Thank you for the paper! I've been advocating for a change in practice to use more LR and was asked by the intensivists to produce the literature. I will send this on....many thanks.
Mary Kay Bader RN, MSN, CCNS,FAHA, FNCS Neuro/Critical Care CNS Mission Hospital Sent from my iPad On May 1, 2015, at 7:42 AM, "Doberenz, Doris" <[email protected]<mailto:[email protected]>> wrote: It has been known for a long time now that normal saline is nowhere normal and when used excessively can have serious side effects, starting with hyperchloraemic acidosis. Prof John Kellum from Pittsburgh, US, is an expert on this topic and I find it quite stunning that the American nursing and medical community is still using so much saline and not aware of the downsides. I attach a very good American paper comparing saline and balanced plasmalyte, that shows that saline in surgical patients was associated with significant morbi-mortality, compared with Plasmalyte. With kind regards Doris Doberenz FRCA FFICM EDAIC EDIC Consultant, Intensive Care and Anaesthesia Charing Cross Hospital Fulham Palace Rd London W6 8RF 0203 311 1234 bleep 5742 Mobile 07855 754 160 Alternative e-mail: [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Mary Kay Bader Sent: 29 April 2015 16:28 To: mabel bellanca Cc: Gail Taylor; [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 153, Issue 1 Warning: This message contains unverified links which may not be safe. You should only click links if you are sure they are from a trusted source. We used it during the normal saline shortage crisis last year. I heard an interesting presentation at ISICEM in Brussels where they compared NS to LR re sodium content and advocated for its use when you are concerned about sodium. Nothing official on which fluid was better Mk Sent from my iPhone On Apr 29, 2015, at 7:45 AM, mabel bellanca <[email protected]<mailto:[email protected]>> wrote: Hi All, Has anyone hear that lactated ringers solution should be used for fluid resuscitation instead of normal saline? On Monday, April 27, 2015, Gail Taylor <[email protected]<mailto:[email protected]>> wrote: We are currently not using nurse driven protocols except in the ED and with our MRTs. These include lab orders but no fluid or antibiotics. On another subject, has anyone started to address the CMS requirements? Thanks, Gail Gail Taylor, RN, MPH, CCRN Corporate Administrator Patient Care Integration Methodist Le Bonheur Healthcare 1211 Union Avenue Suite 638 Memphis, TN 38104 Office: 901-516-0701 or 901-516-0749 Cell: 901-258-3349 Fax: 901-516-0794 [email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');> "Be treated well." 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Re: Nurse Driven Sepsis Protocols (Stephens, Kari) ---------------------------------------------------------------------- Message: 1 Date: Sun, 19 Apr 2015 13:45:56 +0000 From: "Stephens, Kari" <[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');>> To: "[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');>" <[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');>> Cc: "[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');>" <[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');>> Subject: Re: [Sepsis Groups] Nurse Driven Sepsis Protocols Message-ID: <[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]');>> Content-Type: text/plain; charset="us-ascii" I would be interested in nurse driven protocols also. Sent from my iPhone On Apr 17, 2015, at 10:25 AM, "[email protected]<mailto:[email protected]><javascript:_e(%7B%7D,'cvml','[email protected]%5Cx3cmailto:[email protected]%5Cx3e');>" <[email protected]<mailto:[email protected]<javascript:_e(%7B%7D,'cvml','[email protected]%5Cx3cmailto:[email protected]');>>> wrote: Good Morning, Our pharmacy department and myself are putting together a presentation on nurse driven protocols and we are needing further resources. We are looking for facilities who have implemented this and have evidence to support that this worked at your facility. Any PowerPoints, research articles or handouts are greatly appreciated! We love anything with stats and data. Even a contact person would be greatly appreciated. Thank you, Katerina Rhynes - RN, BSN Sepsis Coordinator Wesley Medical Center Quality Department 550 N. 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