John, We resuscitate ESRD patients aggressively, but carefully, by using targets (CVP, SV). If the CXR is clear...bolus and treat the shock. Our renal service was nervous about aggressive resuscitation when we first implemented our sepsis program in 2007. They are now firm believers in resuscitating ESRD. It's a shame to develop liver failure from under-resuscitation in a patient who already has renal failure- outcomes are very poor when this occurs. We've never had to intubated an ESRD patient for fluid overload. We tend to dialyze them in the first 24-48 hours once the shock is resolved.
Patty Cormack RN, MSN Critical Care Clinical Educator Sepsis Coordinator CV Coordinator Vanguard West Suburban Medical Center P 708-763-6662 Pager 630-255-6049 [email protected] From: [email protected] [mailto:[email protected]] On Behalf Of John Brady Sent: Tuesday, December 04, 2012 6:03 PM To: [email protected]; [email protected]; [email protected] Subject: Re: [Sepsis Groups] mortality When you have sepsis patients that have chronic renal failure how aggressive are you with volume resuscitation? John Brady Quality Nurse Manager St. Mary Medical Center 760 242 2311 ( 5369) From: [email protected] [ mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, December 03, 2012 5:56 AM To: [email protected]; [email protected] Subject: Re: [Sepsis Groups] mortality I count by discharge ICD9 code...so anyone with severe sepsis &/or septic shock get counted for that month upon discharge...separate stats for each code. Peggy Sienecki, RN Sepsis Coordinator Fawcett Memorial Hospital Port Charlotte, FL From: [email protected] [ mailto:[email protected]] On Behalf Of CARIANN M DAHLQUIST Sent: Wednesday, November 28, 2012 2:29 PM To: [email protected] Subject: [Sepsis Groups] mortality Hello fellow sepsis coordinators, I am inquiring how everyone counts their sepsis mortality. I am curious if you count each patient chart or if you count by patient days? I currently only audit the critical care patients, however I am looking to expand to house wide. Any input would be appreciated- Thanks, CariAnn ------------------------------------------------------------------------ ------------------------------------------- CONFIDENTIAL & PRIVILEGED COMMUNICATION This email and any files transmitted with it are confidential, may contain privileged or copyright information, and are intended solely for the use of the intended recipient. If you are not the intended recipient of this email, you are required to notify the sender immediately and delete this email from your system. You may not copy, distribute or use this email or the information contained in it for any purpose other than to notify the sender. We do not guarantee that this material is free from viruses or any other defects although due care has been taken to minimize the risk. Any views expressed in this message are those of the individual sender, except where the sender specifically states them to be the views of Altru Health System. ________________________________ Notice from St. Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure. This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. This footer also confirms that this email message has been scanned for the presence of computer viruses.
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