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Sepsis

Benjamin M. Enciso, DO, Patricia Martinez Quinones, MD and Cassandra Q. White, MD, FACS Reviewed 06/2019
 


BASICS

DESCRIPTION

Sepsis-3 definitions: 
  • Sepsis: life-threatening acute organ dysfunction caused by a dysregulated host response

    • Organ dysfunction is defined as an increase in the Sequential Organ Fai...

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: r...

TREATMENT

GENERAL MEASURES

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

  • Secure airway and correct hypoxemia when indicated.

  • Volume resuscitation with crystalloids at 30 mL/kg within ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Arterial and central venous catheters in unstable patients

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

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: a systematic review and met...

ADDITIONAL READING

  • Arora S, Singh P, Singh PM, et al. Procalcitonin levels in survivors and nonsurvivors of sepsis: systematic review and meta-analysis. Shock.  2015;43(3):212–221. [View Abstract...

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, early use of broad-spectrum antimicrobial therapy, and removal/drainage of any foci of infection. Use vasopres...

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