The hypotension guidelines for the sepsis measure use SBP <90 and/or MAP <65 or 40 mmHg drop from baseline. Just one value is required (e.g. MAP >65, but SBP <90; use the SBP).
On the topic of hypotension, we had a miss for <30 m/kg given within 3 hours of initial hypotension. The initial hypotension occurred about 4 ½ hours prior to Severe Sepsis time zero. According to the CMS guidelines we should have given 30 ml/kg for the hypotension, even though at the time the patient did not have Severe Sepsis criteria. Can anyone explain this to me? I don’t understand why we are expected to treat Severe Sepsis prior to the presence of all criteria. Thanks, Molly Molly Duane RN, BSN, CCRN-K Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Office: 313-745-4340 Cell: 248-709-6218 Email: [email protected]<mailto:[email protected]> From: Sepsisgroups [mailto:[email protected]] On Behalf Of Christina Ford Sent: Thursday, February 07, 2019 11:31 AM To: '[email protected]' Subject: [Sepsis Groups] Hypotension Trying to get a good handle on the Hypotension aspect of this. Should we be looking at the bp and MAP or just the MAP. I have been using both – however the argument was brought to me that is the MAP is still above 65 the patient is profusing so intervention should not be needed?? Also are there set parameters for bp when looking for hypotension or are we to use the standard of below 120/80? Can you give any information on the proper way to screen and/or abstract ?? Chris Christina Ford, BSN-RN Quality Resource and Improvement Manager Lima Memorial Health System 419-226-5197 ext 2580 [email protected]<mailto:[email protected]> [cid:[email protected]] Confidentiality Note: This message is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you. Please consider the environment before printing this e-mail This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation.
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