Hi Geri, I am trying to understand your question as it relates to ED patients and in-patients. If a lactate is positive in the ED, then ED triage time is time of presentation, regardless of where the patient is when the test is returned. If your scenarios are that lactates are ordered on ED patients and the tests do not return before admission to the inpatient unit, then the above applies.
If lactates are being ordered on patient already on the floor, and come back positive, and the lactate > 2 is the organ failure that meets severe sepsis criteria, then you can use the time of that lactate as time of presentation so that you get credit for drawing it in the first 3 hours. Thanks, Mary Ann Barnes-Daly, RN BSN CCRN DC Regional Clinical Initiative Lead-Sepsis and ICU Liberation (ABCDE) Gordon and Betty Moore Foundation Grant Sutter Health Sacramento- Sierra Region Mobile: 916.200.5604 Office: 916.887.7084 E-mail: [email protected]<mailto:[email protected]> Assissant: Ruby Dulay 916-887-7086 [email protected] [cid:[email protected]] You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete. R. Buckminster Fuller From: [email protected] [mailto:[email protected]] On Behalf Of Buss, Gerri Sent: Tuesday, March 25, 2014 7:44 AM To: [email protected] Subject: [Sepsis Groups] lactic acid levels Our ER is ordering more lactic acid levels and sometimes these are completed before we determine a time of presentation for the sepsis bundle to start in the in-patient setting. Is there a standard amount of time prior to the time of presentation that you can use the lactic acid level for the 3 hour bundle? Should we count only those that are completed after the time of presentation is established? Some of our physicians would like the previous lactic acid level to count if it was completed within 3 hours prior. Gerri Buss, MS, RN Consultant Performance Excellence Department Blessing Hospital Quincy,Il 62305 217-223-8400 ext 6894 [email protected]<mailto:[email protected]> [cid:[email protected]] “There’s nothing so useless as doing efficiently that which should not be done at all” Peter Drucker The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you.
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