For now you are unable to use IBW, however check the new guidelines for January 2018. They address IBW for obese patients if the MD specifically mentions it. From the Spec Manual starting in January 2018:
Use the patient's actual weight. Use estimated weight only if actual weight is not available to determine the volume of crystalloid fluids the patient should receive. Do not use ideal weight unless indicated by the physician/APN/PA. * If there is physician/APN/PA documentation identifying the patient has obesity (defined as a Body Mass Index >30), the clinician may choose to use Ideal Body Weight (IBW) to determine the target ordered crystalloid fluid volume. If the clinician prefers to use IBW, it must be documented clearly and the clinician must indicate that IBW will be the weight used to determine the target ordered volume Beth Beth Knight, BSN, RN, OCN Clinical Outcomes Specialist Healthcare Quality Franciscan Health Indianapolis, Carmel, Mooresville Phone: 317-528-1470 [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Belfi, Karen Sent: Monday, July 31, 2017 2:01 PM To: Nicole Dyess; [email protected] Subject: Re: [Sepsis Groups] FLUID REQUIREMENTS CAUTION: Email is from an EXTERNAL source, exercise caution. Do not click on any links or attachments unless you are certain that they are safe and are required for business. If you believe this is a suspicious email forward the message to [email protected]<mailto:[email protected]>, for verification. There is no need to forward this email to information security if you do not think it is suspicious. The guidelines state not to use ideal body weight. Use the patient's actual weight. Use estimated weight only if actual weight is not available to determine the volume of crystalloid fluids the patient should receive. Do not use ideal weight. Karen Belfi, RN, MSN Quality Outcomes Coordinator Lankenau Medical Center (484)476-8092 From: Sepsisgroups [mailto:[email protected]] On Behalf Of Nicole Dyess Sent: Saturday, July 29, 2017 12:02 PM To: [email protected]<mailto:[email protected]> Subject: [EXTERNAL] [Sepsis Groups] FLUID REQUIREMENTS This message originated from outside MLHS systems. Any attachments or links should be carefully considered before proceeding. Please contact the Help Desk at 484-596-4357 with any questions or forward a questionable email to [email protected]<mailto:[email protected]> ________________________________ For the 30ml/kg fluid requirement, is anyone using IBW for your obese patients? I have found conflicting statements on if this will satisfy the requirement. If you do use IBW, can you send me your reference that supports using it. Thanks! Nicole Dyess, PharmD Antimicrobial Stewardship Team Leader Conway Regional Health System 2302 College Ave, Conway, AR 72034 (501) 513-5152 (501) 450-2368 Fax [Description: Description: cid:[email protected]] ________________________________ The information contained in this e-mail and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.
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