End Points of Sepsis Resuscitation
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and…
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Vasopressors and Inotropes in Sepsis
Vasopressor and inotropes are beneficial in shock states. Norepinephrine is considered the first-line vasopressor for patients with sepsis-associated hypotension. Dobutamine is considered the first-line inotrope in sepsis, and should be…
Fluid Resuscitation in Severe Sepsis
Since its original description in 1832, fluid resuscitation has become the cornerstone of early and aggressive treatment of severe sepsis and septic shock. However, questions remain about optimal fluid composition,…
Source Identification and Source Control
Identifying sources of infection and establishing source control is an essential component of the workup and treatment of sepsis. Investigation with history, physical examination, laboratory tests, and imaging can in…
Appropriate Antibiotic Therapy
Prescribing antibiotics is an essential component of initial therapy in sepsis. Early antibiotics are an important component of therapy, but speed of administration should not overshadow the patient-specific characteristics that…
The New Usual Care
Recent literature continues to refine which components of the early goal-directed therapy (EGDT) algorithm are necessary. Given it utilizes central venous pressure, continuous central venous oxygen saturation, routine blood transfusions,…
Defining and Diagnosing Sepsis
Sepsis is a heterogeneous clinical syndrome that encompasses infections of many different types and severity. Not surprisingly, it has confounded most attempts to apply a single definition, which has also…
Severe Sepsis Care in the Emergency Department
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA www.emed.theclinics.com Consulting Editor AMAL MATTU February 2017 • Volume 35 • Number 1
Medicolegal Issues in Expedition and Wilderness Medicine
There is increased participation in wilderness expeditions to remote and austere environments, which increases the likelihood of an accident and/or medical emergency and the professional liability risks for trip organizers….
Preparing for International Travel and Global Medical Care
Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod…
