I disagree as well due to a lack of a source of infection with the elevated 
lactate  or documentation of severe sepsis/septic shock.








Andrea Crittenden RN| Quality Improvement Specialist |
Providence Health & Services, Southwest Washington |

Office: 360.486.6465 |
Quality Services MS:04H17

413 Lilly Rd NE

Olympia, WA 98506-5166 |
[email protected]<mailto:[email protected]>



[cid:[email protected]]



From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Schrecengost, Lisa M.
Sent: Tuesday, March 28, 2017 8:33 AM
To: Nielsenshultz, Yara <[email protected]>; Davis, Diana 
<[email protected]>; '[email protected]' 
<[email protected]>
Subject: Re: [Sepsis Groups] Septic shock question

Is there a source of infection documented?   Or documentation of severe sepsis 
or septic shock?  If not, then I disagree.

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Nielsenshultz, Yara
Sent: Tuesday, March 21, 2017 5:50 PM
To: Davis, Diana; '[email protected]'
Subject: Re: [Sepsis Groups] Septic shock question

I would say yes. A lactate >/= 4 is automatically septic shock (as long as the 
patient also meets criteria for severe sepsis, which it looks like they do).

YARA NIELSENSHULTZ, RN, BSN, MS
Clinical Quality Manager
EmCare, North Division
Direct: (215) 442-5122
Fax: (215) 957-2875
www.EmCare.com<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.emcare.com%2F&data=01%7C01%7CAndrea.Crittenden%40providence.org%7C0b4f4e7ec4f547728f3c08d47ba8eac3%7C2e3190869a2646a3865f615bed576786%7C1&sdata=1WhTjNmlNRtyvm63u7DHTPM%2FD5VaEIQSZjbFvG67eWQ%3D&reserved=0>

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Davis, Diana
Sent: Monday, March 20, 2017 1:59 PM
To: '[email protected]' 
<[email protected]<mailto:[email protected]>>
Subject: [Sepsis Groups] Septic shock question


Septic shock

    To everyone:

    Hoping to get some clarification re: potential septic shock pt.

    1207- B/P-  84/57 P- 135.

    Lactate at 1430- 4.8- lactate  at 1810- 4.3

    WBC- 0.1 at 1621

    Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

    No source identified

    Will this patient meet septic shock due to lactate level?

    We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

    Thank you.

    Diana Davis, Quality Outcomes Coordinator

    CMH Regional Health System

    937-382-9315


Diana Davis, Quality Outcomes Coordinator
CMH Regional Health System
937-382-9315



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