Hello,

How long do we review the record for septic shock? For example if a patient 
develops severe sepsis but  Lactate <4 and not initially hypotensive, but then 
patient's Next Lactate <2 no other organ dysfunction,  and then the patient 
crashes again and develops septic shock are we supposed to use this date/time. 
OR does septic shock present only count for the initial severe sepsis episode? 
Is there a timeframe between Severe Sepsis Presentation Time and Septic Shock 
Present Time?  I know clinically we want to do everything possible, but want to 
make sure all hospitals are looking at the same information and this review is 
already extremely burdensome on our hospital staff.

The other thing to consider for next round of specifications is documentation 
of infection within 6 hours of vitals, organ dysfunction. I can see a need for 
initial documentation of infection for severe sepsis, but if a patient has an 
infection and 8 hours later crashes, why would we need additional documentation 
of infection as obviously it hasn't resolved?

Thanks!

Cindy

Cynthia Wells
Steward Health Care
Director of Clinical Performance Analytics
(508) 404-8647


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