Physician documentation at 0906 = septic shock (at time of admission) Thanks,
MARY ANN BARNES-DALY RN BSN CCRN DC | Clinical Performance Improvement Consultant Sutter Health - Office of Patient Experience | 2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| Office 916.286.6717 | [email protected] "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: Sepsisgroups [mailto:[email protected]] On Behalf Of CARIANN M DAHLQUIST Sent: Wednesday, October 14, 2015 7:55 AM To: [email protected] Subject: [Sepsis Groups] Septic Shock presentation I have a patient arrived at 2148 and by 2233 we met the 3 criteria to meet severe sepsis including an initial lactic of 3.96. Patient received 1 liter NS bolus @ 2217, however was not hypotensive with a BP 82/55 until 2350. Repeat lactate level at 0106 results at 5.22 Physician documentation at 0906 states likely septic shock on admit My question is initial lactate was not 4 or greater to represent septic shock, the patient did not receive 30 ml/kg fluids to determine persistent hypotension and the physician documentation is the next morning stating septic shock on admit, how do I determine the timing of septic shock presentation in this patient? Thanks much! 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]> ------------------------------------------------------------------------------------------------------------------- CONFIDENTIAL & PRIVILEGED COMMUNICATION This email and any files transmitted with it are confidential, may contain privileged or copyright information, and are intended solely for the use of the intended recipient. If you are not the intended recipient of this email, you are required to notify the sender immediately and delete this email from your system. You may not copy, distribute or use this email or the information contained in it for any purpose other than to notify the sender. We do not guarantee that this material is free from viruses or any other defects although due care has been taken to minimize the risk. Any views expressed in this message are those of the individual sender, except where the sender specifically states them to be the views of Altru Health System.
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
