Sepsis is the ONE shock in which I teach my nurses to look at MAP. It is a vasodilatory shock & if their systolic is 90 but diastolic is 30 they are not getting perfusion due to inadequate MAP. Hope this helps.
Tina Jackson MSN, RN, CCRN Clinical Nurse Educator Holy Spirit Health System Camp Hill, Pa. 17011 717-763-2428 cell 713-8891 [email protected] From: [email protected] [mailto:[email protected]] On Behalf Of Kristine Lundeen Sent: Monday, February 13, 2012 12:26 PM To: [email protected] Subject: [Sepsis Groups] hypotension - is it all equal? The Surviving Sepsis Campaign (SSC), defines hypotension as SBP < 90 or MAP < 65 (http://www.survivingsepsis.org/files/Tools/evaluationforseveresepsisscr eeningtool.pdf) when screening a patient for severe sepsis. However, in the sepsis resuscitation bundle, one of the four standards to measure quality of fluid resuscitation is whether or not MAP is > 65. Interestingly, they do not specify that SBP be > 90, only MAP > 65. (http://www.survivingsepsis.org/About_the_Campaign/Documents/2008%20Guid elines%20Poster.pdf and http://www.survivingsepsis.org/Bundles/Individual_Changes/Pages/apply_va sopressors.aspx). In the context of SSC sepsis resuscitation, all hypotension (SBP < 90 or MAP < 65) does not seem to be equal. It appears that SSC uses MAP, not SBP, as the hemodynamic parameter to consider, when measuring the effectiveness of fluid and vasopressor resuscitation. How do providers on this list serve practice? Do you consider the patient with MAP < 65 as hypotensive, even it her/his SBP is > 90? Is there a risk of hypoperfusion of end organs, if MAP is still < 65 while SBP > 90? Kristine Kristine Lundeen, RN, MN MultiCare Health System, Tacoma, WA Office: 253-403-1164 ________________________________ MULTICARE'S SHARED VALUES | Respect | Integrity | Stewardship | Excellence | Collaboration | Kindness Mailgate1.multicare.org made the following annotations --------------------------------------------------------------------- NOTICE: This e-mail and the attachments hereto, if any, may contain privileged and/or confidential information. It is intended only for use by the named addressee(s). If you are not the intended recipient of this e-mail, you are hereby notified that any examination, distribution or copying of this e-mail and the attachments hereto, if any, is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by email or telephone and permanently delete this e-mail and the attachments hereto, if any, and destroy any printout thereof. MultiCare Health System, Tacoma, WA 98415 (253) 403-1000. ============================================== Attention: This Message is intended only for the use of the individual or entity to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination or copying of this message or the taking of any action in reliance on the contents of this message is strictly prohibited. If you have received this message in error, please notify us immediately and destroy the original message. Thank you.
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