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

Scand J Trauma Resusc Emerg Med. 2012 Jun 27;20:41. doi: 10.1186/1757-7241-20-41.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Cardiotonic Agents / administration & dosage
  • Cardiotonic Agents / therapeutic use
  • Combined Modality Therapy / methods
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / standards*
  • Fluid Therapy / methods
  • Fluid Therapy / standards
  • Hemodynamics / drug effects
  • Hemodynamics / physiology
  • Humans
  • Practice Guidelines as Topic
  • Sepsis / diagnosis*
  • Sepsis / physiopathology
  • Sepsis / therapy*
  • 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

Substances

  • Anti-Bacterial Agents
  • Cardiotonic Agents
  • Vasoconstrictor Agents