I understand a repeat lactate has to be done within 6 hours.  My question is if 
the initial lactate is <4 and the repeat lactate is > 4 does the patient now 
qualify for septic shock.  Also, if the patient does not have septic shock 
within 6 hours of the first episode of severe sepsis.  Do you stop looking for 
septic shock during the rest of the patient stay.

Thanks in advance for the advice


Linda Brown BSN RN
Performance Improvement
Nebraska Methodist Hospital
Omaha, Ne
402-354-4006



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