I would say no, based on what is presented below, because septic shock is based 
on initial lactate, which is less than 4.

Karen Belfi, RN, MSN
Quality Outcomes Coordinator
Lankenau Medical Center
484-476-8092
Pager: 5240
[cid:[email protected]]

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Clement, Joseph (DPH)
Sent: Thursday, March 17, 2016 5:09 PM
To: PAMELA J. ANDERSON; [email protected]
Subject: [EXTERNAL] Re: [Sepsis Groups] Severe Sepsis with Initial Lactate <4, 
repeat 3hrs later >4-?Shock or not


I would answer Yes to the septic shock question - as long as the shock 
date/time is within 6 hours of the severe sepsis time, it would count.



If anybody believes otherwise I'd love to hear as that's how we've done it.


Joseph Clement, MS, RN, CCNS
Clinical Nurse Specialist
San Francisco General Hospital
ph: 415206-6174
pg: 415 327-0220

________________________________
From: Sepsisgroups 
<[email protected]<mailto:[email protected]>>
 on behalf of PAMELA J. ANDERSON <[email protected]<mailto:[email protected]>>
Sent: Thursday, March 10, 2016 6:19 AM
To: 
[email protected]<mailto:[email protected]>;
 [email protected]<mailto:[email protected]>
Subject: [Sepsis Groups] Severe Sepsis with Initial Lactate <4, repeat 3hrs 
later >4-?Shock or not



v5.0b Specs indicate septic shock presentation date and time is determined by 
persistent hypotension... OR tissue perfusion present as evidenced by INITIAL 
lactate >=4.

Severe sepsis was present @ 09:12, with the initial lactate of 3.6. The repeat 
done @ 12:01 was 6.7 (30cc/kg was given).

Because there was no documentation of "septic shock", and the patient was not 
hypotensive at the end of the bolus, based on the verbiage from the specs, I 
would answer, "NO" to the question of whether Septic Shock was present.
Any thoughts?
Thanks-
Pam

Pamela Anderson, BSN, RN
Clinical Data Abstractor
Sepsis Coordinator
Loyola University Health System
Center for Clinical Excellence
2160 S. First Avenue | Bldg 105-3915 | Maywood, IL 60153
(O) 708-216-5544 | (F) 708-216-7867 | (E) 
[email protected]<mailto:[email protected]>



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