∗ Sepsis is common∗ SEPSIS KILLS!!! (36,800 deaths in UK in 2005)∗ Early intervention saves lives (in a study of over15,000 patients across 30 countries over 2 years,mortality fell by 20%)Why is it important?
∗ High flow oxygen∗ Peripheral blood cultures∗ IV antibiotics (as per local policy)∗ Fluid resuscitate∗ Serum lactate∗ Measure hour fluid balance (?catheterise)First hour care in sepsis or ‘sepsis six’
∗ Further fluid resuscitation if indicated∗ Ensure Hb > 7 g / dl∗ If still shocked (low BP / urine output / high↓lactate) insert central line and ensure CVP = 8-12mmHg; consider noradrenaline or dopamine∗ Check ScvO2; consider dobutamine if <70%Six hour resuscitation bundle
∗ APACHE II score∗ ?Low tidal volume ventilation∗ Ventilation care bundle∗ Hydrocortisone∗ ?vasopressin∗ ?Activated protein CITU
∗ Assessment of sepsis∗ Management of sepsisSummary
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