CEDARLINE MEDICAL CENTER, SACRAMENTO
2100 Halcyon Parkway, Sacramento, CA 95816
Phone: (916) 555-0142 | NPI: 1730345829 | Tax ID: 94-2788907
| Time | Medication / Item | Dose | Route | Site | Administered By |
|---|---|---|---|---|---|
| 04/14/2026 20:05 | Blood cultures x 2 sets (peripheral) Drawn PRIOR to first antibiotic dose. |
2 sets (aerobic + anaerobic each) | Peripheral venipuncture, separate sites | Right antecubital; Left antecubital | L. Okonkwo, RN |
| 04/14/2026 19:50 | Lactate (initial) + sepsis labs — specimen collection Initial lactate resulted 3.8 mmol/L. |
Green-top + chemistry tubes | Venous draw, right AC | Right AC | L. Okonkwo, RN |
| 04/14/2026 20:12 | Lactated Ringer's — 30 mL/kg bolus 30 mL/kg bolus initiated; full volume completed prior to vasopressor initiation. Hemodynamic reassessment at 23:10 showed persistent MAP <65. |
2040 mL (30 mL/kg x 68 kg) | IV, two 18-gauge peripheral lines, pressure bag | Right AC; Left forearm | M. Delgado, RN |
| 04/14/2026 20:25 | Ceftriaxone 2 g IV Administered within 1-hour target from ED arrival (19:42). Pyxis dispense verified ED Bay 2, sepsis protocol. |
2 g | IV, 30-minute infusion | Left forearm IV | M. Delgado, RN |
| 04/14/2026 21:40 | Acetaminophen 650 mg For T 103.0 F. |
650 mg | PO | — | M. Delgado, RN |
| 04/14/2026 22:50 | Lactate (repeat) — specimen collection Repeat lactate drawn AFTER completion of 30 mL/kg crystalloid. Resulted 2.4 mmol/L. |
Green-top tube | Venous draw, left AC | Left AC | M. Delgado, RN |
| 04/14/2026 23:10 | Right internal jugular central venous catheter placement Placed for vasopressor administration. Post-procedure imaging confirmed appropriate tip position; no pneumothorax. |
Triple-lumen 16 cm | Procedure — ultrasound-guided | Right IJ | S. Halvorsen, MD |
| 04/14/2026 23:25 | Norepinephrine bitartrate infusion Initiated for persistent MAP <65 after completion of full 30 mL/kg LR. Titrated to peak 10 mcg/min ~01:00. |
Initiated at 2 mcg/min (range ordered 2-10 mcg/min titrated to MAP >=65) | IV continuous via right IJ CVC | Right IJ CVC | R. Castaneda, RN (ICU) |
| 04/14/2026 23:55 | MICU transfer Transferred from ED to MICU on norepinephrine. |
— | — | — | Transport team |
| 04/15/2026 01:00 | Norepinephrine bitartrate infusion (titration) Peak dose; MAP achieved 78-82. |
Titrated up to 10 mcg/min (peak) | IV continuous via RIJ CVC | RIJ CVC | R. Castaneda, RN |
| 04/15/2026 06:00 | Ceftriaxone 2 g | 2 g | IV, 30-minute infusion | RIJ CVC | R. Castaneda, RN |
| 04/15/2026 06:00 | Pantoprazole 40 mg | 40 mg | IV push | RIJ CVC | R. Castaneda, RN |
| 04/15/2026 09:30 | Norepinephrine bitartrate infusion (wean) Weaning initiated as MAP sustained >75 on reduced dose. |
Weaning from 6 mcg/min, step-down q30 min as tolerated | IV continuous via RIJ CVC | RIJ CVC | R. Castaneda, RN |
| 04/15/2026 16:25 | Norepinephrine bitartrate infusion — DISCONTINUED Total pressor duration approximately 17 hours (23:25 on 04/14 to 16:25 on 04/15). MAP sustained >=70 off all pressors. |
Off at 0 mcg/min | IV | RIJ CVC | T. Whitman, RN |
| 04/15/2026 08:00 | Metformin 1000 mg PO BID — HELD Held in setting of AKI / lactic acidosis risk. |
Home dose held | PO (held) | — | R. Castaneda, RN |
| 04/15/2026 08:00 | Lisinopril 20 mg PO daily — HELD Held in setting of AKI and hypotension; to resume when renal function and BP stable. |
Home dose held | PO (held) | — | R. Castaneda, RN |
| 04/15/2026 08:00 | Atorvastatin 40 mg PO daily — CONTINUED Continued. |
40 mg | PO | — | R. Castaneda, RN |
| 04/15/2026 12:00 | Insulin (regular) per sliding scale Home oral agents held; ISS while NPO/critically ill. |
Per glucose-based scale | SC | Abdomen | R. Castaneda, RN |