Sepsis Clinical Guide

March 2019

General Practitioners

Country of origin: USA

Sepsis is a serious systemic infection that can quickly lead to circulatory shock, organ failure and death if inappropriately treated. It is also a serious problem in hospitals throughout the US and the world. In 2013, over 1 million people were admitted to US hospitals for sepsis (#1 cause of index admissions) at a total aggregate cost to the US healthcare system of $23.7 billion dollars (#1 most expensive condition), according to an AHRQ report. Over 250,000 people die of sepsis in the US every year, more than from prostate cancer, breast cancer and AIDS combined. Despite its large toll on public health, public awareness of this condition is poor and the quality of treatment is highly variable often due to delayed recognition and treatment.

In sepsis, time is of the essence. Successful treatment hinges on prompt recognition of symptoms, correct antibiotic administration, and hemodynamic stabilization. Lack of appropriate sepsis management knowledge at the bedside leads to delayed symptom recognition, serious complications, medical errors, increased treatment costs, and avoidable morbidity and mortality. For this reason, we created this app to provide busy health professionals with essential management information based on the latest practice guidelines in a format that is easily accessible at the point of care.

The Sepsis app was developed on the ESCAVO mobile publishing platform created specifically for mobile publishing of scientific content. The platform features an intuitive user interface, search, annotation and bookmarking functions, and calculator support. All content is extensively referenced and footnoted where appropriate. This app remains free of charge due to the generous sponsorship of Beckman Coulter.

Clinical topics covered in the Sepsis app include:
- Updated with the latest definitions, diagnostic criteria, and management guidelines including the 2016 Sepsis-3 definitions and the 2016 Surviving Sepsis Campaign (SSC) guidelines
- Epidemiology, risk factors and pathophysiology of sepsis and septic shock
- Common differentials and etiology, guidelines on performing appropriate H&P and workups
- Management of common causes including hospital-acquired pneumonia (HAP), ventilator-acquired pneumonia (VAP) and intra-abdominal infections
- Sepsis management bundles, early goal-directed therapy, hemodynamic management, adjunctive therapies, mechanical ventilation of sepsis-induced ARDS, and other essential management guidelines from the SSC and the American Thoracic Society (ATS)
- Antibiotic therapy including specific guidelines for the treatment of HAP from ATS and the Infectious Diseases Society of America (IDSA)
- Information on the diagnosis and management of pediatric and neonatal sepsis including the management of pediatric fever, important differences from management of sepsis in adults, management of sepsis-induced persistent pulmonary hypertension of the newborn (PPHN), empiric antibiotic treatment recommendations for GBS infections, interventions in pediatric septic shock, and other pediatric-specific information
- Important score calculators including the Sequential Organ Failure Assessment (SOFA), quick-SOFA, SIRS, APACHE II, Multiple Organ Dysfunction Score (MODS), the Simplified Acute Physiology Score (SAPS) II, National Early Warning Score (NEWS), the Clinical Pulmonary Infection (CPI) score, the Inferior Vena Cava Collapsibility Index, and others
- Drug administration information for the management of sepsis including antibacterial and antifungal antibiotics, adrenergic and other vasoactive agents, corticosteroids and diuretics

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