EMERGENCY

SUMMIT 2017
SEPSIS-3
 Health problem and burden
 High mortality

 More than CVD and AMI

 1991  Sepsis-1
 SIRS + infection

 2001 Sepsis-2
 SIRS + Infection + additional Criteria

 2016 Sepsis-3
 SOFA, qSOFA
What is definition of sepsis?
A. Sepsis is define as systemic inflammatory
response syndrome due to dysregulated host
response to infection
B. Sepsis is define as life threatening organ
dysfuction due to dysregulated host response to
infection
SEPSIS-3 (2016)
 Sepsis is define as life threatening organ
dysfuction due to dysregulated host response to
infection
 Septic shock is define a subset of sepsis where
underlying circulatory an cellular abnormalities
are profound enough to increase mortality
MANAGEMENT
• Central Line Access
• 1st line therapy – fluids, fluids, fluids!
• Crystalloid to colloid
• Initial 1-2 Liters (30cc /kg) crystalloid fluid
within the first 3 hours
• Vasopressors Norephineprine, ephinephrine,
Vasopressin, dopamine
• Steroid hydrocortisone
• Careful in CHF, CKD patients !! Monitoring
Cultures / Antibiotics / Labs
 Cultures PRIOR to Antibiotics
 Initial broad spectrum antibiotics (ex: vancomycin,

piperacilin-tazobactam)
 1 HOUR after diagnose

 Consider need for Source Control !

Drainage of abscess or cholangitis, removal of infected

catheters, debridement or amputation of osteomyelitis
CONCLUSIONS
 These updated definitions and clinical criteria
should clarify longused descriptors and facilitate
earlier recognition and more timely management
of patients with sepsis or at risk of developing it.
 This process, however,remains a work in progress

 SEPSIS-4??
THANK YOU