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Sepsis

Harsimran S Brar, M.B.B.S and Hugh Peterson, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

Definitions of sepsis and approaches to estimating risk for and progression of sepsis continue to evolve. New definitions of sepsis and septic shock were developed by an internationa...

DIAGNOSIS

HISTORY

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

  • General symptoms

    • Fever, chills, rigors, myalgias

    • Mental status changes: re...

TREATMENT

GENERAL MEASURES

  • Early venous access, administration of IV fluids, and antibiotics

  • Secure airway and correct hypoxemia when indicated.

  • Within first hour of presentation: Appropriate volume resu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Arterial and central venous catheters in unstable patients

  • CBC, chemistry, lactate, procalcitonin, stroke volume variation, and INR/PTT if DIC is...

REFERENCES

1
Fernando  SM, Tran  A, Taljaard  M, et al. Prognostic accuracy of the quick Sequential Organ Failure Assessment for mortality in patients with suspected infection: ...

ADDITIONAL READING

  • Cecconi M, Evans L, Levy M, Rhodes A. Sepsis and septic shock. Lancet. 2018 Jul 7;392(10141):75-87.

  • Levy MM, Evans LE, Rhodes A. The Surviving Sepsis ...

CODES

ICD10

  • A41.9 Sepsis, unspecified organism

  • A41 Other sepsis

  • R65.2 Severe sepsis

  • R65.20 Severe sepsis without septic shock

  • A41.8 Other specified sepsis

  • A41.89 Other specified sepsis

  • O85 Puerperal sepsis

  • A4...

CLINICAL PEARLS

  • Early identification of patients with sepsis can be challenging. qSOFA and SIRS scores are useful but imperfect aids in initial patient assessment. SOFA score is useful as a predictor ...

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