Re: Fluids given prior to admission I am also curious if fluids given prior to admission count for the bolus requirement, similar to an aspirin given by EMS for MI patients. However, clinically, it seems wise to NOT count on fluids given prior to arrival since the assessment that qualifies the patient for bolus treatment is completed after those fluids were given; whatever fluids were given previously did not prevent the patient from worsening and developing severe sepsis or septic shock. Thus, starting a 30 ml/kg bolus on admission seems appropriate clinically to prevent progression into multiple organ failure and should improve mortality rates, even if the core measure is found to "allow" those fluids to count. Gayle Porter RN BSN Sepsis Program Coordinator Valley Regional Medical Center Brownsville, TX 956-350-7179 [email protected]<mailto:[email protected]>
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