Plasmalyte avoids the hyperchloremia and does not have incompatabilty issues
that lactate has. It seems to be a good choice. C Mascioli MD MMC Oak Ridge Tn
________________________________
From: [email protected]
[[email protected]] On Behalf Of Jamie Roney
[[email protected]]
Sent: Tuesday, November 27, 2012 11:25 AM
To: Fuchs, Barry; Mary Draper
Cc: [email protected]
Subject: Re: [Sepsis Groups] use of vasopressors
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 �Cwe look
for the physician to start pressors.
I’m wondering what other facilities are doing?
Thanks!
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