Hi CariAnn,
I would say that all of those parameters are important, however you need the
lactic acid to complete the picture of the patient. You want to see a trending
down of your lactic acid. You want to know that on a cellular level the tissue
is not still being deprived. One important thing I have learned in working with
the SSC in our Med/Surg collaborative is be on the lookout for cryptic shock.
This is the where the B/P looks normal but the lactate is elevated. It's only a
matter of time before the pt's B/P is no longer "normal". You are basically
allowing the cells to be deprived during this time. I also watched a great
U-Tube video by Dr Dellinger and Dr Shaughnessy on lactic acid. "Lactate
Measures: When, Why, and How Much".
I hope this helps.
Amy
Amy L. Sprague MSN, RN, ACNS-BC, CCRN
Clinical Nurse Specialist~Critical Care
Franciscan St. Francis Health
8111 S. Emerson Avenue
Indianapolis, IN 46237
Office (317)528-6800
[email protected]
"Work for a cause, not for applause.
Live life to express, not to impress.
Don't strive to make your presence noticed,
just make your absence felt."
From: Sepsisgroups [mailto:[email protected]] On
Behalf Of CARIANN M DAHLQUIST
Sent: Thursday, July 10, 2014 4:56 PM
To: [email protected]
Subject: [Sepsis Groups] lactic acid
Hello,
Inquiring how other facilities are doing with physicians obtaining the second
lactic acid within 6 hours if initial was > 2mmol/L? I am having some push
back from our Critical Care that feel as though this leads to additional labs
being drawn that they do not feel are needed as they are treating the patient
based on MAP, CVP, blood pressure, etc...
They do have several good points such as a patient that has liver failure and
has a baseline lactic of 2.05, why continue to drawn more labs?
Any ideas or processes would be appreciated.
Thanks.
CariAnn
CariAnn Dahlquist RN
Quality Management
Altru Health System | Grand Forks, ND
701.780.5339 phone | 701.780.1942 fax |
[email protected]<mailto:[email protected]>
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