Hi there,
For our 6 hour bundle measure for reassessment of fluid status. We are using 
the Non-invasive cardiac output monitor.  This is a tool we use to determine if 
the patient may tolerate additional fluid by measuring SVI and CI all 
non-invasive. We found this to be more accurate than the stagnate CVP.  We 
usually will bolus the patient with 30cc/kg, wait one hour and then conduct 
this test. If we find a 10% change (greater) in the SVI, we know the patient 
can tolerate at least 250-500cc normal saline.  In addition, we use this first 
to determine fluid status for a HD, HF and a patient with a low EF. I 
personally have used this tool for a HD patient and successful provided the 
patient with 2.5 liters and the patient's outcome was positive.  If you have 
any questions, please email me.
Lisa Dumont
Sepsis Coordinator SouthCoast hospital group
[email protected]


-----Original Message-----
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Sent: Wednesday, January 22, 2014 3:07 PM
To: [email protected]
Subject: Sepsisgroups Digest, Vol 93, Issue 2

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Today's Topics:

   1. Re: 6 hr bundle (Wendy A. Nieman)
   2. Re: 6 hr bundle (Cormack, Patricia (WS))


----------------------------------------------------------------------

Message: 1
Date: Fri, 17 Jan 2014 18:37:30 +0000
From: "Wendy A. Nieman" <[email protected]>
To: DanaMarie Smith <[email protected]>,
        "[email protected]"
        <[email protected]>
Subject: Re: [Sepsis Groups] 6 hr bundle
Message-ID:
        
<914034fb349c4d4e9436177ad9011a6e300...@nodcmstmbx07.no.trinity-health.org>
        
Content-Type: text/plain; charset="iso-8859-1"

We sometimes use SVV with an arterial Flow-Trac device

Wendy



Wendy Nieman RN

ICU and Medicine Quality Coordinator

Quality Benchmarking & External Reporting

Practice Improvement Department

Phone: 734-712-1151

Fax: 734-712-7099

St. Joseph Mercy Hospital

Ann Arbor Michigan 48104

[email protected]<mailto:[email protected]>



This is a confidential professional/peer review and quality improvement 
document of Saint Joseph Mercy Health Systam and the Trinity Health system of 
providers.  It is protected from disclosure pursuant to the provisions of MCL 
333.20175, 333.21513, MCL 333.21515, MCL 333.16222, MCL 331.531, MCL 331.533, 
MCL 330.1749, MCL 330.1143a, and other state laws as well as the Federal 
Patient Safety and Quality Improvement Act, 42 U.S.C 299b-21-b-26 and other 
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________________________________
From: [email protected] 
[[email protected]] on behalf of DanaMarie Smith 
[[email protected]]
Sent: Thursday, January 16, 2014 1:52 PM
To: [email protected]
Subject: [Sepsis Groups] 6 hr bundle

Hi Everyone,
 I sent this yesterday but not sure if I did it right. Anyway I want to know if 
there are any hospitals using different methods of measuring fluid 
resuscitation in 6 hr bundle instead of CVP and SVC. Just trying to get some 
ideas. I would greatly appreciate it.
                                                   Thank You,
                                                          Dana


Dana Marie Smith RN
Clinical Data Analyst
Quality/Performance Improvement
Phone # 215- 612-4888
Fax # 215-612-4463


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Message: 2
Date: Fri, 17 Jan 2014 12:59:37 -0600
From: "Cormack, Patricia (WS)" <[email protected]>
To: "DanaMarie Smith" <[email protected]>,
        <[email protected]>
Subject: Re: [Sepsis Groups] 6 hr bundle
Message-ID:
        <[email protected]>
Content-Type: text/plain; charset="us-ascii"

Hi Dana,

If you have equipment that measures hemodynamics from an arterial
waveform, monitoring the  stroke volume in response to fluid
resuscitation is very helpful. Can determine fluid responsiveness. If SV
increases with fluid challenge, pt is fluid responsive. Hope that helps.

Patty Cormack

 

From: [email protected]
[mailto:[email protected]] On Behalf Of
DanaMarie Smith
Sent: Thursday, January 16, 2014 12:53 PM
To: [email protected]
Subject: [Sepsis Groups] 6 hr bundle

 

Hi Everyone,

 I sent this yesterday but not sure if I did it right. Anyway I want to
know if there are any hospitals using different methods of measuring
fluid resuscitation in 6 hr bundle instead of CVP and SVC. Just trying
to get some ideas. I would greatly appreciate it.

                                                   Thank You,

                                                          Dana

 

 

Dana Marie Smith RN

Clinical Data Analyst

Quality/Performance Improvement

Phone # 215- 612-4888

Fax # 215-612-4463

 

 



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End of Sepsisgroups Digest, Vol 93, Issue 2
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