Yes - but the physician already stated the pt has severe sepsis - so the lactate >4 indicates septic shock.
If it were due to cardiac arrest, liver failure, burns etc - then they would most likely not meet sepsis/severe sepsis criteria (infection related) - so it would not be septic shock. Brenda :) Brenda Downs MSN, APRN, ACNS-BC Cell: 480-720-6102 Program Director Clinical Performance Improvement - ICU Care [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Mary ann David Sent: Thursday, November 12, 2015 10:49 PM To: 'Barnes-Daly, Mary Ann'; 'Tribuiani, Barbara'; '[email protected]' Subject: Re: [Sepsis Groups] Septic Shock Present However, there are other reasons lactate can be elevated but not septic shock such as cardiac arrest, ischemia, burns, liver failure, etc. Shouldn't those be considered? Thanks, Mary Ann David, MSN, RN, CNS, ACNS-BC Clinical Nurse Specialist, MICU/SICU/RRT Sharp Chula Vista Medical Center Tel. No. 619-502-3165 Hospital Cell No. 619-502-5578 Pager No. 619-688-7124 Fax. No. 619-502-4076 Email. [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Barnes-Daly, Mary Ann Sent: Tuesday, November 10, 2015 10:30 AM To: 'Tribuiani, Barbara'; '[email protected]' Subject: Re: [Sepsis Groups] Septic Shock Present Physician documentation is used only if the other criteria are not found. In this case, severe sepsis is present - so the Lactate of 4.3 = septic shock 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]<mailto:[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 Tribuiani, Barbara Sent: Wednesday, November 04, 2015 10:21 AM To: '[email protected]' Subject: [Sepsis Groups] Septic Shock Present Hello All- I have a patient who meets criteria for septic shock due to the initial lactate of 4.3 however the physicians clearly document that the patient has "severe sepsis without shock" How do I answer the question "septic shock present" in this case?? Thank you, Barb Barbara Tribuiani, RN, BSN Quality Improvement Department Phone: 610-237-4208 Fax: 610-237-4264 T Together E Everyone A Achieves M More Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.
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