Initial emergency department diagnosis and management of adult patients with severe sepsis and septic shock

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine Vol. 20; no. 1; p. 41
• Main Authors: Perman, Sarah M, Goyal, Munish, Gaieski, David F
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27.06.2012; Springer Nature B.V; BioMed Central; BMC
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Anti-infective agents; Blood; Cardiac arrhythmia; Cardiotonic Agents - administration & dosage; Cardiotonic Agents - therapeutic use; Care and treatment; Combined Modality Therapy - methods; Critical care; Diagnosis; Early-goal directed therapy; Emergency medical care; Emergency medical services; Emergency medicine; Emergency service; Emergency Service, Hospital - organization & administration; Emergency Service, Hospital - standards; Evidence-based medicine; Fluid Therapy - methods; Fluid Therapy - standards; Health aspects; Hemodynamics; Hemodynamics - drug effects; Hemodynamics - physiology; Hospitals; Humans; Hypotension; Infections; Medical diagnosis; Mortality; North America; Pathogens; Patients; Practice Guidelines as Topic; Resuscitation; Review; Sepsis; Sepsis - diagnosis; Sepsis - physiopathology; Sepsis - therapy; Septic shock; Severity of Illness Index; Shock, Septic - diagnosis; Shock, Septic - physiopathology; Shock, Septic - therapy; Survival Rate - trends; Time Factors; Triage - methods; Triage - standards; Vasoconstrictor Agents - administration & dosage; Vasoconstrictor Agents - therapeutic use; North America; United States > US
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/1757-7241-20-41

Severe sepsis is a medical emergency affecting up to 18 million individuals world wide, with an annual incidence of 750,000 in North America alone. Mortality ranges between 28-50% of those individuals stricken by severe sepsis. Sepsis is a time critical illness, requiring early identification and prompt intervention in order to improve outcomes. This observation has led to increased awareness and education in the field of Emergency Medicine; it has also led to the implementation of critical interventions early in the course of patient management, specifically Early-Goal Directed Therapy, and rapid administration of appropriate antimicrobials. This review begins with a brief summary of the pathophysiology of sepsis, and then addresses the fundamental clinical aspects of ED identification and resuscitation of the septic patient.