Sepsis - Diagnosis and Management Life-threatening organ dysfunction caused by a dysregulated host response to infection SEPTIC SHOCK is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Patients w/ septic shock are identified with the following 3 features: 1. Clinical construct of sepsis 2. Persistent hypotension (requiring vasopressors to maintain MAP >65 mm Hg) 3. Serum lactate >2 mmol/L (despite adequate volume resuscitation) Previously, we used SIRS for screening, which was defined as positive if 2 of the following were present: 1. Temp > 38 C or < 36 C 2. HR > 90 bpm 3. RR > 20 breaths/min 4. WBC > 12 K or < 4K We now use qSOFA, defined as positive if 2 of the following are present: 1. AMS (GCS < 15) 2. SBP < 100 3. RR > 22 qSOFA > 2 indicates increased likelihood of prolonged ICU stay or in-hospital mortality Management Principles: Early recognition and treatment with: 1 Empiric broad spectrum antibiotics 2 Initial fluid resuscitation 3 Vasopressor support (if needed) 4 Source identification and control Dr. Meredith Greer @EmmGeezee #Sepsis #Criteria #Diagnosis #Management #QSOFA #SIRS #criticalcare #icu
