I am just wanting to clarify that I am on the same page with the septic shock and IV fluids. Patient has severe sepsis already and has a lactic of 3 and then progresses to systolic BP in the 80's. Patient is NOT given fluids to total 30ml/kg, however only given 1 liter NS and then vasopressors needed to be initiated. Physician continues to only document severe sepsis, am I correct in thinking that even though patient required vasopressors and BP < 90 I cannot take that as septic shock? I can ONLY take septic shock if patient had adequately received the 30ml/kg IV fluids and then continued to be hypotensive? Thanks, CariAnn
>>> "Barnes-Daly, Mary Ann" <[email protected]> 11/10/2015 12:30 PM >>> Physician documentation is used only if the other criteria are not found. In this case, severe sepsis is present – so the Lactate of 4.3 = septic shock Thanks, MARY ANN BARNES-DALY RN BSN CCRN DC | Clinical Performance Improvement Consultant Sutter Health - Office of Patient Experience | 2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| Office 916.286.6717 | [email protected] “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” ~R. Buckminster Fuller From: Sepsisgroups [mailto:[email protected]] On Behalf Of Tribuiani, Barbara Sent: Wednesday, November 04, 2015 10:21 AM To: '[email protected]' Subject: [Sepsis Groups] Septic Shock Present Hello All- I have a patient who meets criteria for septic shock due to the initial lactate of 4.3 however the physicians clearly document that the patient has “severe sepsis without shock” How do I answer the question “septic shock present” in this case?? Thank you, Barb Barbara Tribuiani, RN, BSN Quality Improvement Department Phone: 610-237-4208 Fax: 610-237-4264 T Together E Everyone A Achieves M More Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. --------------------------------------------------------------------------------------------------------------------- CONFIDENTIAL & PRIVILEGED COMMUNICATION This email and any files transmitted with it are confidential, may contain privileged or copyright information, and are intended solely for the use of the intended recipient. If you are not the intended recipient of this email, you are required to notify the sender immediately and delete this email from your system. You may not copy, distribute or use this email or the information contained in it for any purpose other than to notify the sender. We do not guarantee that this material is free from viruses or any other defects although due care has been taken to minimize the risk. Any views expressed in this message are those of the individual sender, except where the sender specifically states them to be the views of Altru Health System.
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