I believe the rationale is to determine if the current treatment plan is working - in other words, if your initial lactate is >4, and then your repeat lactate is higher than the initial lactate, it is an indication that there may be something more occurring or that additional treatment needs to be considered. In addition, if the repeat lactate is lower, it could be an indication that what is being done is working. Hope this helps! Pam
Pamela Anderson, BSN, RN Clinical Data Abstractor Interim Sepsis Coordinator Loyola University Health System Center for Clinical Excellence Maguire Center | Bldg 105-3909 | Maywood, IL 60153 (O) 708-216-5544 | (F) 708-216-7867 | (E) [email protected]<mailto:[email protected]> NOTE: The information contained in this message may be privileged and confidential and protected from disclosure. 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. If you believe you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you. Loyola University Health System From: Sepsisgroups [mailto:[email protected]] On Behalf Of Bruce S. Bainbridge Sent: Friday, February 19, 2016 1:07 PM To: 'DHILLON, ROOPINDER'; '[email protected]' Subject: Re: [Sepsis Groups] Repeat Lactate Thanks. I see that the repeat Lactate is required if initial Lactate is >2. I see no justification of the repeat value if the initial Lactate is >4. So if we already have met criteria for Septic Shock, why should we fail for not drawing an unneeded lab? Am I missing something? From: DHILLON, ROOPINDER [mailto:[email protected]] Sent: Friday, February 19, 2016 10:14 AM To: Bruce S. Bainbridge; '[email protected]' Subject: RE: Repeat Lactate Yes, Repeat lactate has to be done any time the Initial Lactate is >2. I found out today if Initial Lactate is >4 and even if there is no persistent hypotension we still need to have documentation for All of the Focus Exam criteria or 2 of the Hemodynamic monitoring. If not we fail the measure despite the fact patient does not have persistent hypotension after the conclusion of right amount of fluids. From: Sepsisgroups [mailto:[email protected]] On Behalf Of Bruce S. Bainbridge Sent: Tuesday, February 16, 2016 5:28 PM To: '[email protected]' Subject: [Sepsis Groups] Repeat Lactate I may have missed this discussion, but I had a patient fail SEP-1 when no repeat Lactate level was ordered. If the initial Lactate was >4, I see no guideline that necessitates a repeat draw in this case. Is a repeat draw still required if the initial Lactate is already >4? I appreciate all your help with this. Bruce Bainbridge, RN, BA | Clinical Data Analyst | Tri-City Medical Center | Quality & Performance Improvement | 4002 Vista Way | Oceanside, CA 92056 760-940-3789 I [email protected]<mailto:[email protected]> |www.tricitymed.org<http://www.tricitymed.org/> CONFIDENTIALITY NOTICE This message and any included attachments are from the Tri-City Healthcare District and are intended only for the addressee. The information contained in this message is confidential and may constitute non-public information under international, federal, or state securities laws and is intended only for the use of the addressee. Unauthorized forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail. This message has been scanned for malware by Websense. www.websense.com<http://www.websense.com/> Visit us at www.UHhospitals.org<http://www.UHhospitals.org>. The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee. Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. Click here<https://www.mailcontrol.com/sr/J+r5OHPofBHGX2PQPOmvUqy!8K4P2+3016MQ8ZAxHyB!cET6UJ4oxTBXLwg7UG9VUPRTX8TXuBnp5oVq8TaMKA==> to report this email as spam. 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.
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