Sepsis: Your Zebras
The publication and enforcement of sepsis guidelines and bundles has decreased mortality in severe sepsis and septic shock, but we run the risk of defaulting to autopilot when treating our febrile patients and missing other potential fatal diagnoses. What else do you need to keep in mind when evaluating and treating the febrile patient, besides sepsis? Hear hoofbeats, treat for horses, consider zebras. Here's a basic back-pocket differential diagnosis for the non-infected feb
Sepsis: Your Treatment
This is part two in a three-part series regarding sepsis management. Choices with fluids: Current sepsis guidelines recommend a fluid bolus of 30cc/kg in the treatment of sepsis, to treat end-organ dysfunction or hypotension. But-- many of our patients have heart failure or kidney disease and are at significant risk for fluid overload. How do you deduce whether or not your patient will respond to that fluid bolus? Historically, central venous pressure (CVP) monitoring was use
Sepsis: Your Triage
This is part one in a three-part series regarding sepsis. Sepsis is one of the most common life-threatening diagnoses made in the emergency department. It's more common than (and causes more mortality than) STEMI or stroke, and yet, even with the intensive surviving sepsis campaign recommendations and core measures, we still have a lot of options when we consider the evaluation, diagnosis, and management of our septic patients. Choices with evaluation: Since 1992, sepsis has
