Management of sepsis and septic shock in the emergency department

Intern Emerg Med. 2021 Sep;16(6):1649-1661. doi: 10.1007/s11739-021-02735-7. Epub 2021 Apr 22.

Abstract

Early management of sepsis and septic shock is crucial for patients' prognosis. As the Emergency Department (ED) is the place where the first medical contact for septic patients is likely to occur, emergency physicians play an essential role in the early phases of patient management, which consists of accurate initial diagnosis, resuscitation, and early antibiotic treatment. Since the issuing of the Surviving Sepsis Campaign guidelines in 2016, several studies have been published on different aspects of sepsis management, adding a substantial amount of new information on the pathophysiology and treatment of sepsis and septic shock. In light of this emerging evidence, the present narrative review provides a comprehensive account of the recent advances in septic patient management in the ED.

Keywords: Antibiotic therapy; Emergency medicine; Fluid resuscitation; Preload responsiveness; Vasopressors.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Disease Management
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data
  • Fluid Therapy / methods
  • Fluid Therapy / trends
  • Humans
  • Monitoring, Physiologic / methods
  • Resuscitation / methods
  • Resuscitation / trends*
  • Sepsis / physiopathology
  • Sepsis / therapy*
  • Shock, Septic / physiopathology
  • Shock, Septic / therapy*
  • Vasoconstrictor Agents / pharmacology
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vasoconstrictor Agents