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The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
The STOP Sepsis Bundle
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The STOP Sepsis Bundle

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The STOP Sepsis Bundle Toolkit …

The STOP Sepsis Bundle Toolkit
Strategies to Timely Obviate the Progression of Sepsis in the Emergency Department

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  • 1. STOP Sepsis
    6-hour
    Strategies to
    Timely
    Obviate the
    Progression of Sepsis
    6-hour STOP Bundle
    summarized by sun yaicheng http://decode-medicine.blogspot.com/
  • 2. Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock
    Rivers E. N Engl J Med 2001;345:1368-77.
  • 3.
  • 4.
  • 5.
  • 6. Sepsis
    SIRS
    Severe Sepsis
    Septic Shock
    Sepsis
    SIRS
    Severe Sepsis
    Septic Shock
    Systemic Inflammatory Response Syndrome
    • Temp < 36 ° C or > 38.3 ° C
    • 7. HR > 90
    • 8. RR > 20 or PCO2 < 32
    • 9. WBC < 4K or > 12K or bands > 10%
    Bone et al. Chest 1992;101:1644
  • 10. SIRS
    Severe Sepsis
    Septic Shock
    Sepsis
    SIRS with Infection
    Bone et al. Chest 1992;101:1644
  • 11. SIRS
    Severe Sepsis
    Septic Shock
    Sepsis
    Sepsis plus Organ Dysfunction
    • Elevated Creatinine (>2)
    • 12. Elevated INR (DIC)
    • 13. Altered Mental Status (GCS <12)
    • 14. Elevated Lactate (>4)
    • 15. Hypotension that responds to fluid
    Bone et al. Chest 1992;101:1644
  • 16. SIRS
    Severe Sepsis
    Septic Shock
    Sepsis
    Severe Sepsis and Hypotension
    • Hypotension that does NOT respond to fluid (500 cc bolus)
    Bone et al. Chest 1992;101:1644
  • 17. Criteria to initiate the bundle
    SIRS plus source of infection plus a
    • SBP < 90 mmHg after a 20 mL/kg fluid bolus
    • 18. Lactate > 4 mmol/L
    • 19. Organ dysfunction
    STOP
    SEPSIS
    SCCM 34th Critical Care Congress: Abstract 44. Presented Jan. 17,2005.
  • 20. STOP Bundle Strategies
    • Hemodynamic monitoring (CVP/ScvO2) within 2 hours
    • 21. Broad spectrum antibiotics administered within 4 hours
    • 22. EGDT achieved at 6 hours, including CVP ≧ 8 mmHg, MAP ≧65 mmHg, ScvO2≧70%
    • 23. Monitor for decreasing lactate; and administer steroid if on a vasopressor
  • 24.
  • 25.
  • 26.
  • 27.
  • 28. Fever, general malaise, poor appetite for days
    DM, HTN
    70/40 mmHg, 39 ° C
  • 29.
  • 30. Diagnosis
    Liver Abscess with Septic Shock
    Next ?
  • 31. What‘s the key point ?
    summarized by sun yaicheng
    http://decode-medicine.blogspot.com/

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