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Emergency Department Management of Severe Sepsis

Emergency Department Management of Severe Sepsis Patients with severe sepsis often present to the emergency department, and have higher mortality rates than patients with myocardial infarction or stroke. Recent studies have fostered a better un- derstanding of the physiology of sepsis and have validated methods for identifying and resuscitating patients with severe sepsis. Many of these therapies have impressive outcome benefits with early implementation. This article will review the epidemiology of severe sepsis, the germane physiology, and best-practice diagnostic and interventional strategies. Key words: activated protein C, early goal-directed therapy, sepsis, systemic inflammatory response syndrome, SIRS, shock ITHOUT the fanfare of other dis- 30%. The annual cost of caring for patients eases with significant mortality, with sepsis is about $16.7 billion (Angus et al., sepsis is a leading cause of hos- 2001). Prompt recognition and management pitalization and death in the United States, of sepsis in the emergency department (ED) with a mortality rate of about 28% for the es- is essential because each year about 458,000 timated 751,000 annual cases (Angus et al., septic patients enter the hospital through the 2001; Shapiro, 2006). These 215,000 deaths ED (Angus et al., 2001; McCaig & Burt, 2005). exceed the annual toll from either myocar- Sepsis is http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advanced Emergency Nursing Journal Wolters Kluwer Health

Emergency Department Management of Severe Sepsis

Frakes, Michael A.
Advanced Emergency Nursing Journal , Volume 29 (3) – Jul 1, 2007
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Copyright
© 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins
ISSN
1931-4485
eISSN
1931-4493
DOI
10.1097/01.TME.0000286965.79040.f1

Abstract

Patients with severe sepsis often present to the emergency department, and have higher mortality rates than patients with myocardial infarction or stroke. Recent studies have fostered a better un- derstanding of the physiology of sepsis and have validated methods for identifying and resuscitating patients with severe sepsis. Many of these therapies have impressive outcome benefits with early implementation. This article will review the epidemiology of severe sepsis, the germane physiology, and best-practice diagnostic and interventional strategies. Key words: activated protein C, early goal-directed therapy, sepsis, systemic inflammatory response syndrome, SIRS, shock ITHOUT the fanfare of other dis- 30%. The annual cost of caring for patients eases with significant mortality, with sepsis is about $16.7 billion (Angus et al., sepsis is a leading cause of hos- 2001). Prompt recognition and management pitalization and death in the United States, of sepsis in the emergency department (ED) with a mortality rate of about 28% for the es- is essential because each year about 458,000 timated 751,000 annual cases (Angus et al., septic patients enter the hospital through the 2001; Shapiro, 2006). These 215,000 deaths ED (Angus et al., 2001; McCaig & Burt, 2005). exceed the annual toll from either myocar- Sepsis is

Journal

Advanced Emergency Nursing Journal – Wolters Kluwer Health

Published: Jul 1, 2007

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