No UOP for 8 hours is excessive.

I suggest that in hospital UO less than 0.5 ml/kg per hour for three hours is 
likely indicative of poor perfusion or kidney dysfunction.

In nursing home maybe something like UO < 200 for 8 hours. But if other signs 
are present UO, should be assessed more often than 8 hours. UO is a very 
powerful vital sign, but is often not monitored well.


G



From: Karin Molander <[email protected]<mailto:[email protected]>>
Date: Tuesday, April 1, 2014 6:48 PM
To: "Kane, Ellen - SJHMC" 
<[email protected]<mailto:[email protected]>>
Cc: 
"[email protected]<mailto:[email protected]>"
 
<[email protected]<mailto:[email protected]>>
Subject: Re: [Sepsis Groups] early recognition of sepsis in skilled nursing 
homes

In the planning stages,
Idea is for badge card for SNFs and EMS. With SIRS (rr >20, p> 90, T >38 or 
<36.) that they can "see". + no uop for 8 hours, glucose > 120, altered mental 
status. ( May add risk factors here: age >, liver dz, kidney dz, diabetes, 
immunocompromised) If two met and present or presumed infxn, then + sepsis 
screen
Ivf, blood cultures, CBC, lactate transfer to higher level of care if need be.  
EMS notify + sepsis screen w ring down to receiving hospital (in Britain they 
do POC lactates on rigs!).
More research done overseas...

Karin Molander MD
Mills-Peninsula hospital
Burlingame, CA

Sent from my iPhone

On Mar 31, 2014, at 10:27 AM, "Kane, Ellen - SJHMC" 
<[email protected]<mailto:[email protected]>> wrote:

Is anyone working on a protocol for early recognition of sepsis for patients in 
skilled nursing homes in their area?

Ellen Kane, RN, MSN, CPHQ
Quality Specialist
Quality Department

Dignity Health
St. Joseph's Hospital and Medical Center
350 West Thomas Road
Phoenix, AZ 85013
602-406-4939 (O)
602-746-0725 (P)
602-406-4115 (F)

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