Hi - if there is only one hypotensive BP in a 6hr window prior to or after TOP, then you don't have initial hypotension. There needs to be 2 hypotensive BP's in that window, and they need to be within 3 hrs of each other (don't need to be consecutive). The time of the qualifying 2nd BP would be the time of initial hypotension. In this scenario, if you only have 1 low BP, it would be organ dysfunction criteria but not initial hypotension. Hope this helps - Pam
Pamela Anderson, BSN, RN Clinical Data Abstractor NSQIP-Pediatric SCR Center for Clinical Effectiveness Bldg 105-3914 Loyola University Medical Center 2160 S. 1st Avenue Maywood, IL 60153 [email protected] Office 708-216-5228 Fax 708-216-7867 ________________________________ From: "Duane, Molly" <[email protected]> Sent: Tuesday, June 4, 2019 5:31 PM To: "'[email protected]'" <[email protected]> Subject: [External] [Sepsis Groups] Fluid resuscitation prior to time zero Warning: This email originated from the Internet! DO NOT CLICK links if the sender is unknown, and NEVER provide your password. Good Evening, Can someone please explain why we are held accountable to give 30 ml/kg for hypotension prior to time zero? Time zero: 0954 (0420: RR 22, 0435 Temp 35.0; 0420 SBP 87; 0954 H&P: possible sepsis). The patient received 500 ml boluses X4: at 0430, 0929, 1154 & 1210. Pt weighed 53 kg/required 1530 ml. The miss is: we did not give 30 ml/kg within 3 hours of initial hypotension (0420). Do you all give 30 ml/kg for all hypotension, even if the provider does not think sepsis is the cause for the hypotension? In this case we gave more than enough fluid within 3 hours of time zero, but obviously still missed. Any thoughts? Thanks, Molly Molly Duane RN, BSN, CCRN-K Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Office: 313-745-4340 Cell: 248-709-6218 Email: [email protected]<mailto:[email protected]> This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation. Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.
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