The document emphasizes the importance of a high index of suspicion for sepsis and advocates for immediate antibiotic administration and the establishment of sepsis response protocols. It highlights the need for collaboration among healthcare professionals and suggests practices like monitoring blood glucose levels and considering corticosteroids for treatment. The document also cautions against over-treatment and promotes participation in clinical trials.

1. Saving lives from sepsis: not the SSC guidelines
Simon Finfer
sfinfer@georgeinstitute.org.au
29/11/2019 1affiliated with UNSW Sydney

3. In-hospital Mortality 27%

4. Treatments proven to improve outcomes in sepsis

5. Do
Don’t
Have high index of suspicion and understand those at risk
Take a history - understand confirmation and fixation bias - what is the likely source
Have a sepsis pathway or protocol
Have a rapid response team who know what they are doing
Give (not prescribe) antibiotics now if you think patient has bacterial sepsis
Talk to others - infectious disease specialists, surgeons, your team - especially your team
Pay nurses well, pay ICU doctors well - have enough of both
Consider corticosteroids for persistent septic shock
Understand late mortality
Enrol patient in a clinical trial
Immune stimulation
Vitamin C / Thiamine
Vasopressin vs. adrenaline vs. noradrenaline
Lots more
Fixate on magic bullets
Target normoglycemia
Target hypothermia
Do too much - ventilation, transfusion, fluid resuscitation, oxygen, CRRT, HFO
Give synthetic colloid - especially HES
Don’t
know /
Doesn’t
matter
IMPROVESEPSISOUTCOME

6. Treatments proven to improve outcomes in sepsis