We have to remind ourselves to do what is best for patients first and worry 
about CMS guidelines second. Which I am sometimes struggling with because I 
know by watching the stroke volume the patient just can’t handle anymore fluid 
but guidelines say give it.   Good luck. We all feel the same pressure

Sent from my iPhone

On Aug 8, 2018, at 1:46 PM, Mary Draper 
<[email protected]<mailto:[email protected]>> wrote:

I have not run across this issue. Tough scenario. It was probably best for the 
patient to receive the dialysis first and then be given the antibiotic.

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Tara Miller
Sent: Tuesday, August 07, 2018 10:52 AM
To: 
'[email protected]<mailto:[email protected]>'
 
<[email protected]<mailto:[email protected]>>
Subject: [External] [Sepsis Groups] Antibiotics Admin/ Dialysis

________________________________
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links if you do not recognize the sender.
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Good afternoon.

We had a scenario of a patient who was in “septic shock” along with severe 
hyperkalemia with EKG changes. The patient had to go on emergent hemodialysis 
in the emergency room. The physician, pharmacist, and nursing staff did not 
want to give the antibiotics due to having it pulled right back out with 
dialysis. Once the patient was removed from dialysis machine, the antibiotics 
was given which was on hour 4.

Has anyone else had this same situation? What are you doing about it? Are you 
just taking the fallout for sepsis or are you administering the antibiotic 
regardless?


Thanks.

Tara R Miller, RN, BSN
Team Leader, Quality Management
Mobile Infirmary Medical Center
Office: 435-5109
Cell: 605-8270

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