Sepsis Management in the ICU

The EMGuideWire Team is visited by a prior crew member, Russell Trigonis, MD! Join them as they discuss how the patient diagnosed with Sepsis in your ED has their care continued in the ICU!

Pearls

• Start pressors with IVF (30-40cc/kg). NE at 7mcg/min peripherally can always be stopped, but better earlier than later.
• Increase NE until at 20mcg/min, if still hypotensive, then add a 2nd pressor like Vasopressin at 0.03units/min and 100mg Hydrocortisone Q8h.
• Start antibiotics early and identify source. CXR, US lungs/abd, UA, CT abd should all be considered. 
• Procalcitonin is helpful for stopping abx. Doesn’t change ED treatment.
• Don’t order Vitamin C or thiamine in ED.

-Travis Barlock, MD