Dr Townsend,
Thank you for your responses back to everyone and assisting with
clarification. My question on the fluids is:
Patient septic shock presentation time is 1659 based on physician
documentation
A patient requires 2305 ml of fluids to be given.
Patient given 1000 ml NS at 1643
1000 ml st 1743
1000 ml at 1838
1000 ml at 2000
Would my persistent hypotension present within 1 hour of fluid
administration be after enough to fulfill the 2305 ml requirement or
after the 4000 ml she was actually given? Patient did go on to receive
vasopressors as well at 2000.
Thank you greatly!
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])
>>> "Townsend, Sean, M.D." <[email protected]> 9/30/2015 11:55
AM >>>
I do not believe this is correct. I believe that if the order is
written that way an assumption can be made that was how the fluid was
delivered, within 2 hours of the start. If on the other hand there is a
flow sheet that states it happened faster, that is not a problem.
Sean R. Townsend, M.D.
Vice President of Quality & Safety
California Pacific Medical Center
2330 Clay Street, #301
San Francisco, CA 94115
email [email protected]
office (415) 600-5770
fax (415) 600-1541
From: Cobb, Amy L. [mailto:[email protected]]
Sent: Wednesday, September 30, 2015 4:49 AM
To: Townsend, Sean, M.D.; [email protected]
Subject: [Sepsis Groups] Crystalloid fluids
Question:
Looking for some clarification on the requirements regarding the
crystalloid fluid administration. From the Spec manual it looks like
there is a documentation requirement for the time over which the IVFs
are to be given in the physician order. For example, the order must be
written to say “give 30ml/kg Normal saline IV bolus over next 2hrs”. It
looks like we cannot accept (“Choose Value 1”) if we do not have that
time frame even if it shows on the MAR that a bolus was given in an
hour. Correct?
Thank you!
Amy Cobb RN, BSN
Sepsis Coordinator/ICU Tracker
Research Outcomes
Morton Plant Hospital
MS #73
300 Pinellas St.
Clearwater, FL 33756
727-298-6953 (Desk)
727-462-3638 (Fax)
[email protected]
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