If septic shock is defined by the SSG as "sepsis-induced hypotension persisting 
after adequate fluid resuscitation" wouldn't it be correct to say that an 
initial lactate *4 is still severe sepsis but a lactate *4 AFTER fluid 
resuscitation is sepsis induced "persistent" hypoperfusion?  And, only then it 
shall be referred to as septic shock?

I'm having a difficult time with the assumption that an initial lactate of *4 
with a normal blood pressure and a patient who is alert and oriented x4 is 
being diagnosed with shock.  I do agree that the initial lactate may qualify 
the patient for the need for fluid resuscitation (if it is sepsis-induced), but 
not necessarily a diagnosis of shock at this point.

Amber Parman RN, BSN, CCRN
Denton Regional Medical Center
Sepsis Coordinator
940-384-4363
[email protected]
[cid:[email protected]]     [cid:[email protected]]
Enhancing community health through service
 with compassion, excellence and efficiency.


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