Thank you Robin. Yes seems like that. But it is so confusing. We are not giving adequate fluids and as a result patient is further going into hypotension. Nobody ordered Lactic Acid (who knows, it might be >4) and due to CMS guidelines we cannot say this is Septic Shock. I wonder how many cases fit into this category. The government data is going to be skewed.
From: Myran, Robin [mailto:[email protected]] Sent: Friday, February 05, 2016 3:26 PM To: DHILLON, ROOPINDER; [email protected] Subject: RE: [Sepsis Groups] Septic Shock presentation I've attached a slide from the 10/26/15 webinar that (I believe) addresses the exact scenario you outline below. Septic Shock Present = No. Robin Robin Myran, MSN, RN, PCCN Sepsis Coordinator Hoag Memorial Hospital Presbyterian One Hoag Drive Newport Beach, CA 92658 Office: (949) 764-4588 Fax: (949) 764-5387 Cell: (949) 300-9137 [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of DHILLON, ROOPINDER Sent: Tuesday, February 02, 2016 7:04 AM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] Septic Shock presentation Please see the following scenario... The Patient had severe sepsis based on the following... Source of infection, SIRs and Organ dysfunction (Hypotensive with Systolic 75). No initial lactate was done and the Crystalloid fluid administered was <30 ml/kg. What should I answer for the question Septic shock present, considering the patient was hypotensive even after conclusion of the fluid amount (rate was also <125 ml/hr). Thank you, Roopa Dhillon MBBS, MBA Clinical Quality Analyst I Quality Improvement/Clinical Outcomes University Hospitals Elyria Medical Centre 630 East River Elyria, Ohio 44035 T 440-329-4959 F 440-329-5971 Roopinder.Dhillon@UHhospitals<mailto:Roopinder.Dhillon@UHhospitals> .org Quality Assurance/Peer Review Privileged Pursuant to Ohio Rev. Code secs. 2305.24, 2305.25, 2305.251, 2305.252 and 2305.253 Visit us at www.UHhospitals.org<http://www.UHhospitals.org>. The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee. Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. Please note that the information contained in this message and any files transmitted with it are privileged and confidential and are protected from disclosure under the law, including the Health Insurance Portability and Accountability Act (HIPAA). If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited and may subject you to criminal or civil penalties. If you have received this communication in error, please notify the sender by replying to the message and delete the material from any computer. Thank you, Hoag Memorial Hospital Presbyterian and its Affiliates Visit us at www.UHhospitals.org. The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee. Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law.
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