 2012, at 8:31 AM, "[email protected]" <[email protected]>
wrote:
The question is witch cristaloid to use......saline solution or ringer?....
From my HTC Sensation 4G on T-Mobile. The first nationwide 4G network
----- Reply message -----
De: "Adrian Verdin Z." <[email protected]>
Para: "Mary Draper" <[email protected]>
CC: "[email protected]" <[email protected]>
Asunto: [Sepsis Groups] use of vasopressors
Fecha: mar., nov. 20, 2012 2:57 p. m.
Yes those are part of the 4 principal goals in surviving sepsis campain. We
Also use the arterial line waves forms ior the plestitmographic waves for fluid
Administracion or to use pressors
<images.jpeg>
Dr. Adrián Verdín Z.Terapia intensivaAnestesia614 159 3883 cell614 1800 800 ext
16574
El 20/11/2012, a las 10:47, "Mary Draper" <[email protected]>
escribió:
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 CCRNQuality Manager-Best Practice
SupportQuality Management SupervisorOffice (925) 674-2045Cell (925) 451-8792Fax
(925) [email protected]<image001.png> 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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