Molly, >From my understanding, the difference between the two criteria, hypotension >for organ dysfunction and initial hypotension, is primarily what qualifies as >organ dysfunction versus the definition of Septic Shock.
1. Initial hypotension correlates with Persistent hypotension, and are both used as a measure to determine a patient's fluid responsiveness. In this quality, we want to determine that this isn't a single hypotensive measurement, just like the measure element for persistent hypotension. 2. This is different from the recognition that a single hypotensive BP is indicative of organ dysfunction. As hypotension is a late sign of shock, a single measurement is enough to trigger the screen for organ dysfunction (along with any of the other criteria i.e. increased CR, increased PT/PTT, etcetera), making the patient positive for Severe Sepsis. I hope this makes sense to you. Thanks, Gregory RN Gregory Briddick, Jr BSN, RN, CCRN, TCRN Sepsis Program Coordinator SUNY Upstate University Hospital 750 East Adams St, UH-1112 Syracuse NY 13210 Phone: 315-464-1556 [email protected] "Leadership is not magnetic personality, that can just as well be a glib tongue. It is not "making friends and influencing people", that is flattery. Leadership is lifting a person's vision to higher sights, the raising of a person's performance to a higher standard, the building of a personality beyond its normal limitations." - Peter F. Drucker
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