Septic Shock
Legacy Content
This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Shock, septicClick Expand to show legacy content.
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Category/Organ System: |
Category: Cardiovascular Problems (old) |
Type: |
[[:Category: Medical Problem (old)]][[Category: Medical Problem (old)]] |
Main Diagnosis: | Septic Shock |
Sub Diagnosis: | SEPTIC SHOCK |
Diagnosis Code: | Septic Shock - 4400 |
Comorbid Diagnosis: | No |
Charlson Comorbid coding (pre ICD10): | 0 |
Program: | Critical Care and Medicine |
Status: | Currently Collected
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Mutually exclusive with Severe Sepsis
Also see Septicemia definition.
See QA Septic Shock audit started September 2009.
Definition
(1) Blood pressure (BP) criteria
- If at least one of the following is present, code Septic Shock:
- systolic BP < 90 mmHg for > 30 minutes and not responding to fluid resuscitation or
- mean (m)BP < 65 mmHg (is this an "and" to the next line?)
- BP drop of > 40 mmHg from baseline for > 30 min or
- use of vasopressor to maintain systolic BP >= 90 mmHg in the absence of other causes of shock, e.g.:
- no hypovolemia
- no MI
- no pulmonary embolus
- If none of the BP criteria are met:
- see Severe Sepsis
(2) Other Criteria
Plus at least two of:
- temperature > 38.5 C
- HR > 90
- RR > 20
(3) Organ Failure Criteria
Plus at least one of (organ failure):
- Neuro changes: GCS < 14
- Lactic Acidosis: at least one of
- LA > 2.0 or
- PH < 7.30 or
- BE < 10
- Oliguria: at least one of
- urine < 0.5 cc/kg/hr or
- urine output < 30 ml / hr or
- serum creatinine increase > 40 uM from baseline
- Hypoxia: at least one of
- Coagulopathy: drop in platelets > 25% from baseline plus at least one of
- > 25% PT or
- > 25% PTT or
- NR >1.5
Data Integrity Rules
Septic shock (44-00) is mutually exclusive with 45-00 Severe Sepsis.