The following article was shared by one of our ER physician's and might be of help. https://www.acep.org/dart/ Please note especially the tab 'Give a 1L Crystalloid Bolus To Start and 30CC/KG Target in an Hr.' The third line in that states, "A history of heart failure, liver failure, or renal failure is not a contraindication to fluid resuscitation. These patients might need less total fluid or smaller boluses with more frequent reassessment of intravascular volume status."
From: Burger, Carolyn [mailto:[email protected]] Sent: Friday, May 20, 2016 2:05 PM To: DHILLON, ROOPINDER; [email protected] Subject: RE: Sepsis-Fluid Resuscitation Yes, struggling with this as well. More for in patient setting than ER. Carolyn Burger, RN, BS Clinical Performance Coordinator Performance Support 269-983-8896 [email protected]<mailto:[email protected]> [healthy-heart[1]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of DHILLON, ROOPINDER Sent: Tuesday, May 17, 2016 11:35 AM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] Sepsis-Fluid Resuscitation Hi, Is anyone facing physician pushbacks with Fluid Resuscitation of a sepsis/severe sepsis patient with CHF or Renal dysfunction? How are you educating physicians regarding this? Any strategies for persuading physicians to continue with fluid resuscitation in such patients. Thank you, Roopa Dhillon MBBS, MBA Clinical Quality Analyst I Quality Improvement/Clinical Outcomes University Hospitals Elyria Medical Centre 630 East River Elyria, Ohio 44035 T 440-329-4959 F 440-329-5971 Roopinder.Dhillon@UHhospitals<mailto:Roopinder.Dhillon@UHhospitals> .org Quality Assurance/Peer Review Privileged Pursuant to Ohio Rev. Code secs. 2305.24, 2305.25, 2305.251, 2305.252 and 2305.253 [UH jpg] 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. ________________________________ CONFIDENTIALITY NOTICE: This email and any attachments are for the exclusive and confidential use of the intended recipient. If you are not the intended recipient, please do not read, distribute or take action in reliance upon this message. If you have received this in error, please notify us immediately by return email and promptly delete this message and its attachments from your computer system. Visit us at 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.
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