This is the consensus definition of septic shock.It’s not about lab results but rather response to fluid.
> "Septic shock: sepsis with persisting arterial hypotension or hypoperfusion > despite adequate fluid resuscitation.” Lactic acid is a measure of tissue hypoxia indicating severe sepsis defined as sepsis with organ dysfunction, hypotension or hypoperfusion. This is a good reference showing all of the lab indicators and their meaning. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/infectious-disease/sepsis/ Lewis Holmes, MD, MPH Porter Medical Center > On Nov 13, 2015, at 1:03 PM, Harkey,Jessica <[email protected]> wrote: > > This patient has already coded out with a sepsis diagnosis, therefore the > elevated lactate would be the criteria for septic shock. The way I understand > the intent of the treatment, the measure and criteria, is that even if there > were other types of lactic acidosis, the sepsis will more than likely be > higher risk of mortality therefore treat the septic shock without delaying > while other sources of lactic acidosis are considered. So infection + SIRS+ > shock (lactate >4)= implement the bundle timely and treat sepsis first > regardless of other potential sources of lactate. Then evaluate after the > bundle has been completed. > Jessica Harkey, MSN, RN, ACCNS, CCRN > Sepsis Program Coordinator > San Joaquin Community Hospital > > Sent from my iPad using Mail+ for Outlook <http://taps.io/mailplus> > > From: Mary ann David > Sent: 11/12/15, 9:48 PM > To: 'Barnes-Daly, Mary Ann', 'Tribuiani, Barbara', sepsisgroups > 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] > <mailto:[email protected]>] On Behalf Of > Barnes-Daly, Mary Ann > Sent: Tuesday, November 10, 2015 10:30 AM > To: 'Tribuiani, Barbara'; '[email protected] > <mailto:[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] > <mailto:[email protected]>] On Behalf Of Tribuiani, > Barbara > Sent: Wednesday, November 04, 2015 10:21 AM > To: '[email protected] > <mailto:[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. > _______________________________________________ > Sepsisgroups mailing list > [email protected] > <mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > <http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org>
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