Initial emergency department diagnosis and management of adult patients with severe sepsis and septic shock.
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.
Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, USA.
Sarah M
SM
Perman
Munish
M
Goyal
David F
DF
Gaieski
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards*; D005440:Fluid Therapy / Q000379:methods / Q000592:standards; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014218:Triage / Q000379:methods / Q000592:standards; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents