Since an elevated lactate is either a marker for severe sepsis (<2.0) or septic shock (> 4.0) I would consider using > 2.0 This is not technically a ‘critical value’ but it should result in a sepsis screen followed by appropriate action If the lactate draw is a result of suspected severe sepsis, then again, the > 2.0 value should be used.
Thanks, Mary Ann Daly, RN BSN CCRN DC Regional Clinical Initiative Lead-Sepsis and ICU Liberation (ABCDE) Gordon and Betty Moore Foundation Grant Sutter Health Sacramento Sierra Region E-mail: [email protected]<mailto:[email protected]> Blackberry: 916.200.5604 Office: 916.614.6370 You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete. R. Buckminster Fuller From: [email protected] [mailto:[email protected]] On Behalf Of Sullivan, Cynthia Sent: Sunday, June 16, 2013 2:33 PM To: [email protected] Subject: Re: [Sepsis Groups] Lactate levels Hello all: I’m canvasing the group to find out at what is the cut off result that the lab is required to call a Lactate level to the primary RN? I’m pushing our lab to call if it’s greater than 2.5 and I’m curious as to what the norm of it being a critical/panic result is. It’s a time delay in our ER when the nurse has to constantly be checking for the results (because they aren’t panic). Thank-you, Cynthia Cynthia Sullivan RN, VA-BC, CCRN, MSN PICC Team Coordinator (607) 274-4466 From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Lindsay Hindin Sent: Friday, June 07, 2013 12:41 PM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] Code sepsis in ED I am looking at who you use for a Code sepsis team in the ED ? We are currently using lactates at triage via Advanced Nursing Interventions (ANI’s) and include lactic acid testing on several presentations such as AMS, fever, CHF, suspected pneumonia and abdominal pain. Lab is calling a critical results if the lactate is > 2.5. This process is hardwired; we lack the second phase of implementation of the treatment bundle. How do you do this effectively and quickly? Thanks Lindsay Hindin, BSN, RN Director of Emergency Services South Miami Hospital 6200 SW 73 Street | Miami, FL 33143 Direct: 786-662-4301| Fax: 786-662-5101 | Ascom: 786-662-2933 Learn more: www.baptisthealth.net<http://www.baptisthealth.net/> ________________________________ This message originates from Baptist Health South Florida (BHSF). It contains information that may be confidential or privileged and is intended only for the individuals or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. This message may not be copied or distributed without this disclaimer. All personal messages express views solely of the sender, which are not to be attributed to BHSF. If you received this message in error, please notify us immediately at [email protected]<mailto:[email protected]>. BHSF scanned this email for viruses, vandals and malicious content.
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