There is no time frame stated for the fluids. There are currently no reasons in the guidelines for not infusing the full 30 mL/kg. CMS has said they may review this for the next guideline update but for now they don't allow for a reason not to infuse. However, they said of course to use clinical judgment and not to order fluids for someone for whom it is clinically contraindicated.
Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center > On Jan 21, 2016, at 3:11 PM, Wilson, Van <[email protected]> wrote: > > at what time does the IVF have to be started? it looks like within 3 hrs of > presentation of septic shock, however part of the definition of septic shock > is severe sepsis with persistant hypotension measured one hr after bolus... > > ________________________________________ > From: Sepsisgroups [[email protected]] on behalf of > Patricia Posa [[email protected]] > Sent: Thursday, January 14, 2016 7:49 PM > To: Murray, Theresa > Cc: [email protected]; Sullivan-Wright, Dawn M.; > Gieselman, Morris > Subject: Re: [Sepsis Groups] Repeat volume assessment and tissue perfusion > CMS requirements > > Hi Theresa > > The full 30ml/kg needs to be given. There are no exceptions per CMS guidelines > > The reassessment can be done anytime after the fluid bolus is completed and 6 > hours from time met criteria for septic shock > > Pat > > Sent from my iPhone > >> On Jan 13, 2016, at 1:09 PM, "Murray, Theresa" <[email protected]> >> wrote: >> >> At our shop we are talking about the volume resuscitation. Does it have to >> be the entire 30ml/kg, or can the clinician treat the hypotension with >> volume to the point of normotension especially in a renal or CHF patent and >> still get credit for the metric? I have heard different responses. >> Thanks in advance for the info >> >> >> >> Theresa Murray RN, MSN, CCRN, CCNS >> Critical Care Clinical Nurse Specialist >> Community Health Network >> 1500 N. Ritter Ave >> Indianapolis Indiana 46219 >> 1-317-355-4258 office >> 1-317-351-7860 fax >> 1-317-904-7212 pager >> 1-317-627-9350 Mobile >> [email protected] >> >> Cookeville Regional Medical Center >> 931-783-5035 >> >> >> >> This email message has been delivered safely and archived online by >> Mimecast. For more information please visit http://www.mimecast.com >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> >> CONFIDENTIALITY NOTE: This e-mail contains information that may be >> privileged, confidential and subject to legal restrictions and penalties >> regarding its unauthorized disclosure or other use. You are prohibited from >> copying, distributing or otherwise using this information if you are not the >> intended recipient or the employee or agent to deliver to the intended >> recipient. If you have received this e-mail in error, please notify us >> immediately by return e-mail and delete this e-mail and all attachments from >> your system. Thank you. >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > ----------------------------------------- Confidentiality Notice: The > information contained in this email message is privileged and confidential > information and intended only for the use of the individual or entity named > in the address. If you are not the intended recipient, you are hereby > notified that any dissemination, distribution, or copying of this information > is strictly prohibited. If you received this information in error, please > notify the sender and delete this information from your computer and retain > no copies of any of this information. > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
