There are many drug incompatibilities with Lactated Ringers, thus making NS a great carrier in addition to the volume resuscitation.
Jamie Jamie K. Roney, RN, BSN, BSHCM, CCRN CHS Sepsis Coordinator 806-725-4689 tel 806-773-1914 cell "Be a yardstick of quality. Some people aren't used to an environment where excellence is expected." ~Steve Jobs From: [email protected] [mailto:[email protected]] On Behalf Of Fuchs, Barry Sent: Monday, November 26, 2012 8:30 PM To: Mary Draper Cc: [email protected] Subject: Re: [Sepsis Groups] use of vasopressors In our ICU we use LR as the default except in severe liver disease or hyperkalemia, to both avoid the acidosis - which often complicates resp failure management and b/c of recent data suggesting a mortality benefit when resuscitation is done with low chloride solutions. barry Sent from my iPad On Nov 26, 2012, at 4:32 PM, "Mary Draper" <[email protected]<mailto:[email protected]>> wrote: We use normal saline which is recommended by the guidelines. Mary Draper RN BSN CCRN Quality Manager-Best Practice Support Quality Management Supervisor Office (925) 674-2045<tel:(925)%20674-2045> Cell (925) 451-8792<tel:(925)%20451-8792> Fax (925) 674-2373<tel:(925)%20674-2373> [email protected]<mailto:[email protected]> On Nov 21, 2012, at 8:31 AM, "[email protected]<mailto:[email protected]>" <[email protected]<mailto:[email protected]>> wrote: The question is witch cristaloid to use......saline solution or ringer?.... From my HTC Sensation 4G on T-Mobile. The first nationwide 4G network ----- Reply message ----- De: "Adrian Verdin Z." <[email protected]<mailto:[email protected]>> Para: "Mary Draper" <[email protected]<mailto:[email protected]>> CC: "[email protected]<mailto:[email protected]>" <[email protected]<mailto:[email protected]>> Asunto: [Sepsis Groups] use of vasopressors Fecha: mar., nov. 20, 2012 2:57 p. m. Yes those are part of the 4 principal goals in surviving sepsis campain. We Also use the arterial line waves forms ior the plestitmographic waves for fluid Administracion or to use pressors <images.jpeg> Dr. Adrián Verdín Z. Terapia intensiva Anestesia 614 159 3883 cell 614 1800 800 ext 16574 El 20/11/2012, a las 10:47, "Mary Draper" <[email protected]<mailto:[email protected]>> escribió: Our facility continues to bolus an additional 3-5 liters if the lactate comes back ≥ 4. If after that and we have a CVP that is still < 8, we would continue to bolus. Thanks. Mary Draper RN BSN CCRN Quality Manager-Best Practice Support Quality Management Supervisor Office (925) 674-2045 Cell (925) 451-8792 Fax (925) 674-2373 [email protected]<mailto:[email protected]> <image001.png> From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Hefton, Suzanne Sent: Monday, November 19, 2012 5:55 PM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] use of vasopressors New to the list serve so I apologize if this has been asked previously….Currently, we report Fluid Bolus of 20ml/kg, CVP for lactate > 4 or inability to maintain MAP and initiation of vasopressors if MAP < 65 as separate measures. Some of our ED physicians have questioned if we should wait to start pressors until we have gotten to a CVP of 8. Example: pt has a MAP of 60 and a CVP of 4 after the fluid bolus –we look for the physician to start pressors. I’m wondering what other facilities are doing? Thanks! _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message. ________________________________ Notice from St. Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure.
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