Sepsis - Interventions that do / do not improve outcomes Do: - Have high index of suspicion and understand those at risk - Take a history - understand confirmation and fixation bias - what is the likely source - Have a sepsis pathway or protocol - Have a rapid response team who know what they are doing - Give (not prescribe) antibiotics now if you think patient has bacterial sepsis - Talk to others - infectious disease specialists, surgeons, your team - especially your team - Pay nurses well, pay ICU doctors well - have enough of both - Consider corticosteroids for persistent septic shock - Understand late mortality - Enroll patient in a clinical trial Don't Know / Doesn't Matter: - Immune stimulation - Vitamin C / Thiamine - Vasopressin vs. adrenaline vs. noradrenaline - Lots more Don't: - Fixate on magic bullets - Target normoglycemia - Target hypothermia - Do too much - ventilation, transfusion, fluid resuscitation, oxygen, CRRT, HFO - Give synthetic colloid - especially HES Dr. Steve Mathieu - https://twitter.com/stevemathieu75 #Sepsis #Interventions #Management #Factors #Matter #EBM #Effectiveness #Improve #Outcomes #Evidence
