Dr. Townsend, Just to clarify, in the below scenario, IF the patient had an initial Lactate >4 and Severe Sepsis, they would meet the Septic Shock Presentation, correct? They would also meet if the physician documented the Septic Shock? (and it still remains that the case would fail, as the fluids were not ordered at the correct volume).
Thanks! Kathy Nelson Manager, Public Data Center for Health Information Services Advocate Health Care 3075 Highland Parkway, Downers Grove, IL 60515 630.929.6782 (internal: 55-6782) [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Townsend, Sean, M.D. Sent: Tuesday, September 29, 2015 7:20 PM To: Jennifer L Halligan [SJGH] Cc: [email protected] Subject: Re: [Sepsis Groups] Determining Septic Shock PRESENT -if 30ml/kg not given In thinking about this more, although it feels clinically odd, by the CMS definition we cannot formally declare shock. While I agree any clinician after a prolonged period of hypotension even if under-resuscitated would eventually call that shock (and it probably would be given prolonged hypoperfusion) for purposes of this measure it's not shock. Of course it doesn't clearly matter however because the measure will be failed for not giving the fluid. So it's a failure in any event. It's just that the bucket it would be assigned to is a severe sepsis failure rather than shock if you had the ability to parse these out. On Sep 29, 2015, at 2:34 PM, Jennifer L Halligan [SJGH] <[email protected]<mailto:[email protected]>> wrote: Hi, This question is for those abstractors out there (or maybe Dr. Townsend knows the answer), Am I correct to say that I cannot determine using "clinical criteria" if Septic Shock was PRESENT (septic shock present data element) if the crystalloids given did not total 30ml/kg needed? In my scenario the pt weight is 68.8 kg. (requires 2064 ml to meet 30ml/kg). Pt received 2 liters NS and in the hour after receiving this 2 L the BP did not respond (remained less than 90/map<65). In this scenario I can only use MD documentation of septic shock present, correct??? Thank you!! Jennifer Halligan, RN Quality Review Nurse San Joaquin General Hospital Tel: 209-468-7471 Fax: 209-468-7011 _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org This e-mail, and any attachments thereto, is intended only for use by the addressee(s) named herein and may contain legally privileged and/or confidential information. If you are not the intended recipient of this e-mail (or the person responsible for delivering this document to the intended recipient), you are hereby notified that any dissemination, distribution, printing or copying of this e-mail, and any attachments thereto, is strictly prohibited. If you have received this e-mail in error, please respond to the individual sending the message and permanently delete the original and any copy of any e-mail and any printout thereof. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
