I will answer the second question because I know the answer.  The first one I'm 
sure the folks out here can be helpful about.

It was simply based on the fact that common things are common and the studies 
in septic shock (Rivers, ARISE, ProCESS, ProMISE) used common crystalloids.  
Frankly, those of us involved in drafting the measure all have very little 
experience with some of the other suggestions that have come up and remain 
unconvinced that landmark papers tell us there is a great advantage to using 
them.  Thus, they weren't even considered.  I know you may take issue with 
decision, and perhaps it can be revisited if there is a compelling reason, but 
it seems to amount to little mortality advantage in the scheme of things.


From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Clement, Joseph (DPH)
Sent: Tuesday, October 06, 2015 8:08 AM
To: [email protected]
Subject: [Sepsis Groups] Rate of Infusion in Fluid Orders and PlasmaLyte use


Hello,



I have a couple of questions about Fluids:



[]  My understanding is there is a requirement for the rate (or duration) of 
fluid administration to be present in the order in order to be counted against 
the 30 ml/kg volume.  I think I've heard others say, however, that if there is 
clear documentation of the actual rate of administration (for example, in 
nursing documentation such as a MAR or a flowsheet), then this is not required. 
Does anybody know for sure?



[] I understand that plasmaLyte can not be counted against the 30ml/kg volume 
(though Lactated Ringers can).  Is anybody aware of a rationale for this?



Thank you,



Joe




Joseph Clement, MS, RN, CCNS
Clinical Nurse Specialist
San Francisco General Hospital
ph: 415206-6174
pg: 415 327-0220
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