Clinically, I think it is adviseable to repeat the lactate when Severe
Sepsis is expected as it may have risen and the more signs of end organ
failure, the higher the risk of death.

Also, if the lactate is greater than 4, then the patient is showing signs
of Septic Shock even if they are normotensive. In that case, I would
strongly advise intensive care unit monitoring.

>From a "coding standpoint", my understanding is that the first event is the
only one recorded.  So if the patient had Simple Sepsis at presentation,
only the first event is coded.

Karin Molander MD
Mills-Peninsula Hospital
Sutter

On Wed, Oct 21, 2015 at 12:26 PM, John Robertson <[email protected]>
wrote:

> Sepsis Group
>
>
>
> We have implemented a protocol to start lactic acid testing for all
> patients who present and meet the Sepsis definition – in the hope that they
> don’t/won’t progress to severe sepsis or septic shock.
>
>
>
> Question – if we have already got a lactic acid on a patient who presented
> today with Sepsis, and they progress to severe sepsis – did we ‘beat the
> clock’ with the lactic acid we already took, or does the clock then start
> when the Severe Sepsis diagnosis is made?
>
>
>
> John Robertson, CQO
>
> Hillsdale Hospital
>
>
>
>
>
> _______________________________________________
> Sepsisgroups mailing list
> [email protected]
> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
>
>


-- 
Karin H. Molander
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