Sepsis Definitions

Join the EMGuideWire Team,from Carolinas Emergency Medicine Residency Program in Charlotte, NC, as they explore the critical core concepts on the important topic of Sepsis. In this first episode, the team will discuss the definitions of Sepsis.

Pearls:

• Sepsis is a dysregulated systemic inflammatory response to infection causing intravascular inflammation, tissue ischemia, cytopathic injury, and dysregulated apoptosis.
• SIRS terminology is now outdated. Current terminology is “Sepsis” (SIRS, suspected source, end organ damage) and “Septic Shock.”
• Septic shock: SBP <90 or MAP <65 despite fluids; or if lactate is >2 after fluids.
• qSOFA = RR > 22, AMS, SBP < 100; 2-3 points = poor outcomes.
• Epidemiology: 164,000 cases annually. Bacterial etiology most common. Mortality for sepsis and septic shock is 10 and 40% respectively.

Summarized by Travis Barlock, MD PGY-1

References:

• Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. New England Journal of Medicine 2003; 348:1546.
• Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:762.