Intraoperative Hyoptension requiring A-Line and Pressor

mdomineseymdominesey
in CDI Talk Archive
Hi Folks,

A patient in surgery, 30 minutes after induction has BP that bottoms out, requires bolus of fluid, and a NEW art-line placed for IV infusion of a pressor (Phenylephrine aka Neo-Synephrine).

This hypotension required intervention, but was managed. The pressor was infusing for over 2 hrs.

Query for??? Intraoperative shock, or leave it at "Hyoptension, unspecified".

Thanks a bunch

Mark



Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
Clinical Documentation Excellence
Sr. Clinical Documentation Improvement Specialist
Sibley Memorial Hospital

Information Technology
5255 Loughboro Rd NW
Washington DC, 20016-2695

W: 202.660.6782
F: 202.537.4477
mdominesey@sibley.org
[cid:image001.gif@01CDB36F.BEB495A0]
http://www.sibley.org




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Comments

  • mdomineseymdominesey
    edited May 2016
    For a spinal fusion, patient under general endotrachial anaesthesia. Obese patient, also on lactulose. So... hypovolemic already because of NPO for surgery? and probable continued fluid loss because of hyperdynamic GI motility and osmolality issues caused by lactulose?

    Thanks for the thinking.

    MND



    Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
    Clinical Documentation Excellence
    Sr. Clinical Documentation Improvement Specialist
    Sibley Memorial Hospital

    Information Technology
    5255 Loughboro Rd NW
    Washington DC, 20016-2695

    W: 202.660.6782
    F: 202.537.4477
    mdominesey@sibley.org
    [cid:image001.gif@01CDB372.D59A8650]
    http://www.sibley.org

  • Unknown
    edited May 2016
    I think that data substantiates a query. It may not be shock but would be good to have clarity on why the hypotension occurred. Vasodilation may occur with spinal anesthesia.

    -Jane

  • Unknown
    edited May 2016
    Oh not a spinal, I see now. Definitely query worthy in my opinion. I would like to know MD's answer:)

    -Jane

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