If Lactic Acid >2.0 but less than 4.0 or patient hypotensive, a fluid challenge (not the 39ml/kg resuscitation bolus) will usually take that lactic acid right down-raise the BP (not part of this measure at this point but is appropriate care along with Abx), keeping the patient from septic shock. Repeat the lactic acid within 6 hours of sepsis presentation in this case. If the repeat is climbing or if the initial is >4.0, resuscitation fluids are indicated. One hour after resuscitation fluids are infused, repeat the lactic acid again. Treat according to that next level and or the BP.
-----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Friday, October 16, 2015 12:20 PM To: [email protected] Subject: [EXTERNAL] Sepsisgroups Digest, Vol 175, Issue 6 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. fluids ([email protected]) ---------------------------------------------------------------------- Message: 1 Date: Fri, 16 Oct 2015 15:09:34 +0000 From: <[email protected]> To: <[email protected]> Subject: [Sepsis Groups] fluids Message-ID: <23319868f1cf9c4ca1a7ba82cfd61315114b4...@fwdcwpmsghcmd4b.hca.corpad.net> Content-Type: text/plain; charset="us-ascii" Ok, simple question...so, to clarify.....we give fluid when the patient screens positive for severe sepsis? Or we specifically wait to give fluids when the patient is hypotensive and/or lactate greater than 4 - which is septic shock already. Just want to make sure I'm teaching this correctly because I'm constantly asked in the ER. The guidelines say when the patient is hypotensive and/or lactate greater than 4. Thank you, Debbie Debbie Chambless, MSN, RN, ARNP-C Sepsis Coordinator Osceola Regional Medical Center Kissimmee, Fl 34741 Office: 407-518-3949 Cell: 772-807-0525 ~~Recognizing sepsis as a global enemy. Hoping for global unity in finding a solution~~ [cid:[email protected]] -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20151016/a4575f17/attachment.htm> -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.jpg Type: image/jpeg Size: 18061 bytes Desc: image003.jpg URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20151016/a4575f17/attachment.jpg> ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 175, Issue 6 ******************************************** -------------------------------------------------------------------------- Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any action in reliance on the information it contains. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
