September is Sepsis Awareness Month and we wanted to share some great resources on this very important topic.

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. The body’s overwhelming and life-threatening response to an infection can lead to tissue damage, organ failure and death. Septic Shock, on the other hand, is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality. Clinically, septic shock refers to patients who, despite adequate fluid resuscitation, require vasopressors to maintain a mean arterial pressure (MAP) ≥ 65 mmHg, and have a lactate > 2 mmol/L.

Symptoms may include but not limited to:

  • Altered LOC
  • Tachycardia greater than 90 bpm
  • Hypotension (SBP < 90 mmHg, MAP < 70 mmHg, or an SBP decrease > 40 mmHg)
  • Dyspnea and/or Tachypnea (respiratory rate > 22 breaths/minute)
  • Temperature > 38.3° C or < 36° C
  • Decreased capillary refill, cyanosis, or mottling

Management should include but not limited to:

  • Measure lactate level. If initial lactate is > 2 mmol/L, recheck in 2 to 4 hours. 
  • Obtain blood cultures prior to administration of antibiotics.  
  • Administer broad spectrum antibiotics. 
  • Administer 30 mL/kg crystalloid for hypotension or lactate ≥ 4 mmol/L. 
  • Administer vasopressors to maintain MAP ≥ 65 mmHg. Norepinephrine is recommended as the first-choice vasopressor.

Further elements of care can include:

  • Blood products  
  • Mechanical ventilation  
  • Glucose control  
  • Nutrition  
  • Stress ulcer prophylaxis 
  • Venous thromboembolism (VTE) prophylaxis 
  • Discuss goals of care and prognosis with patients and family as early as feasible, incorporating end-of-life planning and palliative care principles, when appropriate

This is just a very brief review of sepsis, Lippincott has created an entire library of mostly free videos, podcasts and guidelines related to this topic. Give the following a visit:

 Sepsis Guidelines and Protocols: Providing Care to Patients (nursingcenter.com)

Also, the Sepsis Alliance also has a multitude of resources for providers that are worth checking out: https://www.sepsis.org/get-involved/sepsis-awareness-month/

Hope you enjoyed this quick post and were able to explore some of the resources. Let us know if you have any topics/experiences you’d like to share with our community in the comments below 🙂

September is for Sepsis, Shocking!!
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