We have been repeating lactate for any initial level >2 for >2 years now to follow if there is adequate lactate clearance instead of following SVO2>70 in the SSC criteria. It does have clinical significance if it is rising because the pt is more unstable if the level increases. We have found it very useful.
Andre Vovan, MD MBA FCCM Chief of Service, Critical Care ________________________________ From: Sepsisgroups <[email protected]> on behalf of DHILLON, ROOPINDER <[email protected]> Sent: Friday, February 19, 2016 10:14 AM To: 'Bruce S. Bainbridge'; '[email protected]' Subject: Re: [Sepsis Groups] Repeat Lactate Yes, Repeat lactate has to be done any time the Initial Lactate is >2. I found out today if Initial Lactate is >4 and even if there is no persistent hypotension we still need to have documentation for All of the Focus Exam criteria or 2 of the Hemodynamic monitoring. If not we fail the measure despite the fact patient does not have persistent hypotension after the conclusion of right amount of fluids. From: Sepsisgroups [mailto:[email protected]] On Behalf Of Bruce S. Bainbridge Sent: Tuesday, February 16, 2016 5:28 PM To: '[email protected]' Subject: [Sepsis Groups] Repeat Lactate I may have missed this discussion, but I had a patient fail SEP-1 when no repeat Lactate level was ordered. If the initial Lactate was >4, I see no guideline that necessitates a repeat draw in this case. Is a repeat draw still required if the initial Lactate is already >4? I appreciate all your help with this. Bruce Bainbridge, RN, BA | Clinical Data Analyst | Tri-City Medical Center | Quality & Performance Improvement | 4002 Vista Way | Oceanside, CA 92056 760-940-3789 I [email protected]<mailto:[email protected]> |www.tricitymed.org<http://www.tricitymed.org/> CONFIDENTIALITY NOTICE This message and any included attachments are from the Tri-City Healthcare District and are intended only for the addressee. The information contained in this message is confidential and may constitute non-public information under international, federal, or state securities laws and is intended only for the use of the addressee. Unauthorized forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail. This message has been scanned for malware by Websense. www.websense.com<http://www.websense.com/> 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. 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
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