Septic Shock: Difference between revisions

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#If the 1st criteria for low BP "IS" met but 2nd criteria is "NOT" met (which is tmp >38.5 or HR >90 or RR >20) examples may be patient is either sedated, ventilated, or patient is hypothermic or heart rate is less than 90 for what ever reason, would they still meet the definition of septic shock if only 1st and 3rd criteria (organ failure) are met? OR....do we code as severe sepsis (which includes organ failure but excludes low BP). If so, how do we capture the low BP? Severe sepsis is organ failure but excludes low BP.[[User: GHall |Gail Hall]], [[User: Jpeterson | Joyce Peterson]], [[User: Mlaporte | Marie Laporte]][[User:TOstryzniuk|Trish Ostryzniuk]] 15:52, 2012 June 1 (CDT)

#are any collectors only using the 1st BP criteria (BP<90mmhg) for septic shock study in TMP? Reason asking is that the drop down list in TMP files only gives hint of BP<90 so wondering if folks are forgetting there are two other option for low BP that they need to consider as indicated in criteria for BP in this article.[[User: GHall |Gail Hall]], [[User: Jpeterson | Joyce Peterson]], [[User: Mlaporte | Marie Laporte]].

#Patient in ER with no measurable BP. Tx with fluids, still no measurable BP. Difficulty inserting central line, suspected sepsis. Started on dopamine in ER. Also given antibiotic for suspected sepsis. ~~first measurable BP 96/66 which does not meet criteria for low BP for septic shock.~~ Question is this, if ~~can't measure~~ BP but being treated for septic shock

#Patient in ER with no measurable BP. Tx with fluids, still no measurable BP. Difficulty inserting central line, suspected sepsis. Started on dopamine in ER. Also given antibiotic for suspected sepsis. Question is this, if BP unmeasurable or not registering but pt is being treated for septic shock is this the time of the first low BP ? I spoke to Kendiss this morning-the answer is "yes"-the unmeasurable BP would be the first low BP for the study[[User:Mlaporte|Mlaporte]] 08:00, 2012 June 4 (CDT)

~~Patient met the criteria for severe sepsis, likely in shock but no measureable BP. What exactly~~ is the ~~start~~ time of first low BP ~~if not measureable.~~ --~~Note~~: ~~Marie will rewrite this question.........16~~:10, 2012 June 1 (CDT)

*Marie, when you complete final question, let me know and I will email off to Kendiss the above.[[User:TOstryzniuk|Trish Ostryzniuk]] 16:10, 2012 June 1 (CDT)

[[Category: Data Integrity Rules]]

[[Category:Diagnosis Coding]]

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 #If the 1st criteria for low BP "IS" met but 2nd criteria is "NOT" met (which is tmp >38.5 or HR >90 or RR >20) examples may be patient is either sedated, ventilated, or patient is hypothermic or heart rate is less than 90 for what ever reason, would they still meet the definition of septic shock if only 1st and 3rd criteria (organ failure) are met?  OR....do we code as severe sepsis (which includes organ failure but excludes low BP).  If so, how do we capture the low BP?   Severe sepsis is organ failure but excludes low BP.[[User: GHall |Gail Hall]], [[User: Jpeterson | Joyce Peterson]], [[User: Mlaporte | Marie Laporte]][[User:TOstryzniuk|Trish Ostryzniuk]] 15:52, 2012 June 1 (CDT)
 #are any collectors only using the 1st BP criteria (BP<90mmhg) for septic shock study in TMP?  Reason asking is that the drop down list in TMP files only gives hint of BP<90 so wondering if folks are forgetting there are two other option for low BP that they need to consider as indicated in criteria for BP in this article.[[User: GHall |Gail Hall]], [[User: Jpeterson | Joyce Peterson]], [[User: Mlaporte | Marie Laporte]].
-#Patient in ER with no measurable BP. Tx with fluids, still no measurable BP.  Difficulty inserting central line, suspected sepsis.  Started on dopamine in ER.  Also given antibiotic for suspected sepsis.  first measurable BP 96/66 which does not meet criteria for low BP for septic shock.     Question is this, if can't measure BP but being treated for septic shock
+#Patient in ER with no measurable BP. Tx with fluids, still no measurable BP.  Difficulty inserting central line, suspected sepsis.  Started on dopamine in ER.  Also given antibiotic for suspected sepsis.      Question is this, if BP unmeasurable or not registering but pt is being treated for septic shock is this the time of the first low BP ?  I spoke to Kendiss this morning-the answer is "yes"-the  unmeasurable BP would be the first low BP for the study[[User:Mlaporte|Mlaporte]] 08:00, 2012 June 4 (CDT)
-Patient met the criteria for severe sepsis, likely in shock but no measureable BP.  What exactly is the start time of first low BP if not measureable.    --Note: Marie will rewrite this question.........16:10, 2012 June 1 (CDT)
 *Marie, when you complete final question, let me know and I will email off to Kendiss the above.[[User:TOstryzniuk|Trish Ostryzniuk]] 16:10, 2012 June 1 (CDT)
 [[Category: Data Integrity Rules]]
 [[Category:Diagnosis Coding]]