These results suggest that the most important aspects of care are early diagnosis and rapid effective fluid resuscitation and antimicrobial therapy.
If sepsis is suspected, broad-spectrum antibiotics are given first. This is because there won't be time to wait until a specific type of infection has been identified. Broad-spectrum antibiotics work against a wide range of known infectious bacteria. They usually cure most common infections.
Respiration. The first priority when treating a critical illness is to ensure a patent airway and adequate ventilation. If the venous oxygen saturation target is not met, provide supplemental oxygen or begin mechanical ventilation. There are many reasons that a septic patient might need mechanical ventilation.
INITIAL FLUID RESUSCITATION
Intravenous fluid should be initiated immediately when sepsis is recognized. Delaying fluid resuscitation can worsen tissue hypoxia, leading to multiple organ dysfunction.
The recommended first-line agent for septic shock is norepinephrine, preferably administered through a central catheter. Norepinephrine has predominant alpha-receptor agonist effects and results in potent peripheral arterial vasoconstriction without significantly increasing heart rate or cardiac output.
Shock requires emergency medical treatment. The first priority is to get blood pressure back up to normal. This may be done by giving blood and fluids through a vein. Blood-pressure-raising medicines may be administered.
Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis.
What is the Sepsis Six Care bundle? The UK Sepsis Trust developed the 'Sepsis Six' – a set of six tasks including oxygen, cultures, antibiotics, fluids, lactate measurement and urine output monitoring- to be instituted within one hour by non-specialist practitioners at the frontline.
Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
Experts' recommendations currently position norepinephrine (NE) as the first-line vasopressor in septic shock.
NICE - the National Institute for Health and Care Excellence - urges hospital staff to treat people with life-threatening sepsis within one hour, in its quality standard. In clinical practice, this is often referred to as the 'golden hour' after diagnosis.
Taking into account the current international and local guidelines on sepsis, the four major pillars of sepsis are blood culture, antibiotics, arterial blood gas (ABG), and fluid therapy[6].
For more than two decades, sepsis was defined as a microbial infection that produces fever (or hypothermia), tachycardia, tachypnoea and blood leukocyte changes.
Sepsis is a potentially fatal or life changing syndrome wherein the body responds to an infection with a systemic immune response. Many clinicians consider sepsis to have three stages, starting with sepsis and progressing to severe sepsis and septic shock.
Septic shock is an emergency that is best treated by establishing priorities beforehand. The first priority is early recognition. The earliest recognizable clinical presentation is fever and hyperventilation.
The shock syndrome is a pathway involving a variety of pathologic processes that may be categorized as four stages: initial, compensatory, progressive, and refractory (Urden, Stacy, & Lough, 2014). Initial stage - cardiac output (CO) is decreased, and tissue perfusion is threatened.
Preferred empiric monotherapy includes meropenem, imipenem, piperacillin-tazobactam, or tigecycline. Empiric combination therapy includes metronidazole plus levofloxacin, aztreonam, or a third- or fourth-generation cephalosporin.
Ideally, these clinical criteria should identify all the elements of sepsis (infection, host response, and organ dysfunction), be simple to obtain, and be available promptly and at a reasonable cost or burden.
Balanced crystalloids are the fluid of first choice for sepsis resuscitation based on ready availability and taking medication costs into account. Use of 0.9% saline compared to a balanced crystalloid, such as lactated Ringer's or PlasmaLyte, produces more kidney dysfunction and with a greater risk of dying.
It can help to reverse septic shock and to restore cardiovascular stability for people who are at high risk of severe illness or death. Intravenous fluids improve oxygen delivery to organs and so reduce long-term disability associated with poor tissue perfusion.
Diagnosis. Infection was suspected in all patients who had cultures submitted and who were started on antibiotics within a 24 h window. Sepsis-1 defines sepsis as infection-induced SIRS (13). The clinical criterion is suspected infection plus SIRS.
Amoxicillin or amoxicillin/clavulanate is the recommended first-line therapy.