Septic Shock Present Based on Lactate Level


As with Severe Sepsis, Septic Shock presentation can be determined based on provider documentation OR on clinical indicators. To determine the presentation of septic shock:

  •  First you MUST have Severe Sepsis
  • Second you MUST have EITHER
    • An Initial Lactate Level >=4 {if the lactate level is the last indicator use result time} OR
    • Hypotension prior to crystalloid fluid administration and hypotension that persists within one hour after crystalloid fluid administration ends.
  • For purposes of determining Septic Shock hypotension that persists after the conclusion of fluid administration, requires two consecutive systolic blood pressure reading <90 or two consecutive mean arterial pressure (MAP) reading <65.
  • If you have an initial Lactate Level >= 4, but no Severe Sepsis, then you do not have Septic Shock
  • If you have hypotension, but no Severe Sepsis, then you do not have Septic Shock



*Content is based on Specifications Manual Version 5.0b – October 2015 through June 2016 discharges.

**The article is part of the Registry Partners Quality Division Sepsis Newsletter.  Follow the blog to read more articles from the Newsletter or contact us to receive a copy of the full newsletter to share with your team!