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Sepsis

Patricia Martinez Quinones, MD, Steven B. Holsten, Jr., MD, FACS and Cassandra Q. White, MD, FACS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Life-threatening acute organ dysfunction caused by a dysregulated host response to infection

  • Organ dysfunction is represented by an acute increase in the Sequential Organ Failure Asse...

DIAGNOSIS

HISTORY

  • Past medical, surgical, social, occupational, and travel history to identify risk factors and potential source

  • General symptoms

    • Fever, chills, rigors, myalgias

    • Mental status changes: res...

TREATMENT

GENERAL MEASURES

  • Early venous access, administration of intravenous fluids, and antibiotics are guiding principles.

  • Secure airway and correct hypoxemia when indicated.

  • Volume resuscitation with...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Place arterial line and central venous catheter in unstable patients.

  • CBC, chemistry, lactate, mixed venous oxygen saturation in initial resuscit...

REFERENCES

1
Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med.  2016;43(3):304–377. [...

ADDITIONAL READING

  • Annane D, Pastores S, Rochwerg B, et al. Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (par...

CODES

ICD10

  • A41.9 Sepsis, unspecified organism

  • R65.10 SIRS of noninfectious origin w/o acute organ dysfunction

  • R65.20 Severe sepsis without septic shock

  • R65.21 Severe sepsis with septic shock

  • A41.59 Other ...

CLINICAL PEARLS

  • Treat sepsis aggressively with fluid support (with hemodynamic monitoring and pressor support if necessary) early use of broad-spectrum antimicrobial therapy and removal/drainage of an...

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