Sorry, to clarify, they said to use 13:06. I wrote back several times. Their rationale: Since the antibiotics were used to calculate the crystalloid fluids (and they also said that if the fluids are hung in the time frame and >125/hr we have to use them, even if we don't need them to meet the 30 mL/kg), that it is now multiple orders, so we are to abstract the latest fluids hung in the time frame.
From: Sepsisgroups [mailto:[email protected]] On Behalf Of Belfi, Karen Sent: Tuesday, March 19, 2019 7:12 AM To: [email protected] Subject: [Sepsis Groups] Crystalloid fluids ________________________________ I wrote to Qnet regarding crystalloid fluids. This was my question: I have a strange case. Pt needs 2760 mL. The pt had an order for 3 liters of fluid, hung 12:07, 1231, 1306. The first liter ran over almost 2 hours. The others ran faster. At 1305 100 mL of antibiotics was hung at 150/hr. It ran concurrently with the first liter of fluid so was calculated into the crystalloid fluids. Would I take 12:07 for the crystalloid fluid time, or 13:05 since that was the latest one that got us to the 30 mL/kg? Thanks! I was told to take 13:05, because even though the fluids were ordered in one order, multiple bags were used to calculate the crystalloid fluids. The severe sepsis time was 10:00. If I used the time the fluids were hung, it would be 12:07, and we would be compliant. But because antibiotics were appropriately hung in the time frame, we had to use them, and it is now an outlier. Has anyone else experienced this? It's very difficult to explain to physicians that even though they did things appropriately, it is an outlier. Thanks, Karen Belfi MSN, RN Main Line Health (484)476-8092 This email and attachments contain information that may be confidential or privileged. If you are not the intended recipient, notify the sender at once and delete this message completely from your information system. Further use, disclosure, or copying of information contained in this email is not authorized, and any such action should not be construed as a waiver of privilege or other confidentiality protections.
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