A more common issue is that the pt develops hypotension >1 hour after the initial 30ml/Kg, we usually give more fluid first and then start pressors if needed. The goal is still to get mean BP >65 but because the hypotension occurs greater than 60 min after the initial 30kml/kg bolus, then the reporting for 6th hour does not apply. That is my understanding. Regardless we will still be treating for the patient which is more important than CMS requirement in my mind.
Andre Vovan, MD MBA Chief of Service, Critical Care Hoag Memorial Hospital Prebyterian Andre Vovan, MD, MBA President/CEO Newport Critical Care, Inc On Thu, Nov 19, 2015 at 11:27 AM, Karin Molander <[email protected]> wrote: > I would vote for 3 UTD, as there was only one blood pressure taken. > > Karin H. Molander MD FACEP > Mills-Peninsula Hospital > Sutter Peninsula Coastal > > On Wed, Nov 18, 2015 at 3:10 PM, Myran, Robin <[email protected]> > wrote: > >> From the Notes for Abstraction for Persistent Hypotension: >> >> >> >> The criteria for determining that persistent hypotension was present are >> as follows: >> >> In the one hour following conclusion of administration of crystalloid >> fluids, two or more consecutive blood pressure readings of either SBP < 90 >> or MAP < 65 or a decrease in SBP by > 40. >> >> >> >> My question: >> >> >> >> What if only one blood pressure was taken and the MAP was less than 65? >> Do I answer the question “2 (No) – persistent hypotension was not present” >> because there wasn’t two or more consecutive low blood pressures? Or do I >> answer the question “3 (No) or UTD – the patient was not assessed for >> persistent hypotension” since there was only one blood pressure taken? >> >> >> >> >> >> Thanks in advance for your thoughts. >> >> >> >> *Robin Myran, MSN, RN, PCCN* >> >> Sepsis Coordinator >> >> Hoag Memorial Hospital Presbyterian >> >> One Hoag Drive >> >> Newport Beach, CA 92658 >> >> Office: (949) 764-4588 >> >> Fax: (949) 764-5387 >> >> Cell: (949) 300-9137 >> >> [email protected] <[email protected]> >> >> >> >> Please note that the information contained in this message and any files >> transmitted with it are privileged and confidential and are protected from >> disclosure under the law, including the Health Insurance Portability and >> Accountability Act (HIPAA). If the reader of this message is not the >> intended recipient, or an employee or agent responsible for delivering this >> message to the intended recipient, you are hereby notified that any >> dissemination, distribution or copying of this communication is strictly >> prohibited and may subject you to criminal or civil penalties. If you have >> received this communication in error, please notify the sender by replying >> to the message and delete the material from any computer. Thank you, Hoag >> Memorial Hospital Presbyterian and its Affiliates >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> > > > -- > Karin H. Molander > > Please note that the information contained in this message and any files > transmitted with it are privileged and confidential and are protected from > disclosure under the law, including the Health Insurance Portability and > Accountability Act (HIPAA). If the reader of this message is not the > intended recipient, or an employee or agent responsible for delivering this > message to the intended recipient, you are hereby notified that any > dissemination, distribution or copying of this communication is strictly > prohibited and may subject you to criminal or civil penalties. If you have > received this communication in error, please notify the sender by replying > to the message and delete the material from any computer. Thank you, Hoag > Memorial Hospital Presbyterian and its Affiliates > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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